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Delivering cognitive therapy for adolescent social anxiety disorder in NHS CAMHS: a clinical and cost analysis

Leigh, E., Creswell, C., Stallard, P., Waite, P. ORCID:, Violato, M., Pearcey, S., Brooks, E., Taylor, L., Warnock-Parkes, E. and Clark, D. M. (2021) Delivering cognitive therapy for adolescent social anxiety disorder in NHS CAMHS: a clinical and cost analysis. Behavioural and Cognitive Psychotherapy, 49 (4). pp. 385-397. ISSN 1352-4658

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To link to this item DOI: 10.1017/S1352465821000035


Background: Cognitive therapy, based on the Clark & Wells (1995) model, is a first-line treatment for adults with social anxiety disorder (SAD), and findings from research settings suggest it has promise for use with adolescents (Cognitive Therapy for Social Anxiety disorder in Adolescents; CT-SAD-A). However, for the treatment to be suitable for delivery in routine clinical care, two questions need to be addressed. Aims: Can therapists be trained to achieve good outcomes in routine Child and Adolescent Mental Health Services (CAMHS), and what are the costs associated with training and treatment. Methods: CAMHS therapists working in two NHS trusts received training in CT-SAD-A. They delivered the treatment to adolescents with SAD during a period of supervised practice. We examined the clinical outcomes for the 12 patients treated during this period, and estimated costs associated with treatment and training. Results: Treatment produced significant improvements in social anxiety symptoms, general anxiety and depression symptoms, and reductions in putative process measures. 75% (9 out of 12) patients showed a reliable and clinically significant improvement in social anxiety symptoms and 64% (7/11) lost their primary diagnosis of SAD. The total cost to the NHS of the CT-SAD-A treatment was £4047 (SD=1003) per adolescent treated, of which £1861 (SD=£358) referred to the specific estimated cost of face-to-face delivery; the remaining cost was for training and supervising therapists who were not previously familiar with the treatment. Conclusions: This study provides preliminary evidence that clinicians can deliver good patient outcomes for adolescents with SAD in routine CAMHS during a period of supervised practice after receiving a two-day training workshop. Furthermore, the cost of delivering CT-SAD-A with adolescents appeared to be no more than the cost of delivering CT-SAD with adults.

Item Type:Article
Divisions:Life Sciences > School of Psychology and Clinical Language Sciences > Anxiety and Depression in Young People (AnDY)
Life Sciences > School of Psychology and Clinical Language Sciences > Department of Psychology
ID Code:97202
Publisher:Cambridge University Press


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