Comparison of child-parent and parent-only cognitive-behavioral therapy programs for anxious children aged 5 to 7 years: short- and long-term outcomes

J Am Acad Child Adolesc Psychiatry. 2015 Feb;54(2):138-46. doi: 10.1016/j.jaac.2014.10.008. Epub 2014 Oct 25.

Abstract

Objective: Childhood anxiety disorders (AD) are prevalent, debilitating disorders. The most effective treatment approach for children less than 8 years old requires further investigation. The study's primary objective was to compare 2 cognitive-behavioral therapy (CBT) group programs. CBT was delivered to children 5 to 7 years old and their parents (child-parent) or only to parents (parent-only), whereas children attended group sessions but did not receive CBT.

Method: Using a prospective, repeated measures, longitudinal study design, 77 children (29 male, mean age = 6.8 years; SD = 0.8 year) with AD and their parents participated in either a 12-week child-parent or parent-only CBT group treatment after a 3-month no-treatment wait-time. Well-validated treatment outcome measures were completed at 5 assessment time points: initial assessment, pretreatment, immediately posttreatment, 6 months, and 12 months posttreatment. A mixed models analysis was used to assess change in AD severity and global functioning improvements from baseline within each treatment and between treatments.

Results: No significant changes were noted in child-parent or parent-only treatment during the 3-month no-treatment wait time. Both treatments saw significant improvements posttreatment and at longer-term follow-up with significant reductions in AD severity measured by clinician and parent report and increases in global functioning. Significantly greater improvements were observed in the child-parent compared to the parent-only treatment.

Conclusion: This study suggests that both parent-only and child-parent group CBT improves AD severity in children 5 to 7 years old. Study results suggest that involvement of both children and parents in treatment is more efficacious than working with parents alone.

Keywords: anxiety disorder; cognitive-behavioral therapy; long-term outcome; parental involvement; young children.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Anxiety Disorders / therapy*
  • Child
  • Child, Preschool
  • Cognition
  • Cognitive Behavioral Therapy / methods*
  • Family Therapy / methods*
  • Female
  • Humans
  • Longitudinal Studies
  • Male
  • Parents / psychology*
  • Prospective Studies
  • Psychiatric Status Rating Scales
  • Severity of Illness Index
  • Social Class
  • Time
  • Treatment Outcome