Article

Psychotherapy of Childhood Anxiety Disorders: A Meta-Analysis

Department of Clinical Child and Adolescent Psychology, University of Basel, Basel, Switzerland.
Psychotherapy and Psychosomatics (Impact Factor: 9.2). 02/2007; 76(1):15-24. DOI: 10.1159/000096361
Source: PubMed

ABSTRACT

The present study compared the efficacy of psychotherapy for childhood anxiety disorders (excluding trials solely treating post-traumatic stress disorder or obsessive-compulsive disorder).
The meta-analysis included studies that met the basic CONSORT (consolidated standards of reporting trials) criteria. Several outcome variables (e.g. effect sizes, percentage of recovery) were analyzed using completer and intent-to-treat analyses during post-treatment and follow-up assessment. Twenty-four studies published by March 2005 were included in this meta-analysis.
In all the included studies, the active treatment condition was cognitive-behavioral. The overall mean effect of treatment was 0.86. No differences in outcome were found between individual and group treatments or child- and family-focused treatments. Follow-up data demonstrated that treatment gains were maintained up to several years after treatment.
These findings provide evidence that anxiety disorders in children can be treated efficaciously. The gathered data support the clinical utility of cognitive-behavioral therapy in this regard. Randomized controlled trial studies investigating treatments other than cognitive-behavioral therapy are missing.

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    • "Auch sprechen trotz ihrer prinzipiellen Wirksamkeit nicht alle Angstpatienten gleichermaßen auf KVT an. So werden selbst nach erfolgreicher Therapie bei Kindern und Jugendlichen Rückfallraten von bis zu 44% berichtet [In-Albon und Schneider, 2006]. Daher versuchen aktuelle Forschungsansätze die Wirkfaktoren von KVT zu identifizieren – also quasi die aktiven «Zutaten» der Therapie –, um diese dann gezielt zur Steigerung des Behandlungserfolgs einzusetzen . "

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    • "The meta-analysis reported 55.4% of all children who had been enrolled in manualized CBT to be free of their primary anxiety disorder at posttreatment (Albon and Schneider, 2007). In our study, the corresponding number was 50%. "
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    ABSTRACT: Background: Little is known about the effect of case-formulation based cognitive behaviour therapy (CBT) for anxious children. Aim: The present study explores the feasibility of case-formulation driven CBT for anxious children. Parents were involved in treatment as either co-facilitators (involved only as the child's assistants, treatment being primarily directed at the child), or as co-clients (parents received therapy targeting theoretically established maintaining mechanisms; children received half of the sessions, parents the other half). Method: Feasibility of the case-formulation driven CBT was established by comparing the completion rate and the percentage of children free of anxiety after treatment, with manualized treatments reported in existing meta-analyses. Children aged 7-12 years and their parents participated (n = 54). Families were assessed at pre- and posttreatment and at 6-month follow-up. Results: All families completed treatment and the percentage of recovery in the case-formulation driven approach was comparable to results obtained in manualized treatments. Conclusion: The findings from this stage I study supports the notion that a case-formulation driven approach to CBT may be a feasible option when selecting treatment for anxious children; however, further studies must be conducted before firm conclusions can be drawn.
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    • "Note also that Sofronoff et al. (2005) found that for the treatment of anxiety in children with Asperger, active parental involvement enhanced the effects of this intervention. Contradictory, in typically developing children with anxiety disorders an additional effect of a family component is not always found (e.g., In-Albon and Schneider 2007; Bodden et al. 2008); however, those studies did not explore the possible role of ASD traits. "
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    ABSTRACT: The aim of this study was to examine ASD traits in children with clinical anxiety in early development, as well as current manifestations. Parents of 42 children with an anxiety disorder (but no known diagnosis of ASD) and 42 typically developing children were interviewed using the Autism Diagnostic Interview (ADI-R). They also completed questionnaires that assessed child anxiety (SCARED-71) and children's ASD symptoms. Results revealed that children with anxiety disorders had higher scores than typically developing children, for both ASD traits in early development as well as current ASD symptoms. A specific association was found between symptoms of Social Anxiety Disorder and ASD traits early in life. Findings are considered in terms of clinical implications, and limitations are discussed.
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