Brief behavior therapy could be cost-effective way of managing patients’ anxiety

When thinking about therapy for anxiety and depression, one might think of frequent long counseling sessions that may seem not only highly time-consuming but expensive. A report in JAMA Network Open looks at whether brief behavioral therapy could be a more cost-effective treatment for anxiety and depression in children and adolescents than assisted referral to community outpatient mental health care.¹

The investigators used data from a randomized clinical trial of children and adolescents with full or probable diagnoses of anxiety or depression. The participants were randomized to either received a brief behavior therapy program, which consisted of 8 to 12 weekly 45-minute sessions of behavioral therapy in a pediatric clinic provided by master’s level therapy, or assisted referral to community outpatient mental health care, which also included calls that supported access to care. Studied outcomes included depression-free days, anxiety-free days, quality-adjusted life-years (QALYs), and costs based on incremental cost-effectiveness ratios from intake through 32-week follow-up.

There were 185 children and adolescents enrolled in the study. Those who were in the brief behavior therapy arm had significantly more days that were anxiety free (difference, 28.63 days; 95% CI, 5.86-50.71 days; P = .01) and QALYs (difference, 0.026; 95% CI, 0.009-0.046; P = .007) when compared to those in the other arm. Participant who received brief behavior therapy also had more days free of depression than the community mental health care arm (difference, 10.52 days; 95% CI, −4.50 to 25.76 days; P = .18), but the difference wasn’t statistically significant. Analysis of cost-effectiveness showed that with a willingness-to-pay threshold of $50,000 per QALY, the probability of brief behavioral therapy being cost-effective in comparison to assisted referral to community outpatient mental health care at 32 weeks was 95.6%.

The investigators concluded that not only did brief behavior therapy lead to a number of better outcomes for children and adolescents, it’s also cost effective. Using it in practice could be a good way to help improve anxiety in patients without exorbitant cost.

Reference

1. Lynch F, Dickerson J, Rozenman M, et al. Cost-effectiveness of brief behavioral therapy for pediatric anxiety and depression in primary care. JAMA Netw Open. 2021;4(3):e211778. doi:10.1001/jamanetworkopen.2021.1778