Background:Cognitive therapy, based on the Clark and 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?Method: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. Seventy-five per cent (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 2-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.

中文翻译：

---

在 NHS CAMHS 中为青少年社交焦虑障碍提供认知治疗：临床和成本分析


背景：基于 Clark 和 Wells (1995) 模型的认知疗法是成人社交焦虑症 (SAD) 的一线治疗方法，研究环境的结果表明它有望用于青少年（社交认知疗法）青少年焦虑症；CT-SAD-A)。然而，为了使治疗适合在常规临床护理中进行，需要解决两个问题。 目标：治疗师能否接受培训以在常规儿童和青少年心理健康服务 (CAMHS) 中取得良好的结果，以及相关成本是多少方法：在两个 NHS 信托机构工作的 CAMHS 治疗师接受了 CT-SAD-A 培训。他们在监督实践期间为患有季节性情感障碍的青少年提供了治疗。我们检查了在此期间接受治疗的 12 名患者的临床结果，并估计了与治疗和培训相关的费用。结果：治疗显着改善了社交焦虑症状、一般性焦虑和抑郁症状，并减少了假定的过程测量。 75%（12 名患者中有 9 名）的社交焦虑症状得到了可靠且具有临床意义的改善，64%（7/11）的患者失去了 SAD 的初步诊断。 CT-SAD-A 治疗的 NHS 总费用为 4047 英镑（标清= £1003) 每名接受治疗的青少年，其中 £1861 (标清= £358）指的是当面送货的具体预估费用；剩下的费用用于培训和监督以前不熟悉治疗的治疗师。结论：本研究提供了初步证据，表明临床医生可以在接受为期 2 天的培训研讨会后的一段监督实践期间，为常规 CAMHS 中的 SAD 青少年提供良好的患者治疗结果。此外，为青少年提供 CT-SAD-A 的费用似乎不高于为成人提供 CT-SAD 的费用。