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18-10-2019 | Uitgave 1/2020

Clinical Child and Family Psychology Review 1/2020

A Meta-analysis to Guide the Enhancement of CBT for Childhood Anxiety: Exposure Over Anxiety Management

Tijdschrift:
Clinical Child and Family Psychology Review > Uitgave 1/2020
Auteurs:
Stephen P. H. Whiteside, Leslie A. Sim, Allison S. Morrow, Wigdan H. Farah, Daniel R. Hilliker, M. Hassan Murad, Zhen Wang
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Abstract

Cognitive behavior therapy (CBT) is the most empirically supported therapy for childhood anxiety disorders (CADs) but has not reliably outperformed other credible interventions. The current study used meta-analysis to examine the frequency with which the most common treatment components are included in outcome studies and the relation of these components to symptom improvement. Seventy-five studies were identified that included youth with an anxiety disorder treated with CBT or a comparison condition. The protocols for the 111 CBT conditions generally consisted of 12, 1-h sessions delivered to the child with minimal parent inclusion. A greater amount of in-session exposure was related to significantly larger effect sizes between CBT and waitlist control across reporters (− 0.12 to − 0.15; P’s < .05) and from pre- to post-treatment for child report (− .06; P < .01). Compared to treatments that omitted relaxation, treatments that included relaxation strategies were associated with significantly smaller pre- to post-treatment effect sizes across reporters (0.38 to 0.80; P’s < .05). The current study suggests that CBT protocols for CADs that emphasize in-session exposure and do not include relaxation have the potential to improve the efficacy and effectiveness of therapy. Dismantling studies directly testing these hypotheses are needed.

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