PROVIDENCE — The Pediatric Anxiety Research Center at the Bradley Hasbro Children’s Research Center has received a $3.4 million grant to compare at-home and office-based outpatient treatment for kids with anxiety and obsessive compulsive disorder.
The funding, provided by The Patient-Centered Outcomes Research Institute, will help researchers devise an alternative outpatient treatment model featuring a bachelor’s level clinician, or mobile exposure coach, working with PhDs to conduct in-home therapy visits.
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Exposure therapy, according to the International OCD Foundation’s website, also known as Exposure and Response Prevention, exposes patients to the thoughts, images, objects and situations that make them anxious and/or start their obsessions. The response part of the treatment refers to patients choosing to behave differently once the anxiety has been triggered – under a therapist’s guidance.
“We know from our research and work with pediatric patients that exposure therapy is a highly effective behavioral treatment for anxiety and OCD, but it is very challenging for kids and families to practice those skills at home,” said Jennifer Freeman, director of research and training at PARC and the study’s principal investigator.
The current outpatient treatment model for youth with anxiety disorders is challenged by shortages of appropriate providers, logistical problems with getting patients to treatment, and trouble getting an adequate dose of exposure treatment in the home.
“We’re exploring creation of a comprehensive patient care model that delivers home-based exposure coaching at an outpatient level of care to better meet the needs of families with anxious children,” Freeman said.
Anxiety disorders and OCD are among the most common and earliest of psychiatric disorders to occur among children and persist if left untreated, often leading to depression, substance abuse, suicide attempts, and disability into adulthood, Freeman said. She said families with children involved in intensive treatment for OCD and anxiety have asked PARC staff for more help.
The five-year, randomized trial, the first evidence-based study of its kind, will assess the effectiveness of the two treatments and provide data to determine the feasibility and acceptability of the model for families. More than 330 patients, ages five to 18-years-old, seeking treatment for anxiety or OCD at PARC will be randomly selected to receive patient-centered treatment using home-based services or traditional provider-centered care.
“We expect the results to validate the role of home-based treatment and create better access to care and patients and families who are more engaged in treatment,” Freeman said.
PARC’s study was selected for PCORI funding through a competitive review process in which patients, clinicians and other stakeholders joined clinical scientists to evaluate the proposals. Applications were assessed for scientific merit, how well they will engage patients and other stakeholders and their methodological rigor among other criteria.
“This project was selected for PCORI funding not only for its scientific merit and commitment to engaging patients and other stakeholders, but also for its potential to fill an important gap in our health knowledge and give people information to help them weigh the effectiveness of their care options,” said PCORI Executive Director Dr. Joe Selby. “We look forward to following the study’s progress and working with PARC to share the results.”
Rob Borkowski is a PBN staff writer. Email him at Borkowski@PBN.com.
