Helping teens overcome anxiety

(Edmonton) Researchers in the Faculty of Medicine & Dentistry at the University of Alberta have received $830,000 in funding to develop an interactive online program that teaches anxious youth to better cope with life’s stressors. The program will initially be based in Edmonton and Halifax, but the research team wants to expand the program to more sites across Canada.

Amanda Newton and her team are receiving $500,000 over five years from the Royal Bank of Canada Children's Mental Health Project. This funding came about as a result of a partnership between the Stollery Children’s Hospital Foundation and the RBC Foundation. The research team also received another $330,000 from the Canadian Institutes of Health Research. Newton is a researcher in the Department of Pediatrics, and an adjunct professor in the Department of Psychiatry and the U of A Faculty of Nursing. Her co-principal investigator is Patrick McGrath with the IWK Health Centre in Halifax.

Newton’s team will spend the next year developing the program, which they hope to officially launch in the fall of 2013 for evaluation. The focus will be on teens between ages 13 and 17 who visit the Stollery Children’s Hospital emergency department and the IWK Health Centre. Youth who come to hospital complaining of anxiety issues or have a combination of symptoms such as headaches, stomach aches and a lack of interest in school, will be flagged as potential candidates for the study and given a pamphlet on the program.

After the teens leave the hospital, they will be contacted by a therapist on the research team who will talk to them for about 20 minutes to determine whether the anxiety is due to a disorder. Youth with anxiety disorders suffer from overwhelming worries on a daily basis, affecting their ability to succeed in school and to enjoy their time with friends and loved ones, says Newton.

Lessons in beating stress

Teens identified as having an anxiety disorder will begin an online treatment program consisting of eight modules or lessons on how to cope with life stressors. This type of treatment is known as cognitive behavioural therapy.

Treatment will combine exposure to feared situations with skills training—such as self-talk or deep breathing—to help replace anxious thoughts about feared situations with healthier thoughts. This type of therapy can help reduce symptoms for mild to moderate anxiety. Each module, presented through video games or storyboards, for example, will take about one week to complete. The modules will give young people the opportunity to practise dealing with potential scenarios that they typically find anxiety-inducing. Parents will also take part in the program, and will be given information on how to best support their child.

Right now, the onus is on families to reach out to a family physician or psychiatrist. But it can be challenging for families to attend appointments during the day. And not all of this type of assistance is covered by health-care plans, so getting help can be costly—another barrier.

The project will allow teens to go through the modules in the comfort of their own home, at their own pace and at whatever time works best for them.

Bridging the gap between crisis and care

“This is really meant to bridge that gap after the crisis—to ensure youth are getting timely care after a crisis due to anxiety,” said Newton. “This program will give youth the opportunity to learn new skills to cope with anxiety, practise their new skills, then reflect on how their new strategies worked. And having this program available will reduce barriers to treatment post-crisis.”

A program like this is needed because there are limited resources in Canada to help teens with anxiety disorders and even fewer trained specialists in this area, notes Newton. By age 16, up to 10 per cent of youth are diagnosed with an anxiety disorder that is serious enough to require treatment. Anxiety-based crises are among the most frequent reasons for emergency department mental health visits by youth in Canada, she says, so “the health-care system needs to look at alternative ways to deliver care.”

Prior research conducted by Newton’s team showed that from 2002 to 2008, 26 per cent of all mental-health visits to emergency rooms by children were due to anxiety-based crises.

“Our research also unveiled that while most anxious youth will receive some counselling during their emergency department visit, the type of specialist care needed for anxiety can’t be initiated in the emergency department, and timely access to this type of followup care is lacking.”

Shoo Lee, scientific director of the CIHR Institute of Human Development, Child and Youth Health, stressed the importance of the research team’s work. “Access to timely and appropriate mental health services is foundational for good health. This investment will open doors for youth and their families.”

Ultimately, Newton hopes to see the program expanded into schools, where it could be offered to teens flagged as having possible anxiety disorders. If youth could be flagged in schools, before an emergency department visit, it would be better for everyone, Newton says.

“Hopefully this program will have much broader applications.”