The feasibility of improving CBT for childhood anxiety disorders through a dismantling study.
This preliminary randomized controlled trial (RCT) examines the feasibility of dismantling cognitive behavioral therapy (CBT) for childhood anxiety disorders. Fourteen children (10 girls) ages 7 to 14 (m = 10.2) with social phobia, generalized anxiety disorder, separation anxiety disorder, or panic disorder were randomized to receive 6 sessions of either a) the pre-exposure anxiety management strategies presented in traditional CBT, or b) parent-coached exposure therapy. The sample was selected from a treatment seeking population and is representative of children in clinical settings. Examination of fidelity ratings, dropouts, and satisfaction ratings indicated that the interventions were distinguishable, safe, and tolerable. The overall sample improved significantly with pre-post effect sizes generally in the large range for both conditions. Between-group effect sizes indicating greater improvement with parent-coached exposure therapy were moderate or large for ten of 12 variables (i.e., 0.53 to 1.52). Re-evaluation after three months of open treatment suggested that the intervention emphasizing exposure early maintained its superiority while requiring fewer appointments.
Department of Psychiatry and Psychology, Mayo Clinic, USA.
Stephen P H
SP
Whiteside
Department of Psychiatry and Psychology, Mayo Clinic, USA.
Chelsea M
CM
Ale
Department of Psychiatry and Psychology, Mayo Clinic, USA.
Brennan
B
Young
Department of Psychiatry and Psychology, Mayo Clinic, USA.
Julie E
JE
Dammann
Department of Psychiatry and Psychology, Mayo Clinic, USA.
Michael S
MS
Tiede
Department of Psychiatry and Psychology, Mayo Clinic, USA.
Bridget K
BK
Biggs
D001008:Anxiety Disorders / Q000628:therapy*; D002648:Child; D002653:Child Behavior Disorders / Q000628:therapy; D002675:Child, Preschool; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007171:Implosive Therapy / Q000379:methods*; D008297:Male; D010352:Patient Dropouts
Anxiety disorders; Child; Exposure; Outcome; RCT; Treatment