CCAP Intervention and Results

The intervention utilized Behavioral Health Specialists (BHSs) to deliver CBT and to promote the delivery of evidence-based pharmacotherapy by relaying expert advice from psychiatrists to the subject’s prescribing primary care provider (PCP). CCAP selected BHSs who were either minimally or not at all familiar with cognitive behavior therapy (CBT) in order to demonstrate that clinicians commonly working in the primary care environment (i.e. mid-level providers) could be trained to do this work. Combination treatment with both CBT and medication was provided due to evidence that it is more effective than singly modality treatment for panic disorder complicated by other comorbid conditions (which is common of a patient seen in primary care).

The study provided an opportunity to assess other types of anxiety disorders in the primary care setting and to learn more about the characteristics, associated complications, and treatments provided for anxiety in this setting. The study conclusively demonstrated that the combined intervention was more effective than care as usual by PCPs, that CBT could be effectively delivered by training inexperienced therapists to work in this setting, that CBT appeared to be the more active and important therapeutic ingredient, and that the intervention was cost effective.