Brief Cognitive-Behavioural Therapy for Children with Anxiety Disorders: Initial Evaluation of a Program Designed for Clinic Settings

Abstract

Four anxiety disordered 8- to 11-year-old children and their parents participated in a shortened version of an efficacious cognitive–behavioural program for anxiety in children, designed to reflect therapy conditions found in usual clinical practice. A modified multiple-baseline design was used that combined clinic setting pragmatics with a necessary level of methodological protection. For ongoing evaluation, weekly measures of the child's trait anxiety and coping ability were obtained from the child and parents. In addition, a battery of measures was used to evaluate outcomes following treatment and at two follow-up intervals. Emphasising increased parent involvement and earlier exposure sessions, the program was found to lead to marked changes in child functioning. In particular, all children showed improvement on self-report, parent report, and independent clinician's ratings over the course of treatment. Moreover, scores on relevant indices were all within a nondeviant range following intervention, and all four children no longer qualified for an anxiety diagnosis at posttreatment and at 3- and 12-month followup. Findings are discussed in terms of implementation and evaluation in practice settings (e.g., critical components of treatment, use of pragmatic single case designs). Suggestions for future research include testing the effectiveness of this brief program on a large and diverse sample of children. Additional research is also required to find out to what extent increased parent involvement and earlier exposure sessions enhance the impact of treatment in the larger context of addressing features of the research-practice gap. Overall, findings provide preliminary support for the effectiveness of a brief cognitive–behavioural program for treating anxiety disorders in children, along with an evaluation strategy, compatible with some of the needs of service delivery settings.