4 - (SYM 23) Development and Perceived Utility of the Revamping Evidence Based Supports to Promote Effective culturally Responsive Treatment (RESPECT) Toolkit for Anxiety and OCD

Background: Improving the quality of evidence-based interventions (EBIs) for anxiety and OCD for marginalized youth is a critical step in reducing mental health care inequities. There is strong evidence that current EBIs need systematic adaptation and augmentation to improve the cultural responsiveness for minoritized youth and families, but little guidance exists for clinicians on what and how to systematically adapt. This presentation will describe the development, content and initial usefulness of a clinician-facing toolkit to improve the cultural responsiveness of services for youth with anxiety and related disorders.

Methods: We undertook a systematic, user-centered process that included: 1) rapid qualitative analysis of clinician and client interviews about experiences in therapy, 2) quantitative chart review of predictors of successful treatment outcome in a community-based, specialty OCD and anxiety treatment center in an urban setting, 3) expert stakeholder feedback and literature review, and 4) iterative refinement of the toolkit with an advisory board. Following initial development of the toolkit, we conducted a national survey with (N=185) clinicians to examine perceived appropriateness and usefulness of the toolkit.

Results: Data from the user-centered process was synthesized to develop the RESPECT Toolkit which contains guidance for 1) relationship building; 2) person-centered culturally responsive assessment; 3) case conceptualization; 4) psychoeducation; 5) exposure; 6) cognitive skills; and 7) augmentation strategies (e.g., mindfulness, racial/ethnic socialization, case management). Clinicians reported agreeing that the toolkit sections were appropriate for use with their clients as follows on a 5-point scale: relationship building (M=4.32, SD=0.65), person-centered culturally responsive assessment (M=4.45, SD=0.60), and case conceptualization (M=4.39; SD=0.65). On average, clinicians rated the toolkit as very useful (M=4.13; SD=0.80).  Themes from open ended responses are undergoing analysis.
Conclusion: Our systematic, user-centered process facilitated the development of the RESPECT toolkit that has the potential to improve the quality of exposure-based CBT for minoritized youth and families. We will highlight successes and challenges encountered during development and their implications for how best to support clinicians to deliver culturally responsive care to minoritized youth.