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Symposia

Child / Adolescent - Anxiety

Using Research Findings to Extend Treatment’s Effectiveness and Reach: Examples from Pediatric Anxiety & OCD

3 - (SYM 33) From Development to Implementation: Using a Team-based Service Model to Increase Access to Exposure Treatment in Pediatric Anxiety and OCD

Saturday, November 22, 2025
10:48 AM - 11:09 AM CST
Location: Strand 9, Level 2
Keywords: Anxiety, OCD (Obsessive Compulsive Disorder), CBT
Recommended Readings: Franklin, M. E., Engelmann, J. M., Bulkes, N. Z., Horvath, G., Piacsek, K., Osterlund, E., Freeman, J. B., Schwartz, R., Himle, M., & Riemann, B. C. (2024). Intensive CBT telehealth for pediatric OCD during the COVID-19 pandemic: Comparison with a matched sample treated in person. Journal of the American Academy of Child & Adolescent Psychiatry Open, 2(1), 26-35.,   Freitag, G. F., Salem, H., Conroy, K., Busto, C., Adrian, M., Borba, C. P. C., . . . Comer, J. S. (2023). The patient-reported outcomes measurement information system (PROMIS) pediatric and parent-proxy short forms for anxiety: Psychometric properties in the kids FACE FEARS sample. Journal of Anxiety Disorders, 94, 1-9. doi:https://doi.org/10.1016/j.janxdis.2023.102677,   Kemp, J., Barker, D., Benito, K., Herren, J., & Freeman, J. (2021). Moderators of psychosocial treatment for pediatric obsessive-compulsive disorder: Summary and recommendations for future directions. Journal of Clinical Child and Adolescent Psychology, 50(4), 478-485. doi:https://doi.org/10.1080/15374416.2020.1790378,   Schwartz, R. A. (2018). Treating incompleteness in obsessive-compulsive disorder: A meta-analytic review. Journal of Obsessive-Compulsive and Related Disorders, 19, 50-60. doi:https://doi.org/10.1016/j.jocrd.2018.08.001,  
Abstract Body
Anxiety disorders are among the most common and earliest emerging mental health problems, yet access to high-quality exposure-based treatment remains extremely limited. This presentation will describe a successful example of the development, testing, and implementation of an innovation to address quality and workforce issues inherent in the child mental health crisis. This innovation known as IMPACT (Improving Access to Child Anxiety Treatment) is a team-based service model pairing a licensed provider and unlicensed “exposure coach” to deliver exposure-based treatment in the home and community settings in outpatient care. We will first discuss the initial development of IMPACT in response to patient and family feedback and how this patient and family partnership led to a 5-year randomized clinical trial testing the IMPACT model compared to traditional office-based treatment for pediatric anxiety and OCD. The main treatment outcomes of this RCT (N=336) for youth ages 5 to 18 also will be described. Following the conclusion of research funding, it is common to encounter obstacles in the ongoing implementation of an innovation. This talk will highlight how the inclusion of payer and hospital administration engagement partners during the research stage helped facilitate implementation efforts to establish the IMPACT model as a service line at an insurance-based academic medical center. Lastly, we will describe our efforts to extend the reach of IMPACT through partnerships with certified community behavioral health centers (CCBHCs) in a new research study to test different delivery modalities of IMPACT to improve equitable access to exposure-based treatment statewide.