The impact of treatment delivery format on response to cognitive behaviour therapy for preadolescent children with anxiety disorders.

Journal: Journal of child psychology and psychiatry, and allied disciplines

Volume: 59

Issue: 7

Year of Publication: 2019

Affiliated Institutions:  Department of Psychology, Centre for Emotional Health, Macquarie University, Sydney, NSW, Australia. Department of Biological and Experimental Psychology, School of Biological and Chemical Sciences, Queen Mary University of London, London, UK. Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK. School of Psychology, University of Sussex, Brighton, UK. Department of Psychology and Behavioural Sciences, Aarhus University, Aarhus, Denmark. Research Institute Child Development and Education, University of Amsterdam, Amsterdam, The Netherlands. School of Psychology and Clinical Language Sciences, University of Reading, Reading, UK. Department of Psychiatry, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands. Department of Clinical Psychology, Faculty of Psychology, University of Bergen, Bergen, Norway. Department of Psychology, University Landau Koblenz, Landau, Germany. Department of Psychology, Ruhr-Universität Bochum, Bochum, Germany. Department of Psychology, Institute of Psychiatry, King's College London, London, UK. Department of Psychology, University of East Anglia, Norwich, UK. Department of Clinical Psychology and Experimental Psychopathology, University of Groningen, Groningen, The Netherlands. Department of Psychology, Child Anxiety and Phobia Program, Florida International University, Miami, FL, USA. Child Study Center, School of Medicine, Yale University, New Haven, CT, USA. Department of Child and Adolescent Psychiatry, Anxiety Disorders Research Network, Haukeland University Hospital, Bergen, Norway.

Abstract summary 

Several delivery formats of cognitive behaviour therapy (CBT) for child anxiety have been proposed, however, there is little consensus on the optimal delivery format. The primary goal of this study was to investigate the impact of the child's primary anxiety diagnosis on changes in clinical severity (of the primary problem) during individual CBT, group CBT and guided parent-led CBT. The secondary goal was to investigate the impact of the child's primary anxiety diagnosis on rates of remission for the three treatment formats.A sample of 1,253 children (5-12 years; Mage = 9.3, SD = 1.7) was pooled from CBT trials carried out at 10 sites. Children had a primary diagnosis of generalised anxiety disorder (GAD), social anxiety disorder (SoAD), specific phobia (SP) or separation anxiety disorder (SAD). Children and parents completed a semistructured clinical interview to assess the presence and severity of DSM-IV psychiatric disorders at preintervention, postintervention and follow-up. Linear mixture modelling was used to evaluate the primary research question and logistic modelling was used to investigate the secondary research question.In children with primary GAD, SAD or SoAD, there were no significant differences between delivery formats. However, children with primary SP showed significantly larger reductions in clinical severity following individual CBT compared to group CBT and guided parent-led CBT. The results were mirrored in the analysis of remission responses with the exception that individual CBT was no longer superior to group CBT for children with a primary SP. The difference between individual and group was not significant when follow-up data were examined separately.Data show there may be greater clinical benefit by allocating children with a primary SP to individual CBT, although future research on cost-effectiveness is needed to determine whether the additional clinical benefits justify the additional resources required.

Authors & Co-authors:  McKinnon Anna A Keers Robert R Coleman Jonathan R I JRI Lester Kathryn J KJ Roberts Susanna S Arendt Kristian K Bögels Susan M SM Cooper Peter P Creswell Cathy C Hartman Catharina A CA Fjermestad Krister W KW In-Albon Tina T Lavallee Kristen K Lyneham Heidi J HJ Smith Patrick P Meiser-Stedman Richard R Nauta Maaike H MH Rapee Ronald M RM Rey Yasmin Y Schneider Silvia S Silverman Wendy K WK Thastum Mikael M Thirlwall Kerstin K Wergeland Gro Janne GJ Eley Thalia C TC Hudson Jennifer L JL

Study Outcome 

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Statistics
Citations :  Creswell, C. , Violato, M. , Fairbanks, H. , White, E. , Parkinson, M. , Abitabile, G. , … & Cooper, P.J. (2017). Clinical outcomes and cost‐effectiveness of brief guided parent‐delivered cognitive behavioural therapy and solution‐focused brief therapy for treatment of childhood anxiety disorders: A randomised controlled trial. The lancet. Psychiatry, 4, 529–539.
Authors :  26
Identifiers
Doi : 10.1111/jcpp.12872
SSN : 1469-7610
Study Population
Male,Female
Mesh Terms
Anxiety Disorders
Other Terms
Anxiety;cognitive therapy;treatment trials
Study Design
Cross Sectional Study
Study Approach
Country of Study
Publication Country
England