Cognitive behavioural therapy for anxiety disorders in children and adolescents

James, Anthony; James, Georgina; Cowdrey, Felicity A.; Soler, A. Franco; Choke, Aislinn

doi:10.1002/14651858.cd004690.pub3

Cited by 281 publications

(177 citation statements)

References 127 publications

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“…Cognitive behaviour therapy (CBT) is an effective treatment (Cartwright-Hatton, Roberts, Chitsabesan, Fothergill, & Harrington, 2004;Compton et al, 2014;James, James, Cowdrey, Soler, & Choke, 2013); however, it typically requires specialist resources and is often not available to those who might benefit from it (Stallard, Udwin, Goddard, & Hibbert, 2007).…”

Section: Practitioner Pointsmentioning

confidence: 99%

Guided parent‐delivered cognitive behaviour therapy for children with anxiety disorders: Outcomes at 3‐ to 5‐year follow‐up

Brown

Creswell

Barker

et al. 2017

British J Clinic Psychol

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Objectives. Brief guided parent-delivered cognitive behaviour therapy (CBT) has been developed to meet the demand for non-intensive interventions for children with anxiety disorders, and initial trials have shown it to be effective for children with a range of anxiety disorders. This study examined outcomes 3-5 years post-treatment.Design. A long-term follow-up (LTFU) cohort study.Methods. Families who (1) completed at least 50% of allocated treatment sessions of guided parent-delivered CBT for childhood anxiety as part of a randomized control trial (RCT), (2) provided consent to be recontacted, (3) had not received further mental health interventions, and (4) were contactable were invited to take part. Fifty-seven families (29% of the original sample) completed structured diagnostic interviews on average 50 months after treatment (39-61 months).Results. At LTFU, 79% of the assessed children who had received the treatment no longer met criteria for their primary diagnosis, 63% did not meet criteria for any anxiety disorder, and 61% did not meet criteria for any DSM-IV disorder. Treatment gains were mostly maintained (60%), and some children went on to recover during the follow-up period without additional input from mental health services (19%). Few young people had relapsed since their last assessment (12%). Mean scores on standardized symptom questionnaires were within the normal range.Conclusions. Children who recovered from anxiety disorders following brief guided parent-delivered CBT typically maintained good outcomes and few relapsed. These findings suggest that this is a viable first-line, low-intensity treatment approach. This study only included a small subsample of those in the original RCT (29%), and more information is required about those who dropped out of treatment and those who required further intervention immediately after treatment.

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Section: Practitioner Pointsmentioning

confidence: 99%

Guided parent‐delivered cognitive behaviour therapy for children with anxiety disorders: Outcomes at 3‐ to 5‐year follow‐up

Brown

Creswell

Barker

et al. 2017

British J Clinic Psychol

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“…Overall reviews and meta-analyses have indicated that programs in which parents of anxious children are incorporated into the treatment result in no greater efficacy than programs targeting the child alone (In-Albon and Schneider 2006;James et al 2006). However, these reviews do not typically consider differences in age of the child, and in fact, there are few studies that either include a sufficient age range or have sufficient power to detect relevant differences (Creswell and Cartwright-Hatton 2007;Rapee et al 2009).…”

Section: Importance Of Including Families In Treatment For Child Anxietymentioning

confidence: 99%

Family Factors in the Development and Management of Anxiety Disorders

Rapee

2011

Clin Child Fam Psychol Rev

147

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Family variables are thought to play a key role in a wide variety of psychopathology according to many theories. Yet, specific models of the development of anxiety disorders place little emphasis on general family factors despite clear evidence that anxiety runs in families. The current review examines evidence for the involvement of a number of family-related variables in the development of anxiety disorders as well as the importance of families in their management. Evidence across most areas is shown to be weak and inconsistent, with the one exception being an extensive literature on the role of parenting in the development of anxiety. There is also currently little evidence that family factors have a strong role to play in the treatment of anxiety, aside from research demonstrating the value of parents and partners as non-critical supports in therapy. The promises and hints in the literature, combined with the currently inconsistent methods, suggest that considerably more research is needed to determine whether specific family factors may yet be shown to play a key role in the development and management of anxiety disorders.

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Section: Introductionmentioning

confidence: 99%

“…Generally, CBT for CADs has been found to have a large pre-post effect size (e.g., ES = 0.86;In-Albon and Schneider 2007) and moderate response rate (e.g., 56 %; James et al 2009). However, CBT has not demonstrated superiority over active controls or treatment as usual (Barrington et al 2005;James et al 2013;Southam-Gerow et al 2010). For example, in the largest RCT for CADs, CBT using the AMSEx model was more effective than pill placebo, but did not differentiate from medication, was less effective than combined treatment, and led to remission rates below 50 % (Ginsburg et al 2011;Walkup et al 2008).…”

Section: Introductionmentioning

confidence: 99%

Components of Cognitive Behavioral Therapy Related to Outcome in Childhood Anxiety Disorders

Ale

McCarthy

Rothschild

et al. 2015

Clin Child Fam Psychol Rev

104

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The present article uses meta-analysis to examine treatment components related to outcome within 35 randomized controlled trials (RCTs) for childhood anxiety disorders (CADs) and eight RCTs for childhood obsessive compulsive disorder (OCD). Examination of the RCTs of cognitive behavioral therapy (CBT) for CADs suggested that adding relaxation and delaying exposures until after the introduction of other anxiety management strategies does not increase the efficacy of exposure-based treatment. In addition, compared to the large effect size (ES) associated with exposure and response prevention (ERP) for OCD (k = 9, mean ES = 1.93), the effect size associated with CBT for CADs (k = 44, mean ES = 0.89) did not differentiate from attention placebo (k = 11, mean ES = 0.55), although it was more effective than waitlist control (k = 24, mean ES = 0.22). Instructively, ERP for OCD involved more exposure initiated earlier and less relaxation than CBT for CADs. In addition, RCTs of ERP were more likely to use clinician-administered measures as opposed to self-report and to be conducted in clinical versus recruited samples. These results suggest that dismantling studies using a gold-standard clinician-rated outcome measure to compare the value of adding anxiety management strategies to exposure will be necessary to increase the efficacy of CBT for CADs to levels achieved by ERP for OCD.

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Cognitive behavioural therapy for anxiety disorders in children and adolescents

Abstract: Cognitive behavioural therapy is an effective treatment for childhood and adolescent anxiety disorders; however, the evidence suggesting that CBT is more effective than active controls or TAU or medication at follow-up, is limited and inconclusive.

Cited by 281 publications

References 127 publications

Guided parent‐delivered cognitive behaviour therapy for children with anxiety disorders: Outcomes at 3‐ to 5‐year follow‐up

Guided parent‐delivered cognitive behaviour therapy for children with anxiety disorders: Outcomes at 3‐ to 5‐year follow‐up

Family Factors in the Development and Management of Anxiety Disorders

Components of Cognitive Behavioral Therapy Related to Outcome in Childhood Anxiety Disorders

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