Outpatient Behavioral Health and Primary Care Clinical Pathway for the Evaluation/Treatment of Patients at Risk for Anxiety Disorder and Obsessive-Compulsive Disorder

Goals and Metrics
Patient Education
Provider Resources
Related Pathways
Child/Adolescent with Risk for Anxiety or Obsessive-Compulsive Disorder (OCD)
Screening for Anxiety or OCD
  • Standard Clinical Interview or Validated Tools
  • Positive Screen
Negative Screen
Continue routine care
Complete Evaluation and Diagnostic Assessment
Completed by Primary Care or BH Clinician
Negative Evaluation
  • Continue routine care
  • Monitor for continued symptoms
Determine Diagnosis
Determine Anxiety/OCD Severity
  • Standard Clinical Interview or Validated Tools
  • Assess Suicidal Ideation (SI), co-morbidities, avoidance
  • Case Examples
Mild Moderate Severe
  • All of the following:
    • Minor Severity of symptoms based on data from interview or assessment tool
    •  
    • Minor Functional Impairment caused by symptoms/ avoidance or mildly distressing symptoms
    •  
    • No Suicidal ideation
    • No comorbid psychiatric diagnoses
  • All of the following:
    • Moderate Severity of symptoms based on data from interview or assessment tool
    •  
    • Moderate Functional Impairment caused by symptoms/avoidance or moderately distressing symptoms
    •  
    • No Suicidal ideation
    •  
  • Can Include:
    • Comorbid psychiatric diagnoses
  • All of the following:
    • Severity of symptoms and associated avoidance substantially in excess of that required to make the diagnosis based on data from interview or assessment tools
    •  
    • Intensity of symptoms leads to serious distress or markedly impaired psychosocial functioning
    •  
  • Can Include:
    • Suicidal ideation
    • Comorbid psychiatric diagnoses
Treatment

Posted: September 2021
Revised: March 2022
Authors: Y. Marroquin, PhD; J. Lewis, PhD; W. Wallace, DO; K. Fletcher, MD; C. Cagande, MD; A. Riisen, PsyD;
J. Keller, DNP; K. Mu, DO;
Reviewed by Children's Hospital of Philadelphia DCAPBS Clinical Care Committee: September 2021