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Table of Contents
Vol. 76, No. 1, 2007
Issue release date: December 2006
Psychother Psychosom 2007;76:15–24

Psychotherapy of Childhood Anxiety Disorders: A Meta-Analysis

In-Albon T. · Schneider S.
Department of Clinical Child and Adolescent Psychology, University of Basel, Basel, Switzerland

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Background: The present study compared the efficacy of psychotherapy for childhood anxiety disorders (excluding trials solely treating post-traumatic stress disorder or obsessive-compulsive disorder). Methods: 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. Results: 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. Conclusions: 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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  1. Anderson JC, Williams S, McGee R, Silva W: DSM-III disorders in preadolescent children. Arch Gen Psychiatry 1987;44:69–76.
  2. Steinhausen HC, Metzke CW, Meier M, Kannenberg R: Prevalence of child and adolescent psychiatric disorders: the Zürich epidemiological study. Acta Psychiatr Scand 1998;98:262–271.
  3. Twenge JM: The age of anxiety? Birth cohort change in anxiety and neuroticism, 1952–1993. J Pers Soc Psychol 2000;79:1007–1021.
  4. Brückl TM, Wittchen H-U, Höfler M, Pfister H, Schneider S, Lieb R: Childhood separation anxiety and the risk of subsequent psychopathology: results from a community study. Psychother Psychosom 2007;76:47–56.
  5. Woodward LJ, Fergusson DM: Life course outcomes of young people with anxiety disorders in adolescence. J Am Acad Child Adolesc Psychiatry 2001;40:1086–1093.
  6. Goodwin RD, Fergusson DM, Horwood LJ: Panic attacks and the risk of depression among young adults in the community. Psychother Psychosom 2004;73:158–165.
  7. Sensky T: The effectiveness of cognitive therapy for schizophrenia: what can we learn from the meta-analyses? Psychother Psychosom 2005;74:131–135.
  8. Casey RJ, Berman JS: The outcome of psychotherapy with children. Psychol Bull 1985;98:388–400.
  9. Weisz JR, Weiss B, Alicke MD, Klotz ML: Effectiveness of psychotherapy with children and adolescents: a meta-analysis for clinicians. J Consult Clin Psychol 1987;55:542–549.
  10. Weisz JR, Weiss B, Han S, Granger DA, Morton T: Effects of psychotherapy with children and adolescents revisited: a meta-analysis of treatment outcome studies. Psychol Bull 1995;117:450–468.
  11. Altman DG: Better reporting of randomized controlled trials: the CONSORT statement (editorial). BMJ 1996;31:570–571.
  12. Altman DG, Schulz KF, Moher D, Egger M, Davidoff F, Elbourne D, Gotzsche PC, Lang T: The revised CONSORT statement for reporting randomized trials: explanation and elaboration. Ann Intern Med 2001;134:663–694.
  13. Compton SN, March JS, Brent D, Albano AM, Weersing VR, Curry J: Cognitive-behavioral psychotherapy for anxiety and depressive disorders in children and adolescents: an evidence-based medicine review. J Am Acad Child Adolesc Psychiatry 2004;43:930–959.
  14. Cartwright-Hatton S, Roberts C, Chitsabesan P, Fothergill C, Harrington R: Systematic review of the efficacy of cognitive behaviour therapies for childhood and adolescent anxiety disorders. Br J Clin Psychol 2004;43:421–436.
  15. Cohen J, March JS, Berliner L: Treatment of PTSD in children and adolescents; in Foa EB, Davidson J, Keane T (eds): Effective Treatments for PTSD. New York, Guilford, pp 106–138.
  16. Franklin ME, Rynn M, March JS, Foa EB: Obsessive-compulsive disorder; in Hersen M (ed): Clinical Behavior Therapy: Adults and Children. New York, Wiley, pp 276–303.
  17. Abramowitz JS, Whiteside SP, Deacon BJ: The effectiveness of treatment for pediatric obsessive-compulsive disorder: a meta-analysis. Behav Ther 2005;3:55–63.

    External Resources

  18. Target M, Fonagy P: Efficacy of psychoanalysis for children with emotional disorders. J Am Acad Child Adolesc Psychiatry 1994;33:361–371.
  19. Cohen J: A power primer. Psychol Bull 1992;112:155–159.
  20. Rosenthal R: Meta-Analytic Procedure for Social Research. Beverly Hills, Sage, 1984.
  21. Orwin RG: A fail safe N for effect size in meta-analysis. J Educ Stat 1983;8:157–159.

    External Resources

  22. Silverman WK, Albano AM: The Anxiety Interview Schedule for DSM-IV, Child and Parents Versions. Albany, Graywind, 1996.
  23. Albano AM, Silverman WK: Clinicians Guide to the Anxiety Disorders Interview Schedule for DSM-IV, Child Version. Boulder, Graywind, 1996.
  24. Silverman WK, Kurtines WM, Ginsburg GS, Weems CF, Lumpkin PW, Carmichael DH: Treating anxiety disorders in children with group cognitive-behavioral therapy: a randomized clinical trial. J Consult Clin Psychol 1999;67:995–1003.
  25. Reynolds CR, Richmond BO: Revised Children’s Manifest Anxiety Scale (RCMAS): Manual. Los Angeles, Western Psychological Service, 1985.
  26. Rabian B: Revised children’s manifest anxiety scale; in Keyser DJ, Sweetland RC (eds): Test Critiques. Austin, Pro-Ed, pp 593–599.
  27. Ollendick TH: Reliability and validity of the Revised Fear Survey Schedule for Children (FSSC-R). Behav Res Ther 1983;21:685–692.
  28. Kovacs M: Rating scales to assess depression in school aged children. Acta Paedopsychiatr 1981;46:305–315.
  29. Kazdin AE, French H, Unis A, Esveldt-Dawson K, Sherick R: Hopelessness, depression, and suicidal intent among psychiatrically disturbed children. J Consul Clin Psychol 1983;51:504–510.
  30. Cohen J: Statistical Power Analysis for the Behavioral Sciences, ed 2. Hillsdale, Erlbaum, 1988.
  31. Ginsburg GS, Drake KL: School-based treatment for anxious African-American adolescents: a controlled pilot study. J Am Acad Child Adolesc Psychiatry 2002;41:768–775.
  32. Baer S, Garland EJ: Pilot study of community-based cognitive behavioral group therapy for adolescents with social phobia. J Am Acad Child Adolesc Psychiatry 2005;44:258–264.
  33. Beidel DC, Turner SM, Morris TL: Behavioral treatment of childhood social phobia. J Consult Clin Psychol 2000;68:1072–1080.
  34. Last CG, Hansen C, Franco N: Cognitive-behavioral treatment of school phobia. J Am Acad Child Adolesc Psychiatry 1998;37:404–411.
  35. Silverman WK, Kurtines WM, Ginsburg GS, Weems CF, Rabian B, Serafini LT: Contingency management, self-control, and education support in the treatment of childhood phobic disorders: a randomized clinical trial. J Consult Clin Psychol 1999;67:675–687.
  36. Muris P, Meesters C, van Melick: Treatment of childhood anxiety disorders: a preliminary comparison between cognitive-behavioral group therapy and a psychological placebo intervention. J Behav Ther Exp Psychiatry 2002;33:143–158.
  37. Manassis K, Mendlowitz SL, Scapillato D, Avery D, Fiksenbaum L, Freire M, Monga S, Owens M: Group and individual cognitive-behavioral therapy for childhood anxiety disorders: a randomized trial. J Am Acad Child Adolesc Psychiatry 2002;41:1423–1430.
  38. Muris P, Mayer B, Bartelds E, Tierney S, Bogie N: The revised version of the Screen for Child Anxiety Related Emotional Disorders (SCARED-R): treatment sensitivity in an early intervention for childhood anxiety disorders. Br J Clin Psychol 2001;40:323–336.
  39. Mendlowitz SL, Manassis K, Bradley S, Scapillato D, Miezitis S, Shaw BF: Cognitive-behavioral group treatments in childhood anxiety disorders: the role of parental involvement. J Am Acad Child Adolesc Psychiatry 1999;38:1223–1229.
  40. Barrett PM, Duffy Al, Dadds MR, Rapee RM: Cognitive-behavioral treatment of anxiety disorders in children: long-term (6-year) follow-up. J Consult Clin Psychol 2001;69:135–141.
  41. Kendall PC, Southam-Gerow MA: Long-term follow-up of a cognitive-behavioral therapy for anxiety-disordered youth. J Consult Clin Psychol 1996;64:724–730.
  42. Kendall PC, Safford S, Flannery-Schröder E, Webb A: Child anxiety treatment: outcomes in adolescence and impact on substance abuse and depression at 7.4 year follow-up. J Consult Clin Psychol 2004;72:276–287.
  43. Barrett PM, Dadds MR, Rapee RM: Family treatment of childhood anxiety: a controlled trial. J Consult Clin Psychol 1996;64:333–342.
  44. Cobham VE, Dadds MR, Spence SH: The role of parental anxiety in the treatment of childhood anxiety. J Consult Clin Psychol 1998;66:893–905.
  45. Heyne D, King NJ, Tonge BJ, Rollings S, Young D, Pritchard M, Ollendick TH: Evaluation of child therapy and caregiver training in the treatment of school refusal. J Am Acad Child Adolesc Psychiatry 2002;41:687–695.
  46. Spence SH, Donovan C, Brechman-Tooussaint M: The treatment of childhood social phobia: the effectiveness of a social skills training-based, cognitive-behavioral intervention, with and without parental involvement. J Child Psychol Psychiatry 2000;41:713–726.
  47. Nauta MH, Scholing A, Emmelkamp PMG, Minderaa RB: Cognitive-behavioral therapy for children with anxiety disorders in a clinical setting: no additional effect of a cognitive parent training. J Am Acad Child Adolesc Psychiatry 2003;42:1270–1278.
  48. Barrett PM: Evaluation of cognitive-behavioral group treatments for childhood anxiety disorders. J Clin Child Psychol 1998;27:459–468.
  49. Kazdin AE, Bass D, Ayers WA, Rodgers A: Empirical and clinical focus of child and adolescent psychotherapy research. J Consult Clin Psychol 1990;58:729–740.
  50. Hayward C, Varady S, Albano AM, Thienemann M, Henderson L, Schatzberg AF: Cognitive-behavioral group therapy for social phobia in female adolescents: results of a pilot study. J Am Acad Child Adolesc Psychiatry 2000;39:721–726.
  51. Gallagher HM, Rabian BA, McCloskey MS: A brief group cognitive-behavioral intervention for social phobia in childhood. J Anxiety Disord 2004;18:459–479.
  52. Flannery-Schroeder EC, Kendall PC: Group and individual cognitive-behavioral treatments for youth with anxiety disorders: a randomized clinical trial. Cogn Ther Res 2000;24:251–278.

    External Resources

  53. Kendall PC: Treating anxiety disorder in children: results of a randomized clinical trial. J Consult Clin Psychol 1994;62:100–110.
  54. Kendall PC, Flannery-Schrieder E, Panichelli-Mindel SM, Southam-Gerow M, Henin A, Warman M: Therapy for youths with anxiety disorders: a second randomized clinical trial. J Consult Clin Psychol 1997;65:366–380.
  55. King NJ, Tonge BJ, Heyne D, Pritchard M, Rollings S, Young D, Myerson N, Ollendick TH: Cognitive-behavioral treatment of school-refusing children: a controlled evaluation. J Am Acad Child Adolesc Psychiatry 1998;37:395–403.
  56. Rapee RM: Group treatment of children with anxiety disorders: outcome and predictors of treatment response. Aust J Psychol 2000;52:125–129.

    External Resources

  57. Silverman WK, Kurtines WM, Ginsburg GS, Weems CF, Lumpkin PW, Carmichael DH: Treating anxiety disorders in children with group cognitive-behavioral therapy: a randomized clinical trial. J Consult Clin Psychol 1999;67:995–1003.
  58. Toren P, Wolmer L, Rosental B, Eldar S, Koren S, Lask M, Weizman R, Laor N: Case series: brief parent-child group therapy for childhood anxiety disorders using a manual-based cognitive-behavioral technique. J Am Acad Child Adolesc Psychiatry 2000;39:1309–1312.
  59. Blonk RWB, Prins PJM, Sergeant JA: Cognitive-behavioral group therapy for socially incompetent children: short-term and maintenance effects with a clinical sample. J Clin Child Psychol 1996;25:215–224.
  60. Crawford AM, Manassis K: Familial predictors of treatment outcome in childhood anxiety disorders. J Am Acad Child Adolesc Psychiatry 2001;40:1182–1190.
  61. Eisen AR, Silverman WK: Prescriptive treatment for generalized anxiety disorder in children. Behav Ther 1998;29:105–121.

    External Resources

  62. Howard BL, Kendall PC: Cognitive-behavioral family therapy for anxiety-disordered children: a multiple-baseline evaluation. Cogn Ther Res 1996;20:423–443.

    External Resources

  63. Joormann J, Unnewehr S: Eine kontrollierte Studie zur Wirksamkeit einer kognitiv-verhaltenstherapeutischen Gruppentherapie bei Kindern und Jugendlichen mit Sozialer Phobie. Z Klin Psychol Psychother 2002;31:284–290.

    External Resources

  64. Léger E, Ladouceur R, Dugas MJ, Freeston MH: Cognitive-behavioral treatment of generalized anxiety disorder among adolescents: a case series. J Am Acad Child Adolesc Psychiatry 2003;42:327–330.
  65. Lumpkin PW, Silverman WK, Weems CF: Treating a heterogeneous set of anxiety disorders in youths with group cognitive behavioural therapy: a partially nonconcurrent multiple-baseline evaluation. Behav Ther 2002;33:163–177.

    External Resources

  66. Masia CL, Klein RG, Storch EA, Corda B: School-based behavioral treatment for social anxiety disorder in adolescents: results of a pilot study. J Am Acad Child Adolesc Psychiatry 2001;40:780–786.
  67. Shortt AL, Barrett PM, Fox TL: Evaluating the FRIENDS program: a cognitive-behavioral group treatment for anxious children and their parents. J Clin Child Psychol 2001;30:525–535.
  68. Southam-Gerow MA, Kendall PC, Weersing VR: Examining outcome variability: correlates of treatment response in a child and adolescent anxiety clinic. J Clin Child Psychol 2001;30:422–436.
  69. Svensson L, Larsson A, Öst LG: How children experience brief-exposure treatment of specific phobias. J Clin Child Adolesc Psychol 2002;31:80–89.
  70. Simons M, Schneider S, Herpertz-Dahlmann B: Metacognitive therapy for pediatric obsessive-compulsive disorder: a randomized pilot study. Psychother Psychosom, in press.
  71. Kraemer HC, Measelle JR, Ablow JC, Essex MJ, Boyce WT, Kupfer DJ: A new approach to integrating data from multiple informants in psychiatric assessment and research: mixing and matching contexts and perspectives. Am J Psychiatry 2003;160:1566–1577.

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