Integrated Behavioral Health Innovations in Childhood Chronic Illness Care Delivery Systems

Study design: At baseline, all adolescents and young adults with IBD ages 12-21 years will be
screened for anxiety and depression symptoms using the PHQ-9 and the Screen for Child Anxiety
Related Disorders (SCARED) during a routine medical visit in the pediatric gastroenterology
clinic. Individuals who screen positive for depression or anxiety will be assessed to confirm
diagnoses using the anxiety and M.I.N.I. 6.0. Participants will also complete a psychosocial
risk assessment as well as medical and socio-demographic inventories. The investigators will
include youth that meet full criteria for major depressive disorder and any anxiety disorder,
dysthymic disorder, and any adjustment disorder. The investigators will also include patients
with subclinical symptoms that have significant psychosocial stressors in addition to their
medical illness. Patients will be excluded if they have active suicidal ideation with plan
requiring ER referral, bipolar disorder, psychosis, substance dependence, eating disorders,
or significant intellectual disability/developmental delay. Participants meeting inclusion
criteria will be randomly assigned to four sessions of IBBT administered on-site by a Fink
social worker or treatment as usual (TAU), which is a facilitated community referral for
mental health treatment.