Cognitive‐behavioural outreach for an adolescent experiencing social anxiety, panic and agoraphobia: A single‐case experimental design. Issue 4 (22nd November 2018)

• Record Type: Journal Article
• Authors: Waldron, Samuel M.; Maddern, Lynn; Wynn, Amber
• Is Part Of: Journal of child and adolescent psychiatric nursing. Volume 31:Issue 4(2018)
• Page Start: 120
• Page End: 126
• Publication Date: 2018-11-22
• Subjects: agoraphobia -- cognitive‐behavioural -- community outreach -- panic -- social anxiety; Child psychiatric nursing -- Periodicals; Adolescent psychiatric nursing -- Periodicals; Child mental health -- Periodicals; Teenagers -- Mental health -- Periodicals; Child mental health -- United States -- Periodicals; Teenagers -- Mental health -- United States -- Periodicals; 618.92890231
• DOI: 10.1111/jcap.12216
• Languages: English
• ISSNs: 1073-6077

Abstract

Abstract: Problem: Previous research suggests that the adult‐focussed Clark and Wells (1995) model of social anxiety disorder (SAD) can be used to guide clinic‐based treatment for adolescents. This single‐case study ( N = 1) investigated whether this model could also guide community‐based outreach work for a 16‐year‐old female who was unable to attend clinic‐based appointments due to social anxiety comorbid with panic and agoraphobia. Methods: An experimental A‐B‐A design was used with three assessment–formulation sessions and 12 intervention sessions, focussing on exposure, cognitive restructuring, attention training, behavioural experiments and imagery rescripting. The Revised Child Anxiety and Depression Scale (RCADS), the Session Rating Scale (SRS) and the Goal Based Outcome form were administered at regular intervals. Findings and Conclusions: Social anxiety and panic scores reduced below the clinical threshold and the young person was able to leave home, travel independently (short‐term goal) and re‐engage with her social–family life (medium‐term goal). SRS scores suggest that the intervention was acceptable and the therapeutic alliance was maintained throughout. In summary, this case study suggests that the Clark and Wells (1995) model of SAD can be used to guide community‐based outreach work with adolescents unable to leave their home. Limitations and ideas for future research are discussed.