Stepped care cognitive behavioural therapy for children with anxiety disorders: a new treatment approach.

Abstract:

BACKGROUND:The current nonrandomized clinical trial explored changes over time in children with an anxiety disorder during stepped care, manual-based cognitive behaviour therapy (CBT). METHODS:Clinically anxious children (8-12 years, n = 133) and their parents participated in child focused CBT (10 sessions). If assessments indicated additional treatment was necessary, participants could step up to a second and possibly third treatment phase (each 5 sessions) including more parental involvement. RESULTS:After the first treatment phase 45% of the Intention-To-Treat sample was free of any anxiety disorder; after the second and third phase an additional 17% and 11% respectively. In total, 74% of the children no longer met criteria for any anxiety disorder following treatment. Child and parent reported anxiety and depression symptoms of children improved significantly during all treatment phases, as well as child reported anxiety sensitivity and negative affect. Children participating in more treatment showed significant improvements during additional treatment phases, indicating that late change occurred for the subgroup that had not changed during the first phase. CONCLUSIONS:Stepped care offers a standardized, assessment based, yet tailored treatment approach for children with anxiety disorders. A more intensive treatment is offered when initial CBT is insufficient, providing children additional opportunities to reach the desired outcome.

journal_name

Behav Cogn Psychother

authors

van der Leeden AJ,van Widenfelt BM,van der Leeden R,Liber JM,Utens EM,Treffers PD

doi

10.1017/S1352465810000500

subject

Has Abstract

pub_date

2011-01-01 00:00:00

pages

55-75

issue

1

eissn

1352-4658

issn

1469-1833

pii

S1352465810000500

journal_volume

39

pub_type

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