title: The therapeutic relationship in cognitive-behavioral therapy and pharmacotherapy for anxious youth.
abstract: OBJECTIVE
  We examined the therapeutic relationship with cognitive-behavioral therapists and with pharmacotherapists for youth from the Child/Adolescent Anxiety Multimodal Study (Walkup et al., 2008). The therapeutic relationship was examined in relation to treatment outcomes.
  
  
  METHODS
  Participants were 488 youth (ages 7-17 years; 50% male) randomized to cognitive-behavioral therapy (CBT; Coping Cat), pharmacotherapy (sertraline), their combination, or placebo pill. Participants met criteria for generalized anxiety disorder, social phobia, and/or separation anxiety disorder according to the Diagnostic and Statistical Manual of Mental Disorders (4th ed.; American Psychiatric Association, 1994). The therapeutic relationship was assessed by youth report at Weeks 6 and 12 of treatment using the Child's Perception of Therapeutic Relationship scale (Kendall et al., 1997). Outcome measures (Pediatric Anxiety Rating Scale; Research Units on Pediatric Psychopharmacology Anxiety Study Group, 2002; and Clinical Global Impressions Scales; Guy, 1976) were completed by independent evaluators blind to condition.
  
  
  RESULTS
  For youth who received CBT only, a stronger therapeutic relationship predicted positive treatment outcome. In contrast, the therapeutic relationship did not predict outcome for youth receiving sertraline, combined treatment, or placebo.
  
  
  CONCLUSIONS
  A therapeutic relationship may be important for anxious youth who receive CBT alone.
authors.affiliation: Department of Psychology.
authors.forename: Colleen M
authors.initials: CM
authors.lastname: Cummings
authors.forename: Nicole E
authors.initials: NE
authors.lastname: Caporino
authors.forename: Cara A
authors.initials: CA
authors.lastname: Settipani
authors.forename: Kendra L
authors.initials: KL
authors.lastname: Read
authors.forename: Scott N
authors.initials: SN
authors.lastname: Compton
authors.forename: John
authors.initials: J
authors.lastname: March
authors.forename: Joel
authors.initials: J
authors.lastname: Sherrill
authors.forename: John
authors.initials: J
authors.lastname: Piacentini
authors.forename: James
authors.initials: J
authors.lastname: McCracken
authors.forename: John T
authors.initials: JT
authors.lastname: Walkup
authors.forename: Golda
authors.initials: G
authors.lastname: Ginsburg
authors.forename: Anne Marie
authors.initials: AM
authors.lastname: Albano
authors.forename: Moira
authors.initials: M
authors.lastname: Rynn
authors.forename: Boris
authors.initials: B
authors.lastname: Birmaher
authors.forename: Dara
authors.initials: D
authors.lastname: Sakolsky
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Gosch
authors.forename: Courtney
authors.initials: C
authors.lastname: Keeton
authors.forename: Philip C
authors.initials: PC
authors.lastname: Kendall
mesh_terms: D000293:Adolescent; D001008:Anxiety Disorders / Q000188:drug therapy / Q000628:therapy*; D001010:Anxiety, Separation / Q000188:drug therapy / Q000628:therapy*; D002648:Child; D015928:Cognitive Behavioral Therapy / Q000592:standards*; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D008297:Male; D010698:Phobic Disorders / Q000188:drug therapy / Q000628:therapy; D010919:Placebos; D011369:Professional-Patient Relations; D017367:Selective Serotonin Reuptake Inhibitors / Q000008:administration & dosage / Q000494:pharmacology*; D020280:Sertraline / Q000008:administration & dosage / Q000494:pharmacology*; D016896:Treatment Outcome
chemical_list: D010919:Placebos; D017367:Selective Serotonin Reuptake Inhibitors; D020280:Sertraline