Minimal Therapist-Assisted Cognitive-Behavioral Therapy Interventions in Stepped Care for Childhood Anxiety

New effective, efficient, and accessible service delivery methods for cognitive-behavioral therapies for pediatric anxiety disorders are needed. Many anxious children (to not receive needed treatment because of barriers such as limited availability of trained practitioners. costs of treatment, and time. A cognitive-behavioral therapy (CBT) stepped care approach that "steps up" care as needed from less intensive therapies with minimal therapist assistance to therapist-directed treatment may address barriers and provide more accessibility to treatment. A stepped care approach does not necessarily mean that traditional weekly face-to-face therapy sessions will not be needed. However, different service delivery methods that begin with CBT minimal therapist-assisted interventions may be it first line of treatment because not all children may need the full treatment package, This article provides an overview of the current research on CBT minimal therapist-assisted interventions (i.e., modified CBT protocols. computer-based therapy, bibliotherapy, telephone-based therapy. group treatment, and pharmacology) and information on how these first-line treatments may be incorporated into a stepped care model. Minimal therapist-assisted interventions within a stepped care model are in the early stages of development, although there is evidence that these types of treatment may be a viable first step to treating pediatric anxiety disorders. More research on minimal therapist-assisted interventions within stepped care models is needed, and challenges associated with disseminating and implementing stepped care need to be addressed.