Effectiveness of a cognitive-behavioral therapy (CBT) manualized program for clinically anxious children: study protocol of a randomized controlled trial

Abstract

BackgroundIn the Netherlands, the prevalence of anxiety disorders is 20%; and children with anxiety are at increased risk for psychopathology throughout adulthood. Recently, a revised version of a cognitive behavioral therapy manualized program called 'Thinking + Doing = Daring' (TDD) was developed for children between 8 and 12 years old with an anxiety disorder. The main aim of this project is to conduct a Randomized Controlled Trial (RCT) to evaluate the effectiveness of TDD.Methods/DesignThe CBT program will be tested with a RCT with 120 clinically anxious children (8-12 years old) referred to one of three mental health care agencies. Children will be randomly assigned to the experimental (N = 60, TDD) or to the control condition (N = 60, treatment as usual). The primary outcome measure will be the child's anxiety symptoms level. Secondary outcome measures will be externalizing (e.g. aggression) and internalizing problems (e.g. depression). Two potential mediators of change will be examined in the current study: therapeutic alliance and parenting. Mother and child in both the experimental and control condition will be surveyed at baseline, post treatment and after 6 and 12 months (follow-up). It is hypothesized that children in the experimental condition will show a stronger decrease in anxiety symptoms compared to children that receive treatment as usual. Moreover, we expect that a strong therapeutic alliance and decreases in parental control and rejection will contribute to treatment success.DiscussionEarly treatment for anxiety problems has the potential to not only result in anxiety reductions, but also to prevent future problems such as substance abuse and psychopathology throughout adulthood. Our results will be immediately relevant to practice, since we are partnering with 'real world' community agencies. If the CBT program proves more effective than treatment as usual, it could be implemented in community mental health care agencies across the Netherlands and beyond. Moreover, it has the potential to make treatment in these community settings shorter, more efficient and therefore cost-effective. Trial registration: Nederlands Trial Register NTR2967

Measuring Anxiety in Children: The Importance of Separate Mother and Father Reports

“…The data in this study originated from a larger study (Jansen et al 2012 ) which investigated the effectiveness of an individual CBT program called Thinking + Doing = Daring ( Denken + Doen = Durven ; Bögels 2008 ). In the current study, three groups were initially planned to be investigated: Participants in the clinically anxious group (1) were 81 mothers and 55 (68%) fathers of clinically referred children with an anxiety disorder.…”

Mind and body: how the health of the body impacts on neuropsychiatry

“…Autoimmune disease, for example rheumatoid arthritis, is also associated with markedly elevated risk of depression (Margaretten et al, 2011a; Covic et al, 2012). Notably, there appears to be a strong correlation between the severity of rheumatoid arthritis and the incidence of depression, with a recent meta-analysis demonstrating that those with the most severe form of arthritic disease have a six-fold higher incidence of depression relative to those with the mildest form Godha et al (2010).…”

Are changes in children's communication patterns predictive of treatment outcomes for children with anxiety?

“…Children were given small gifts for participating in the study, and families received €15 after completing the postassessment. Ethical approval has been granted for the original study of Jansen et al () by the ethical committee of the Faculty of Social Sciences, Radboud University ( ECG16122010 ).…”

“…The general aim of this study was to investigate changes in children's communication patterns and whether these changes were associated with successful treatment outcomes in children with anxiety following a protocolized CBT program. Data were taken from a randomized controlled trial in which the effectiveness of the manualized CBT program developed by Bögels () was evaluated against treatment as usual (see Jansen et al, , for study protocol and Van Doorn, Jansen, Bodden, Lichtwarck‐Aschoff, & Granic, , for outcomes). The data were collected at Dutch mental health care agencies between January 2012 and January 2014, and results showed that the CBT program was generally effective although outcomes did not differ between conditions (Van Doorn et al, ).…”