Using a stepped care approach shows promise as a cost-effective treatment option for adolescents with anxiety, according to new research funded by Australian Rotary Health (ARH).
ARH Mental Health Research Grant recipient Professor Viviana Wuthrich and her team at Macquarie University conducted a pilot trial with anxious adolescents between 12-18 years to examine the initial clinical and cost-effectiveness of stepped care in Headspace centres, when compared to treatment as usual.
“The stepped care approach was such that adolescents received an internet program with brief telephone calls from a therapist first, and then only received face-to-face therapy afterwards if it was needed. We compared this to usual treatment at these services,” Professor Wuthrich said.
The trial found that the stepped care approach was associated with on average 4.5 hours less therapist time, with similar clinical outcomes.
“It was exciting to see that this evaluation in a real-world setting was associated with similar outcomes to university-based studies, that show improved cost effectiveness.”
The team also considered the feedback of clinicians and adolescents, which highlighted some challenges in implementing this model in the real world.
“Adolescent and clinician feedback indicated clear preferences for more choice in what interventions individuals received and the way in which interventions were delivered,” Professor Wuthrich said.
“Therefore, despite significant cost savings, application of stepped care models for mental health need to incorporate consumer and clinician feedback in order to have successful implementation.”
This study has been published in the journal Psychiatry Research, available here. Another paper related to this study is also currently under review.
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