Effectively treating childhood anxiety can be done for less, new study finds

Computer-based interventions can cut childhood anxiety treatment costs nearly in half, according to a new study by researchers from the Center for Children and Families at Florida International University in Miami.

Findings show families can significantly reduce costs—without compromising effectiveness of treatment—by implementing a stepped approach. This means starting with low intensity treatments such as computer-administered treatment sessions, then stepping up to standard, higher intensity interventions including in-person cognitive behavioral therapy.

Anxiety disorders are among the most common and impairing child and adolescent mental health problems. Cost continues to be a reason why only 1 in 5 children receive treatment.

Using Florida Medicaid rates for mental health services, researchers determined the total cost of standard treatment was $780 per child. Applying the stepped approach, the average total cost for a full course of treatment dropped to $433 per child. For anxiety disorders, a full course of treatment typically ranges from 12 to 16 weeks. In the stepped approach, almost 60 percent of patients completed treatment in only four weeks.

"These findings can inform service providers, administrators and policy makers about the potential of stepped care service delivery models," said Carlos E. Yeguez, psychology Ph.D. student at FIU and lead author of the study.

Standard treatment for anxiety consists of several sessions of cognitive behavior therapy, which takes a great amount of time and resources. However, research by FIU psychologist and study co-author Jeremy W. Pettit showed 69 percent of children with anxiety who first completed an eight-session computer-based intervention had significant improvement and spent half the amount of time with a therapist than those who only received cognitive behavior therapy.

Pettit recommends medical professionals find ways to implement stepped care approaches like those used in this study to reduce the cost of and increase access to treatment.

"The amount of cost savings generated by the stepped approach was significant and suggests large system-wide savings if similar approaches are adopted on a large scale," said FIU health economics expert Timothy F. Page, who conducted the cost analysis for the study. "Everybody is being tasked to do more with less. Innovative approaches that reduce the cost of treatment can ensure that resources are available to treat those in need."

The next step in this line of research is to conduct studies in community mental health centers and evaluate whether the study findings replicate in these settings. Before rolling this out on a large scale, researchers must carefully evaluate the efficacy and cost savings of the approach in these settings, which requires funding and partnerships with local agencies.

The study was published in the Journal of Clinical Child & Adolescent Psychology.