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Group and Individual Cognitive-Behavioral Treatments for Youth with Anxiety Disorders: A Randomized Clinical Trial

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Abstract

Children (aged 8–14 years) with anxiety disorders were randomly assigned to cognitive-behavioral individual treatment, cognitive-behavioral group treatment, or a wait-list control. Treatment outcome was evaluated using diagnostic status, child self-reports, and parent- and teacher-reports. Analyses of diagnostic status revealed that significantly more treated children (73% individual, 50% group) than wait-list children (8%) did not meet diagnostic criteria for their primary anxiety disorder at posttreatment. Other dependent measures demonstrated the superiority of both treatment conditions compared to the wait-list condition. However, a child-report of anxious distress demonstrated only the individual treatment to effect significant improvement. Measures of social functioning failed to discriminate among conditions. Analyses of clinical significance revealed that notable proportions of treated cases were returned to nondeviant limits at posttreatment. Treatment gains were maintained at a 3-month follow-up.

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REFERENCES

  • Achenbach, T. M. (1991a). Manual for the Child Behavior Checklist/4-18 and 1991 Profile. Burlington, VT: Department of Psychiatry, University of Vermont.

    Google Scholar 

  • Achenbach, T. M. (1991b). Manual for the Teacher's Report Form and 1991 Profile. Burlington, VT: Department of Psychiatry, University of Vermont.

    Google Scholar 

  • Achenbach, T. M., & Edelbrock, C. S. (1981). Behavioral problems and competencies reported by parents of normal and disturbed children aged four through sixteen. Monographs of the Society for Research in Child Development, 46 (Serial No. 188).

  • Albano, A. M., Marten, P. A., Holt, C. S., Heimberg, R. G., & Barlow, D. H. (1995). Cognitive-behavioral group treatment for social phobia in adolescents: A preliminary study. Journal of Nervous and Mental Disease, 183, 649-656.

    Google Scholar 

  • American Psychological Association Task Force on Promotion and Dissemination of Psychological Procedures (1995). Training in and dissemination of empirically-validated psychological treatments: Report and recommendations. Clinical Psychologist, 48, 3-24.

    Google Scholar 

  • Asher, S. R., Hymel, S., & Renshaw, P. D. (1984). Loneliness in children. Child Development, 55, 1456-1464.

    Google Scholar 

  • Barrett, P., Dadds, M., & Rapee, R. (1996). Family treatment of child anxiety: A controlled trial. Journal of Consulting and Clinical Psychology, 64, 333-342.

    Google Scholar 

  • Beidel, D. C. (1994). Anxiety disorders. In M. Hersen & S. M. Turner (Eds.), Diagnostic interviewing (pp. 55-77). New York: Plenum Press.

    Google Scholar 

  • Beidel, D. C., Christ, M. G., & Long, P. J. (1991). Somatic complaints in anxious children. Journal of Abnormal Child Psychology, 19, 659-670.

    Google Scholar 

  • Benjamin, R. S., Costello, E. J., & Warren, M. (1990). Anxiety disorders in a pediatric sample. Journal of Anxiety Disorders, 4, 293-316.

    Google Scholar 

  • Bernstein, G. A., & Borchardt, C. M. (1991). Anxiety disorders of childhood and adolescents: A critical review. Journal of the American Academy of Child and Adolescent Psychiatry, 30, 519-532.

    Google Scholar 

  • Bierman, K. L., & McCauley, E. (1987). Children's descriptions of their peer interactions: Useful information for clinical child assessment. Journal of Clinical Child Psychology, 16, 9-18.

    Google Scholar 

  • Brady, E. U., & Kendall, P. C. (1992). Comorbidity of anxiety and depression in children and adolescents. Psychological Bulletin, 111, 244-255.

    Google Scholar 

  • Cantwell, D. P., & Baker, L. (1989). Stability and natural history of DSM-III childhood diagnoses. Journal of the American Academy of Child and Adolescent Psychiatry, 28, 691-700.

    Google Scholar 

  • Casey, R. J., & Berman, J. S. (1985). The outcome of psychotherapy with children. Psychological Bulletin, 98, 388-400.

    Google Scholar 

  • Castaneda, A., McCandless, B. R., & Palermo, D. S. (1956). The Children's Form of the Manifest Anxiety Scale. Child Development, 27, 317-326.

    Google Scholar 

  • Chambless, D., & Hollon, S. (1998). Defining empirically supported therapies. Journal of Consulting and Clinical Psychology, 66, 7-18.

    Google Scholar 

  • Clarke, G., Hops, H., Lewinsohn, P. M., Andrews, J., Seeley, J. R., & Williams, J. (1992). Cognitive-behavioral group treatment of adolescent depression: Prediction of outcome. Behavior Therapy, 23, 341-354.

    Google Scholar 

  • Cohen, J. (1977). Statistical power analysis for behavioral sciences. New York: Academic Press.

    Google Scholar 

  • Connors, C. K. (1973). Rating scales for use in drug studies with children. Psychopharmacology bulletin: Pharmacotherapy with children. Washington, DC: U.S. Government Printing Office.

    Google Scholar 

  • Eisen, A. R., & Silverman, W. K. (1993). Should I relax or change my thoughts? A preliminary examination of cognitive therapy, relaxation training, and their combination with overanxious children. Journal of Cognitive Psychotherapy, 7, 265-279.

    Google Scholar 

  • Feehan, M., McGee, R., & Williams, S. M. (1993). Mental health disorders from age 15 to age 18 years. Journal of the American Academy of Child and Adolescent Psychiary, 32, 1118-1126.

    Google Scholar 

  • Fergusson, D. M., Horwood, L. J., & Lynskey, M. T. (1993). Prevalence and comorbidity of DSM-IIIR diagnoses in a birth cohort of 15 year olds. Journal of the American Academy of Child and Adolescent Psychiatry, 32, 1127-1134.

    Google Scholar 

  • Finch, A. J., Saylor, C. F., & Edwards, G. (1985). Children's Depression Inventory: Sex and grade norms for normal children. Journal of Consulting and Clinical Psychology, 53, 424-425.

    Google Scholar 

  • Flannery-Schroeder, E. C., & Kendall, P. C. (1996). Cognitive-behavioral therapy for anxious children: Therapist manual for group treatment. Ardmore, PA: Workbook Publishing.

    Google Scholar 

  • Harter, S. (1982). The Perceived Competence Scale for Children. Child Development, 53, 87-97.

    Google Scholar 

  • Harter, S. (1985). Manual for the Self-Perception Profile for Children. Denver, CO: University of Denver.

    Google Scholar 

  • Hartup, W. W. (1983). Peer relations. In P. Mussen (Ed.), Handbook of child psychology (pp. 103-196). New York: Wiley.

    Google Scholar 

  • Heimberg, R. G., Dodge, C. S., Hope, D. A., Kennedy, C. R., Zollo, L. J., & Becker, R. E. (1990). Cognitive behavioral group treatment for social phobia: Comparison with a credible placebo control. Cognitive Therapy and Research, 14, 1-23.

    Google Scholar 

  • Howard, B., & Kendall, P. C. (1996). Cognitive-behavioral family therapy for anxiety-disordered children: A multiple baseline evaluation. Cognitive Therapy and Research, 20, 423-443.

    Google Scholar 

  • Kane, M. T., & Kendall, P. C. (1989). Anxiety disorders in children: A multiple-baseline evaluation of a cognitive-behavioral treatment. Behavior Therapy, 20, 499-508.

    Google Scholar 

  • Kashani, J. H., & Orvaschel, H. (1990). A community study of anxiety in children and adolescents. American Journal of Psychiatry, 147, 313-318.

    Google Scholar 

  • Kazdin, A. E. (1993). Psychotherapy for children and adolescents: Current progress and future research directions. American Psychologist, 48, 644-657.

    Google Scholar 

  • Kazdin, A. E. (1996). Developing effective treatments for children and adolescents. In E. D. Hibbs & P. S. Jensen (Eds.), Psychosocial treatments for child and adolescent: Empirically based strategies for clinical practice (pp. 9-18). Washington, DC: American Psychological Association.

    Google Scholar 

  • Kazdin, A. E., Bass, D., Ayers, W. A., & Rodgers, A. (1990). Empirical and clinical focus of child and adolescent psychotherapy research. Journal of Consulting and Clinical Psychology, 58, 729-740.

    Google Scholar 

  • Kazdin, A. E., French, H., Unis, A., Esveldt-Dawson, K., & Sherick, R. (1983). Hopelessness, depression, and suicidal intent among psychiatrically disturbed children. Journal of Consulting and Clinical Psychology, 51, 504-510.

    Google Scholar 

  • Kazdin, A. E., & Weisz, J. (1998). Treating psychological problems of youth: Status of empirically supported treatments. Journal of Consulting and Clinical Psychology, 66, 19-36.

    Google Scholar 

  • Kendall, P. C. (1990). Coping cat workbook. Ardmore: PA: Workbook Publishing.

    Google Scholar 

  • Kendall, P. C. (1994). Treating anxiety disorders in children: Results of a randomized clinical trial. Journal of Consulting and Clinical Psychology, 62, 100-110.

    Google Scholar 

  • Kendall, P. C., Flannery-Schroeder, E., Panichelli-Mindel, S., Southam-Gerow, M., Henin, A., & Warman, M. (1997). Therapy for youths with anxiety disorders: A second randomized clinical trial. Journal of Consulting and Clinical Psychology, 65, 366-380.

    Google Scholar 

  • Kendall, P. C., & Grove, W. (1988). Normative comparisons in therapy outcome. Behavioral Assessment, 10, 147-158.

    Google Scholar 

  • Kendall, P. C., Kane, M., Howard, B., & Siqueland, L. (1990). Cognitive-behavioral therapy for anxious children: Treatment manual. Available from the author, Temple University, Department of Psychology, Philadelphia, PA 19122.

    Google Scholar 

  • Kendall, P. C., & Marrs-Garcia, A. (n.d.). Development and psychometric properties of the Coping Questionnaire. Submitted for publication.

  • Kendall, P. C., & Southam-Gerow, M. A. (1996). Long term follow-up of a cognitive-behavioral therapy for anxious youth. Journal of Consulting and Clinical Psychology, 64, 724-730.

    Google Scholar 

  • King, N. J., & Ollendick, T. H. (1989). Children's anxiety and phobic disorders in school settings: Classification, assessment, and intervention issues. Review of Educational Research, 59, 431-470.

    Google Scholar 

  • Klein, R. G., & Last, C. G. (1989). Anxiety disorders in children. Newbury Park, CA: Sage.

    Google Scholar 

  • Kovacs, M. (1981). Rating scales to assess depression in school aged children. Acta Paedopsychiatrica, 46, 305-315.

    Google Scholar 

  • La Greca, A. M., Dandes, S. K., Wick, P., Shaw, K., & Stone, W. L. (1988). Development of the Social Anxiety Scale for Children: Reliability and concurrent validity. Journal of Clinical Child Psychology, 17, 84-91.

    Google Scholar 

  • La Greca, A. M., & Stone, W. (1993). Social Anxiety Scale for Children-Revised: Factor structure and concurrent validity. Journal of Clinical Child Psychology, 22, 17-27.

    Google Scholar 

  • Last, C. G., Hersen, M., Kazdin, A. E., Finkelstein, R., & Strauss, C. C. (1987). Comparison of DSMIII separation anxiety and overanxious disorders: Demographic characteristics and patterns of comorbidity. Journal of the American Academy of Child and Adolescent Psychiatry, 26, 527-531.

    Google Scholar 

  • Mansdorf, I. J., & Lukens, E. (1987). Cognitive-behavioral psychotherapy for separation anxious children exhibiting school phobia. Journal of the American Academy of Child and Adolescent Psychiatry, 26, 222-225.

    Google Scholar 

  • Myers, J. K., Weissman, M. M., Tischler, G. L., Holzer, C. H., Leaf, P. J., Orvaschel, H., Anthony, J., Boyd, J. H., Burke, J. D., Kramer, M., & Stoltzman, R. (1984). Six-month prevalence of psychiatric disorders in three communities. Archives of General Psychiatry, 41, 959-967.

    Google Scholar 

  • Ollendick, T. H., Hagopian, L. P., & Huntzinger, R. M. (1991). Cognitive-behavioral therapy with nighttime fearful children. Journal of Behavior Therapy and Experimental Psychiatry, 22, 113-121.

    Google Scholar 

  • Quay, H. C., & Peterson, D. R. (1983). Interim manual for the Revised Behavior Problem Checklist. Coral Gables, FL: University of Miami, Applied Social Sciences.

    Google Scholar 

  • Renneberg, B., Goldstein, A. J., Phillips, D., & Chambless, D. L. (1990). Intensive behavioral group treatment of avoidant personality disorder. Behavior Therapy, 21, 363-377.

    Google Scholar 

  • Reynolds, C. R., & Richmond, B. O. (1978). What I Think and Feel: A revised measure of Children's Manifest Anxiety. Journal of School Psychology, 24, 313-319.

    Google Scholar 

  • Reynolds, C. R., & Richmond, B. O. (1985). Revised Children's Manifest Anxiety Scale (RCMAS) manual. Los Angeles, CA: Western Psychological Services.

    Google Scholar 

  • Rubin, K. H. (1985). Socially withdrawn children: An ''at risk'' population? In B. Schneider, K. H. Rubin, & J. Ledingham (Eds.), Children's peer relations: Issues in assessment and intervention (pp. 125-140). New York: Springer-Verlag.

    Google Scholar 

  • Sarason, S. B., Davidson, K. S., Lighthall, F. F., Waite, R. R., & Ruebush, B. K. (1960). Anxiety in elementary school children. New York: Wiley.

    Google Scholar 

  • Satterfield, J. M. (1994). Integrating group dynamics and cognitive-behavioral groups: A hybrid model. Clinical Psychology: Science and Practice, 1, 185-196.

    Google Scholar 

  • Saylor, C. F., Finch, A., Spirito, A., & Bennett, B. (1984). The Children's Depression Inventory: A systematic evaluation of psychometric properties. Journal of Consulting and Clinical Psychology, 52, 955-967.

    Google Scholar 

  • Shaffer, C. S., Shapiro, J., Sank, L. I., & Coghlan, D. J. (1981). Positive changes in depression, anxiety, and assertion following individual and group cognitive behavior therapy intervention. Cognitive Therapy and Research. 5, 149-157.

    Google Scholar 

  • Silverman, W. K., & Albano, A. M. (1996). The Anxiety Disorders Interview Schedule for DSM-IV, child and parent versions. Albany, NY: Graywind.

    Google Scholar 

  • Spielberger, C. (1973). Manual for the State-Trait Anxiety Inventory for Children. Palo Alto, CA: Consulting Psychologists Press.

    Google Scholar 

  • Strain, P. S., & Kerr, M. M. (1981). Modifying children's social withdrawal: Issues in assessment and clinical intervention. Progress in Behavior Modification, 11, 203-248.

    Google Scholar 

  • Strauss, C. C. (1987). Modification of the trait portion of the State-Trait Anxiety Inventory for Childrenparent form. Available from the author. Pittsburgh, PA: Western Psychiatric Institute and Clinic.

    Google Scholar 

  • Strauss, C. C. (1988). Behavioral assessment and treatment of overanxious disorder in children and adolescents. Behavior Modification, 12, 234-251.

    Google Scholar 

  • Strauss, C. C., Forehand, R., Smith, K., & Frame, C. L. (1986). The association between social withdrawal and internalizing problems of children. Journal of Abnormal Child Psychology, 14, 525-535.

    Google Scholar 

  • Strauss, C. C., Lease, C., Last, C., & Francis, G. (1988). Overanxious disorder: An examination of developmental differences. Journal of Abnormal Child Psychology, 16, 433-443.

    Google Scholar 

  • Toseland, R. W., & Siporin, M. (1986). When to recommend group treatment: A review of the clinical and research literature. International Journal of Group Psychotherapy, 36, 171-201.

    Google Scholar 

  • Weisz, J. R., Weiss, B., Alicke, M. D.,& Klotz, M. L. (1987). Effectiveness of psychotherapy with children and adolescents: A meta-analysis for clinicians. Journal of Consulting and Clinical Psychology, 55, 542-549.

    Google Scholar 

  • Weisz, J. R., Weiss, B., & Donenberg, G. R. (1992). The lab versus the clinic: Effects of child and adolescent psychotherapy. American Psychologist, 47, 1578-1585.

    Google Scholar 

  • Weisz, J. R., Weiss, B., Han, S. S., Granger, D. A., & Morton, T. (1995). Effects of psychotherapy with children and adolescents revisited: A meta-analysis of treatment outcome studies. Psychological Bulletin, 117, 450-468.

    Google Scholar 

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  1. Department of Psychology, Temple University, Philadelphia, Pennsylvania

    Ellen C. Flannery-Schroeder & Philip C. Kendall

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  1. Ellen C. Flannery-Schroeder
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Flannery-Schroeder, E.C., Kendall, P.C. Group and Individual Cognitive-Behavioral Treatments for Youth with Anxiety Disorders: A Randomized Clinical Trial. Cognitive Therapy and Research 24, 251–278 (2000). https://doi.org/10.1023/A:1005500219286

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