Psychological stepped care for anxious adolescents in community mental health services: A pilot effectiveness trial.

Abstract Stepped-care (SC) interventions for treating adolescent anxiety have been shown to reduce therapy time and societal costs with similar therapeutic outcomes to best practice when applied in university clinics. This pilot study examined clinical- and cost-effectiveness of SC in two community mental health services. Fifty-three anxious adolescents (aged 12-18 years) were randomly allocated to SC or treatment as usual (TAU). Adolescent- and clinician-rated symptom severity and quality of life collected over time indicated SC used significantly less therapy time, with similar benefits in clinical effectiveness, waiting time and quality adjusted life years. Significant barriers limited engagement with early therapy steps.