A Meta-analysis to Guide the Enhancement of CBT for Childhood Anxiety: Exposure Over Anxiety Management

A Meta-analysis to Guide the Enhancement of CBT for Childhood Anxiety: Exposure Over Anxiety Management

Authors
Whiteside, S. P. H. Sim, L. A. Morrow, A. S. Farah, W. H. Hilliker, D. R. Murad, M. H. Wang, Z.
Year
2019
Journal
Clinical Child & Family Psychology Review
Volume
18
Pages
18
Cognitive behavior therapy (CBT) is the most empirically supported therapy for childhood anxiety disorders (CADs) but has not reliably outperformed other credible interventions. The current study used meta-analysis to examine the frequency with which the most common treatment components are included in outcome studies and the relation of these components to symptom improvement. Seventy-five studies were identified that included youth with an anxiety disorder treated with CBT or a comparison condition. The protocols for the 111 CBT conditions generally consisted of 12, 1-h sessions delivered to the child with minimal parent inclusion. A greater amount of in-session exposure was related to significantly larger effect sizes between CBT and waitlist control across reporters (- 0.12 to - 0.15; P's < .05) and from pre- to post-treatment for child report (- .06; P < .01). Compared to treatments that omitted relaxation, treatments that included relaxation strategies were associated with significantly smaller pre- to post-treatment effect sizes across reporters (0.38 to 0.80; P's < .05). The current study suggests that CBT protocols for CADs that emphasize in-session exposure and do not include relaxation have the potential to improve the efficacy and effectiveness of therapy. Dismantling studies directly testing these hypotheses are needed.

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Type of intervention

Treatment and Child Welfare Interventions

Topic

Mental Health Problems and Disorders

Anxiety Problems

Anxiety and Anxiousness

Phobias

Intervention

Psychological Treatments

Cognitive Behavioral Therapy, Behavioral Therapy and Cognitive Therapy

Age group

Preschool Aged Children (3-5 years)

School Aged Children (6-12 years)

Adolescents (13-18 years)

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