(PS9-C75) A Needs Assessment of School-based Clinicians on Cognitive Behavioral Therapy for Anxious Students

Anxiety disorders are prevalent among school-age youth, yet they often go untreated, causing significant functional impairment (Mychailyszyn et al., 2010; Mychailyszyn et al., 2011).  Additionally, global youth anxiety rates have doubled during the COVID-19 pandemic (Racine et al., 2021). Cognitive Behavioral Therapy (CBT) can be effective; however, treatment access is limited by logistical concerns, a shortage of trained providers, and the stigma of help-seeking (Beidas et al., 2012; Sulkowski et al., 2012). Amidst the current youth mental health crisis, school-based mental health services have been highlighted by the US Surgeon General (Murthy, 2021), as well as by experts in the field via America's School Mental Health Report Card (Hopeful Futures Campaign, 2022) and expert testimonials given to U.S. Senate Committee on Finance (Hoover, 2022), as a means to aid early identification, increase access, and decrease stigma, particularly for traditionally underserved youth (Ginsburg et al., 2008).

            An online needs assessment was conducted with 280 social workers and psychologists employed in an urban school district (88% female; 58% Caucasian, 24% African American, and 24% Latinx). Measures included a questionnaire assessing knowledge about CBT for anxiety (10 items), the Evidence Based Practice Attitude Scale, and questions about current CBT use.

            43% of respondents scored 80% or higher on knowledge of CBT for anxiety. Clinicians strongly agreed that evidence-based practices were intuitively appealing (M = 4.28, SD = .60), and were moderately open to adopting new practices (M = 3.95, SD = .76). The 3 most frequently endorsed CBT components were positive self-talk (67%), relaxation (63%), and problem solving (58%). The 3 least used CBT components were exposure (16.2%), psychoeducation (32%) and cognitive restructuring (34%).

            School-based clinicians agreed that evidence-based practices are intuitively appealing and reported openness to implementing new practices. However, less than half of surveyed clinicians reported proficiency in knowledge of CBT for anxiety. Notably, only 16% of clinicians reported use of exposure, an essential component of CBT for anxiety. Research shows that exposure is a key ingredient in the treatment of anxious behaviors (Bilek et al., 2021), including school refusal, which may be exacerbated due to social isolation resulting from the pandemic (Haddad & van Schalkwyk, 2021). Therefore, targeted training in underused components of CBT could aid appropriate school-based treatment of anxiety, taking current contexts into account. Schools are an important access point for mental health services. School-university partnership to build workforce capacity for implementation of CBT may improve access to mental health services for youth.