Clinical decision-making in the treatment of children and adolescents with anxiety disorders in Australia.

Abstract

Objective: Recent evidence that few help-seeking children and adolescents receive evidence-based care for anxiety in Australia highlighted the need for an increased understanding of clinical decision-making in this field. This article reports on a survey that explored the perspective of clinicians regarding the care they provide for children and adolescents with anxiety disorders, and the factors influencing this decision-making process. Underlying decision-making constructs were investigated, including theoretical orientation, assessment, treatment planning and techniques, attitudes towards research and sources used to support clinical practice. Willingness to engage with clinical decision support was also examined.

Method: A sample of Australian mental health practitioners (n = 42) completed an online survey investigating clinical treatment decisions and the principles underlying their choices.

Results: Generally, clinicians subscribe to more than one theoretical orientation, with a majority incorporating a CBT approach. Clinical assessment and treatment formulation processes aligned with evidence-based practices and recommendations. Most clinicians reported high esteem for research to inform both their theoretical approach and clinical practice, and most respondents indicated interest in user-testing a decision support tool.

Conclusions: In contrast to earlier research, Australian clinicians self-report routine employment of evidence-based practices to guide clinical assessment, treatment formulation and treatment delivery in their practices.