Abstract
The school setting is important for delivering targeted prevention to adolescents with anxiety. However, schools may not have available providers with training or experience in delivering evidence-based interventions, e.g., school psychologists. Training providers available in the schools, e.g., school nurses, is important. Further, to investigate their experiences in delivering targeted prevention to adolescents with anxiety could help understand factors promoting implementation success. A qualitative study including focus groups with providers of school-based targeted prevention cognitive-behavioral therapy for anxiety in adolescents was conducted. Focus group interviews were audiotaped and transcribed verbatim. Systematic Text Condensation, a method for thematic cross-case analysis was used. The Active Implementation Framework (AIF) was used to contextualize the results. Seventeen providers participated in the study. They reported several facilitators contributing to successful implementation: Their feeling of competence in delivering the interventions were built through skills-based training, supervision, and collegial support. Conducting initial assessment of each adolescent helped the providers individualize the interventions. Seeing positive outcomes in adolescents gave the providers motivation to continue implementation. Further, collaborating with teachers facilitated both recruitment of adolescents and administering group sessions. Minimal leadership-oriented factors were reported. Overall, the findings correspond to some of the drivers in AIF. This study offers providers’ perspectives on implementation of targeted prevention for anxiety in the school setting. Our results show that providers experience mastery in delivery when receiving support, training, and supervision. This seems to be essential facilitators for implementing much needed targeted prevention for youth with anxiety.
Highlights
The school setting may be optimal for delivering prevention to adolescents with elevated anxiety symptoms, when provided at school and during school hours (Werner-Seidler, Perry, Calear, Newby, & Christensen, 2017; Lyon & Bruns, 2019)
The present study examines providers’ perspectives on administering cognitive-behavioral therapy (CBT) in a randomized controlled trial (RCT) of school-based targeted prevention for anxiety in adolescents (Haugland et al, 2020)
Exposure is an essential intervention in CBT for anxiety and many of the providers expressed that it was valuable to have performed exposure exercises themselves during the training, to be able to later gently push the adolescents to face their fears during the group interventions
Summary
The school setting may be optimal for delivering prevention to adolescents with elevated anxiety symptoms, when provided at school and during school hours (Werner-Seidler, Perry, Calear, Newby, & Christensen, 2017; Lyon & Bruns, 2019). Training school providers in delivering evidence-based targeted prevention for adolescents with anxiety may be beneficial in order to reduce anxiety symptoms, reduce impairment and hinder or postpone onset of anxiety disorders (Haugland et al, 2020). Such efforts are essential because only a limited number of adolescents with anxiety disorders are identified and referred for treatment in specialized mental health settings (e.g., community mental health clinics; Merikangas et al, 2011; Waite & Creswell, 2014). Little is known about facilitators needed to succeed in implementation of such interventions
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