Background:

In light of the growing pediatric mental health crisis and long wait times to see an in-person therapist, a team of mental health leaders from the nationally recognized McLean Anxiety Mastery Program (MAMP) conducted research regarding the benefits of videoconferencing-based cognitive behavioral therapy (VCBT) for intensive treatment of pediatric anxiety and OCD.

Study Details and Results:

Ranging in age from 8 to 19 years, 130 patients with one or more anxiety disorders and/or OCD were enrolled in the study.  70 participants received in-person CBT treatment prior to the start of the COVID-19 pandemic, while the other 60 participants received VCBT during the pandemic. Median length of treatment was 6 weeks. The treatment approach and average treatment length were the same across groups; the only difference was whether the treatment was administered virtually or in-person.

Results of the study demonstrate that there were no statistically significant differences in post-treatment child and caregiver reported anxiety or functional impairment observed between CBT and VCBT groups, while controlling for symptom severity at admission. This suggests that intensive virtual care is an effective treatment option for youth struggling with anxiety and OCD.

The Creation of InStride Health:
With a commitment to delivering the highest quality patient outcomes, InStride Health was founded to provide in-network therapy to children, teens, and young adults with anxiety and/or OCD.  InStride Health treats all severity levels, with particular focus on those with moderate to severe conditions where anxiety and/or OCD are interfering with functioning and causing a cascade of additional problems including social isolation, school avoidance, physical manifestations and more. Leveraging a highly experienced and coordinated care team of child and adolescent psychiatrists, therapists, and coaches, InStride’s approach is different in that care is provided virtually when, where and how patients need it. Whether it is a text from an exposure coach before school or after a particularly tough between-session exposure in the community, treatment is much more than just a regularly scheduled session with a therapist. InStride patients and their families engage in a tailored virtual care journey that can include individual and family therapy, groups for kids and for parents/caregivers, skills coaching, dedicated parent groups and medication management if appropriate.

InStride Health has demonstrated clinically meaningful results of its collaborative care model. Among patients with initially elevated anxiety symptoms at baseline (GAD7>=8), 90% experienced a reduction in anxiety after two months of treatment.  On average, there was a 46% decrease in anxiety symptoms and this reduction was both statistically significant and characterized by a large effect size.* Similarly, 81% of these patients reported a clinically meaningful reduction of anxiety symptoms after four months of starting treatment.** Additionally, after 3 months of treatment, 82% of patients reported reduced functional impairment and symptom severity.*** Overall satisfaction with the program is high, with 100% of all graduates and 97% of caregivers likely to recommend InStride to a friend. 

Clinical outcomes reported for program graduates from InStride inception thru 8/18/2023

*Generalized Anxiety Disorder Scale -7

**Clinically meaningful reduction is defined by a change greater than or equal to the minimally clinically important difference (MCID of +/- 4 points)

***As measured by the OASIS-Y

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About The Clinicians:

Kathryn Boger, PhD, ABPP

Dr. Kathryn (“Kat”) Boger is a board certified and Harvard-trained child and adolescent clinical psychologist who has devoted her career to helping children and teens with anxiety and OCD, as well as their families. She is passionate about improving care for youth and decreasing suffering through innovative, research-based treatment approaches. Dr. Boger co-founded the McLean Anxiety Mastery Program (MAMP), nationally recognized for providing empirically-supported, intensive anxiety and OCD treatment. 

While at MAMP, Dr. Boger served as program director with oversight over all levels of program development and refinement, and served as an assistant professor of psychology at Harvard Medical School. Dr. Boger has published a variety of peer-reviewed journal articles, delivered regional and national talks (including a TEDx,) and provided training to hospitals, schools, and the community. In 2021, Dr. Boger co-founded InStride Health with the mission of increasing access to insurance-backed, research-based care for children, adolescents, and young adults with anxiety and OCD. Her children’s book, Step by Step, is about taking brave steps to face things that feel scary.

Daniel Stone, PhD

Dr. Daniel Stone is a licensed psychologist who specializes in the treatment of childhood anxiety disorders, obsessive compulsive disorder (OCD), and related disorders. Throughout his training and career, Dr. Stone has focused on providing evidence-based assessment and treatment to children, families, and young adults. He earned a BA in psychology at the University of Massachusetts, Boston, and a doctorate in counseling psychology at Northeastern University. Dr. Stone completed his clinical internship in behavioral psychology at Kennedy Krieger Institute and Johns Hopkins University, and his postdoctoral fellowship in behavioral psychology and neuropsychology at McLean Hospital and Harvard Medical School.  During that time he provided intensive exposure-based treatment to children with anxiety and related disorders. 

Dr. Stone is currently an Instructor of Psychology in the Department of Psychiatry at Harvard Medical School and a psychologist at the McLean Anxiety Mastery Program, where he conducts research and development on electronic therapy interventions, such as telehealth and virtual reality therapies. As Director of Digital Health Innovation at InStride, Dr. Stone combines his knowledge of psychological assessment and intervention, with his passion for science and technology to drive forward the development and implementation of new therapeutic techniques to combat the pediatric mental health crisis.