No Need to Worry: The Promising Future of Child Anxiety Research

Abstract

Looking ahead, we review two themes concerning the treatment of youth anxiety: treatment personalization and its dissemination and implementation (DI). Anxious youth can be effectively treated, but not all youth respond, suggesting the need to further adapt, or personalize, interventions for nonresponders. Treatment personalization may benefit from increased knowledge of social phobia, modular and transdiagnostic treatments, and active mechanisms of change. Further, despite the availability of efficacious treatments, they remain underutilized in the community. DI needs to overcome concerns regarding treatment manuals, social and organizational factors, therapist training, and reaching underserved populations. Finally, computer-based programs can facilitate dissemination through both treating anxious youth and training therapists.

Evidence Base Update: 50 Years of Research on Treatment for Child and Adolescent Anxiety

“…Several researchers (e.g., Chorpita & Daleiden, 2014;Kazdin & Blasé, 2011) point out that we are unlikely to have a codified treatment manual for every possible context encountered in reducing mental health symptoms such as anxiety. Thus, consistent with recommendations previously presented in this journal (e.g., Kendall et al, 2012), the sooner we develop a strong theory of change paired with a structured messaging strategy to allow that theory to guide practice, the sooner we can incorporate theory into the inevitable real-time design and adaptation of treatments. Just as manuals represent a structure for delivering knowledge obtained from randomized trials, there ought to be a similar guiding structure that is theory driven but equally grounded in experimental research.…”

“…Thus, rates of treatment success with a given anxiety disorder are often reported in youth diagnosed with more than one anxiety disorder. However, Kendall et al (2012) suggested several factors that can influence individual treatment outcome, including the presence of comorbid internalizing disorders (e.g., , and recommended further consideration of the effects of comorbid disorders on anxiety treatment outcomes given that such research will enhance our ability to specifically tailor interventions to meet individual presentations. Indeed, although some evidence has suggested that a diagnosis of social anxiety disorder is associated with less optimal treatment outcomes (Crawley, Beidas, Benjamin, Martin, & Kendall, 2008), this might be associated with this particular anxiety disorder's high rate of comorbidity with affective disorders , again underscoring the need for further study into differential treatment effects for the anxiety disorders and the effects of comorbidity, homo-, and heterotypic on treatment outcomes.…”

“…A subsequent study replicated this finding such that in a new sample, changes in anxious self-statements mediated treatment outcome, as assessed by youth-reported symptoms of anxiety . Indeed, previous reviews of the child and adolescent anxiety literature in this journal (e.g., Kendall, Settipani, & Cummings, 2012) have recommended further examination of mediators of treatment outcome in an effort to better understand the mechanisms of change underlying empirically supported treatments while enhancing our ability to tailor these interventions to match specific presenting features of the individual client (i.e., ''personalization''). However, rather than examining only internal youth variables such as cognitions or self-statements, it is also recommended that efforts to augment treatment personalization include examinations of therapy process variables such as therapist characteristics and behaviors, collaboration between the therapist and the youth, and the degree of youth involvement in sessions .…”

The prevention of childhood anxiety and promotion of resilience among preschool-aged children: a universal school based trial

“…This practice also increases maintenance of these skills due to the sustained daily contact with children, peer support and inclusion of social and emotional skill development as part of standard curriculum. Furthermore, this approach may neutralize many pragmatic and perceptual barriers to accessing community-based mental health services (Kendall, Settipani, & Cummings, 2012) and represents an ideal context to practice and perfect skill acquisition (Barrett & Pahl, 2006). Although there is a need for early intervention models, the effectiveness of such intervention protocols for younger children remains largely unknown (Egger & Angold, 2006;Eley et al, 2003;Spence, Rapee, McDonald, & Ingram, 2001;Sterba, Egger, & Angold, 2007), which highlights a need for a prevention programme with established effectiveness in this population.…”

Use of Evidence-Based Survey Methods to Explore Early Elementary School Teachers’ Approaches to Managing Student Anxiety

“…It is linked to dysfunction within family relationships, school environments, and peer interactions (Rapee, Schniering, & Hudson, 2009;Wood, 2006). Experts contend that it is often difficult to treat mental illness after the fact, suggesting it is much more effective to prevent mental health challenges rather than try to manage them after they have manifested (Doll & Cummings, 2008;Donovan & Spence, 2000;Kendall, Settipani, & Cummings, 2012;National Association of School Psychologists, 2009). Thus, a focus on mental health prevention, rather than providing treatment solely after illnesses become established is both practically more resource efficient and clinically more effective.…”