How can we get evidence-based interventions to work in primary care? Development and evaluation of adapted CBT for mild to moderate anxiety in children and adolescents

Mental health problems in children and adolescents are a major public health concern. Anxiety is the most common problem, but only a minority of those affected receive adequate care.

Access to early interventions within primary care has the potential to combat a detrimental trajectory for children and adolescents, but more research is needed.

Today, there is a lack of studies exploring early interventions for anxiety adequate to implement within primary care.In response to the increasing mental health problems in children and adolescents in Sweden, a first line mental health (FLMH) has been developed.

A challenge for the FLMH has been to identify evidence-based interventions fitting the needs of their patients and organization, as interventions almost exclusively have been developed and evaluated within a psychiatric context.

Adaptations of evidence-based interventions are made regularly in everyday practice, but research shows that such adaptations typically are conducted reactively rather than proactively.

Adaptations are made in response to practical restraints rather than to provide a better fit for the target group and commonly without considerations of how core components will be affected.The overall aim of this project is to increase access to evidence based interventions for children suffering from mild to moderate anxiety.

Using a scientific method, we will develop an intervention targeting childhood anxiety adapted to fit within primary care.

We will explore the process of adapting evidence-based interventions within the FLMH and evaluate the effect of the intervention in a randomized controlled trial conducted at FLMH-units. The project provides guidelines on how evidence-based interventions can be adapted in the FLMH.

If proven effective, the intervention could be beneficial for a large part of the population and contribute to better public health. After development and evaluation in everyday clinical practice, implementation will be straight-forward.