Care for a Change? Tiered CBT for Youth

Abstract

The third decade of the twenty-first century will likely ring in dramatic changes in the delivery of behavioral health care to young patients and their families. Clinical interventions will have to be effective, accountable, and cost efficient. Fortunately, cognitive behavioral therapy (CBT) spectrum approaches are well suited to these emerging imperatives. However, cognitive behaviorally oriented clinicians and administrators will need to implement well-established methods in new service provision channels. This article presents a tiered care model that incorporates common elements contained in modular CBT packages. The basics of tiered care and the Modular Approach to Therapy with Children with Anxiety, Depression, Trauma and Conduct Problems follow. Keys for uniting common CBT elements into tiered care are delineated. A simple, transparent stratified care system is presented. Three confabulated cases augment the description of the approach. The article concludes with recommendations for administering a stratified care system.