Anxiety and Depression Association of America Annual Meeting

Anxiety and Depression Association of America Annual Meeting

Source:

Clapp D, et al. Clinician-reported barriers to identifying youth who would benefit from exposure therapy. Presented at: Anxiety and Depression Association of America annual conference; March 17-19; Denver, Colorado.

Disclosures: Clapp reports affiliations with Hall-Mercer, Penn Medicine and La Salle University.
March 24, 2022
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Multiple barriers exist for youth access to exposure and response prevention therapy

Source:

Clapp D, et al. Clinician-reported barriers to identifying youth who would benefit from exposure therapy. Presented at: Anxiety and Depression Association of America annual conference; March 17-19; Denver, Colorado.

Disclosures: Clapp reports affiliations with Hall-Mercer, Penn Medicine and La Salle University.
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DENVER — Multiple socioeconomic and clinician-based factors prevent access to and utilization of exposure and response prevention therapy for youths, a speaker said at the Anxiety and Depression Association of America annual conference.

“We have a childhood anxiety program called PATCH, which is a treatment for OCD and anxiety. In Philadelphia and surrounding counties, there is only one agency that does exposure therapy for kids without medical assistance,” Douglas Clapp, LMFT, of Hall-Mercer Community Mental Health at Penn Hospital, said during the presentation.

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“If there’s any other diagnosis, then [clinicians] will use that as a reason for not wanting to recommend ERP. It could be something that creates competitions in recommending adult-centered treatment.”

Clapp and colleagues reported six different themes on why there is an underutilization of ERPs — comorbidities and differential diagnoses aside from anxiety/OCD; difficulties with engagement due to stigma or finances; family factors such as parental misunderstanding of treatment modes or requirements; knowledge level and differing beliefs of clinicians; time restrictions; and inaccurate reporting.

Clapp said he and colleagues had sought to uncover why ERP therapy wasn’t being utilized or recommended for youths in the region.

As part of a larger study on user experience with an ERP toolkit, the researchers surveyed 49 clinicians primarily based in cognitive behavioral therapy (median age 35 years; 73.5% white; 75.5% female) by asking an open-ended question regarding the challenges of identifying youth who might benefit from ERP. Of those, 29 clinicians responded and reported 35 different barriers to treatment access and recommendation.

A seventh category of unspecified reasons, included lack of proper supervision, lack of proactive exposure planning and clinicians’ difficulties in conceptualizing cases.

“There’s a huge gap in that everyone says [ERP] is a profoundly effective treatment, but at the same time, we’re noticing that it’s not being used,” Clapp said. “More importantly, it’s not being used for kids that are from low-income households. They don’t have access to this treatment.”