Behavioral Telehealth in Low-resource Primary Care Settings for Anxiety and Depression in Youth

Inclusion criteria

• Youth is a patient in a participating community health center.
• Youths meet criteria for clinically significant anxiety and / or depression as indexed at baseline assessment by either:

• research diagnosis of anxiety (Social Anxiety Disorder, Generalized Anxiety Disorder, Separation Anxiety Disorder) and / or depressive disorder (Major Depressive Disorder, Persistent Depressive Disorder).
• scores in the clinically elevated range on a standardized anxiety and / or depression symptom measure .
• Youth lives with a legal guardian (hereafter referred to as "parent") >= 50% of the time who consents to study participation.
• Youth speaks English.
• Parent speaks English or Spanish.

Exclusion criteria

• Youth requires alternate treatment as indexed by:

• current clinically significant Post-Traumatic Stress Disorder symptoms (meets diagnostic criteria in research interview and / or scores in the clinically elevated range on a standardized symptom measure) at baseline.
• current suicidal ideation with plan at baseline and / or suicidal behavior within the last year.
• current substance dependence at baseline.
• experience of physical or sexual abuse within the six months prior to baseline.
• parent /guardian does not identify anxiety and / or depression as a treatment priority at baseline.
• Youth is in an active, alternate psychosocial intervention for anxiety or depression that would be concurrent with study participation.
• Youth is on an unstable regimen of psychotropic medication (i.e., receives medication but has not been at a stable dose for at least 8 weeks, or if medication has been discontinued for less than 4 weeks) at baseline.
• Youth is receiving lithium or and anti-psychotic medication at baseline.
• Youth is placed in a special education program for greater than 50% of the school day and / or youth school placement is below the second-grade level at baseline.
• Youth is placed in foster care at baseline.