Journal Mobile Options
Table of Contents
Vol. 76, No. 1, 2007
Issue release date: December 2006
Section title: Special Article
Psychother Psychosom 2007;76:15–24
(DOI:10.1159/000096361)

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

Do you have an account?

Register and profit from personalized services (MyKarger) Login Information

Please create your User ID & Password





Contact Information









I have read the Karger Terms and Conditions and agree.

Register and profit from personalized services (MyKarger) Login Information

Please create your User ID & Password





Contact Information









I have read the Karger Terms and Conditions and agree.

To view the fulltext, please log in

To view the pdf, please log in

Buy

  • FullText & PDF
  • Unlimited re-access via MyKarger (new!)
  • Unrestricted printing, no saving restrictions for personal use
  • Reduced rates with a PPV account
read more

Direct: USD 38.00
Account: USD 26.50

Select

Rent/Cloud

  • Rent for 48h to view
  • Buy Cloud Access for unlimited viewing via different devices
  • Synchronizing in the ReadCube Cloud
  • Printing and saving restriction apply

Rental: USD 8.50
Cloud: USD 20.00

Select

Subscribe

  • Automatic perpetual access to all articles of the subscribed year(s)
  • Unlimited re-access via Subscriber Login or MyKarger
  • Unrestricted printing, no saving restrictions for personal use
read more

Subcription rates


Select


Article / Publication Details

First-Page Preview
Abstract of Special Article

Published online: 12/8/2006

Number of Print Pages: 10
Number of Figures: 0
Number of Tables: 2

ISSN: 0033-3190 (Print)
eISSN: 1423-0348 (Online)

For additional information: http://www.karger.com/PPS

Abstract

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.


Article / Publication Details

First-Page Preview
Abstract of Special Article

Published online: 12/8/2006

Number of Print Pages: 10
Number of Figures: 0
Number of Tables: 2

ISSN: 0033-3190 (Print)
eISSN: 1423-0348 (Online)

For additional information: http://www.karger.com/PPS


Copyright / Drug Dosage

Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher or, in the case of photocopying, direct payment of a specified fee to the Copyright Clearance Center.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in goverment regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.

References

  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.