Symposia
Dissemination & Implementation Science
Brenna N. Renn, Ph.D. (she/her/hers)
Assistant Professor
University of Nevada, Las Vegas
Las Vegas, Nevada
Rakshitha Mohankumar, M.A.
Clinical Psychology Doctoral Student
University of Nevada, Las Vegas
Las Vegas, Nevada
Ting Tong, BS, BA
Lab Manager
University of Nevada Las Vegas
Las Vegas, Nevada
Patrick Raue, Ph.D. (he/him/his)
Professor
University of Washington, Seattle
Seattle, Washington
Anxiety is the most common adult mental health condition. Left untreated, it is costly and imparts significant personal and public health burden. Evidence-based psychotherapy offers an acceptable and effective first-line treatment; however, rural, low-income, and other underserved areas suffer from provider shortages, rendering such treatment largely unavailable. International contexts are beginning to address this problem using provider task sharing, in which low-intensity behavioral health services are delivered by nonspecialist health workers (i.e., those with no prior training as a mental health professional). This approach is designed to improve access to care, particularly for those with mild-to-moderate symptoms, and free up limited expert resources. However, such an approach has not yet gained traction in the U.S., yet offers tremendous potential to improve access to services and address provider shortage by expanding the workforce. We present the (1) treatment development, (2) training program, and (3) preliminary outcomes of a single-arm pilot trial focused on a brief, evidence-based, behavioral intervention for mild-to-moderate anxiety disorders appropriate for nonspecialist delivery in contexts such as primary care or other non-mental health settings. We present an iterative, community- and clinician-engaged process to develop and iteratively refine a brief, structured treatment protocol based on strategies from cognitive behavioral therapy (i.e., exposure, worry management). Qualitative interviews, principles of user-centered design and implementation science, were conducted with mental health specialists, university educators and undergraduate students from relevant disciplines, and people with the “lived experience” of anxiety, informed refinement of the intervention. Findings from these interviews directly influenced the development of the intervention and are presented. Bachelor-level nonspecialists were then trained to deliver this treatment protocol for management of anxiety disorders. Preliminary data from an ongoing single-arm pilot trial, in which nonspecialists deliver this treatment protocol with community-dwelling adults with clinically-significant anxiety, are presented. Such a treatment protocol and delivery model are designed to expand access to care, using an untapped potential workforce.