Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2017 Oct;48(5):721-727.
doi: 10.1007/s10578-016-0697-5.

Assessing Clinical Improvement in School-Based Treatment for Social Anxiety Disorder: Agreement Between Adolescents, Parents, and Independent Evaluators

Jeremy K Fox  1 , Carrie Masia Warner  2   3   4
Affiliations

Assessing Clinical Improvement in School-Based Treatment for Social Anxiety Disorder: Agreement Between Adolescents, Parents, and Independent Evaluators

Jeremy K Fox et al. Child Psychiatry Hum Dev. 2017 Oct.

Abstract

The Clinical Global Impressions of Improvement (CGI-I) scale is widely used in clinical trials to monitor clinically meaningful change during treatment. Although it is standard practice in research to have independent evaluators (IEs) complete the CGI-I, this approach is not practical in school and community settings. Few studies have explored the potential utility of other informants, such as youth and parents. Therefore, this study aimed to investigate agreement between IEs and both adolescents and parents in CGI-I improvement ratings in the context of a randomized controlled trial of cognitive-behavioral therapy for social anxiety disorder, as delivered by psychologists and school counselors. Multilevel growth models indicated that IEs were generally more conservative in their ratings of positive treatment response across time and treatment conditions, though greater agreement was observed between parents and IEs by post-intervention and 5-month follow-up. Possible explanations for these findings and suggestions for alternative approaches are discussed.

Keywords: Cognitive-behavioral therapy; Independent evaluator; Rater agreement; Schools; Social anxiety; Treatment response.

PubMed Disclaimer

Figures

Figure 1
Figure 1
CGI-I response rate (percentage of cases rated as “Improved,” “Much Improved,” or “Very Much Improved”) reported by three raters (adolescent, parent, independent evaluator) over three time points (midpoint of intervention, post-intervention, and five month follow-up). Response rates for SASS and SFL participants are displayed on the left and right, respectively.
See this image and copyright information in PMC

References

    1. Guy W. US Department of Health, Education and Welfare Publication (ADM) 76-338. National Institute of Mental Health; Rockville, MD: 1976. ECDEU Assessment Manual for Psychopharmacology.
    1. Klein RG, Koplewicz HS, Kanner A. Imipramine treatment of children with separation anxiety disorder. J Am Acad Child Adolesc Psychiatry. 1992;31:21–28. - PubMed
    1. Hedges DW, Brown BL, Shwalb DA. A direct comparison of effect sizes from the clinical global impression-improvement scale to effect sizes from other rating scales in controlled trials of adult social anxiety disorder. Hum Psychopharmacol. 2009;24:35–40. - PubMed
    1. Pediatric OCD Treatment Study Team. Cognitive-behavior therapy, sertraline, and their combination for children and adolescents with obsessive-compulsive disorder. JAMA. 2004;292:1969–1976. - PubMed
    1. The TADS Team. The Treatment of Adolescent Depression Study (TADS) Arch Gen Psychiatry. 2007;64:1132–1144. - PubMed

LinkOut - more resources