E05 – Correlates of Delivery of Evidence-Based Interventions for Anxiety in Primary Care Behavioral Health Routine Clinical Practice

Summary

Although anxiety is highly prevalent in primary care and a top reason for referral to Primary Care Behavioral Health (PCBH), understanding of anxiety interventions used in routine PCBH practice is limited. The objective of this study was to examine patient-level and provider-level correlates of delivering evidence-based anxiety interventions to inform research and practice on the implementation of evidence-based treatment in integrated primary care. In a cross-sectional survey, 209 PCBH providers recruited from national email listservs reported on use (yes/no) of various interventions in their most recent session with an adult patient referred for non-PTSD anxiety (e.g., generalized anxiety, social anxiety, panic, phobias). We used multivariate logistic regression to examine whether provider discipline and theoretical orientation, session type, likelihood of follow-up, and patient age, anxiety severity, depressive severity, comorbid concerns, treatment priority, and anxiety medication were associated with intervention delivery. Providers reported using an average of 5.77 (2.05) intervention techniques. Relaxation training was more likely to be used during initial (vs. follow-up) sessions, whereas cognitive therapy was less likely. Cognitive therapy and behavioral activation were less likely to be used for patients who prioritized treating anxiety (vs. other concerns), whereas relaxation training was more likely. Exposure and Acceptance and Commitment Therapy-based interventions were more likely to be delivered by psychologists (vs. other providers). Overall, PCBH providers seemed to consider the patient’s priorities and likely course of treatment in selecting interventions, but their own training background may also factor in. The presenters and audience will discuss clinical, research, and training implications of the results as well as potential implementation strategies to increase the delivery of evidence-based anxiety interventions in integrated primary care.