Introduction
Methods
Literature Search
Study Selection
Outcome Variables and Moderators
Data Extraction
Quality Rating of the Studies
Statistical Analyses
Results
Study and Case Characteristics
Within-Person Symptom Change
N of studies | |
---|---|
World part | |
North America | 48 |
Europe | 13 |
Australia and New Zealand | 8 |
South America | 1 |
Asia | 1 |
Type of diagnosisa | |
AD | 52 [n cases = 231] |
MDD | 8 [n cases = 35] |
PTSD | 11 [n cases = 55] |
Type of sample | |
Referred | 41 |
Recruited | 22 |
Combined referred and recruited | 1 |
Otherb | 2 |
NR | 5 |
Setting | |
University clinic (UC) | 34 |
Outpatient psychiatric clinic (OPC) | 18 |
OPC/UC | 1 |
School | 5 |
Otherc | 4 |
NR | 9 |
Type of treatment | |
CBT-oriented | 59 |
CBM | 3 |
Medication | 3 |
Parent–child interaction therapy | 2 |
Otherd | 4 |
Treatment target groupe | |
Child and parent | 33 |
Child-only | 33 |
Parent-only | 5 |
Type of SC(E)D | |
Experimental | |
Multiple baseline | 41 |
Changing-criterion | 2 |
Alternating-treatments | 1 |
Quasi-experimental | |
AB | 8 |
Non-experimental | |
Pre-post | 11 |
One-phase design | 8 |
Diagnostic Status at Post-Treatment and Follow-up
Model | Probability of a diagnosis post-treatment [CI] | Between study variance | ICC | Probability of a diagnosis follow-up [CI] | Between study variance | ICC | |
---|---|---|---|---|---|---|---|
Intercept model | Overall | 0.14 [0.05–0.31] | 7.04 | 0.68 | 0.12 [0.04–0.28] | 4.12 | 0.56 |
Age as predictor | Average age | 0.12 [0.04–0.32] | 7.91 | 0.71 | 0.12 [0.03–0.34] | 5.44 | 0.62 |
Average age + one SD | 0.12 [0.10–0.14] | 0.14 [0.11–0.18] | |||||
Target group as predictor | child | 0.12 [0.03–0.37] | 7.10 | 0.68 | 0.21 [0.06–0.52] | 4.19 | 0.56 |
parent | 0.03 [0.002–0.40] | 0.16 [0.01–0.73] | |||||
child + parent | 0.18 [0.06–0.43] | 0.07 [0.02–0.25] | |||||
Disorder category as predictor | AD | 0.21 [0.09–0.43] | 6.73 | 0.67 | 0.14 [0.05–0.32] | 3.77 | 0.53 |
MDD | 0.02 [0.001–0.22] | 0.08 [0.007–0.51] | |||||
PTSD | 0.05 [0.005–0.38] | 0.09 [0.01–0.58] |
Discussion
Appendix 1: Studies Included in the Meta-analysis
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Barterian, J. A., Sanchez, J. M., Magen, J., Siroky, A. K., Mash, B. L., & Carlson, J. S. (2018). An examination of fluoxetine for the treatment of selective mutism using a nonconcurrent multiple-baseline single-case design across 5 cases. Journal of Psychiatric Practice®, 24(1), 2-14.
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Bechor, M., Pettit, J. W., Silverman, W. K., Bar-Haim, Y., Abend, R., Pine, D. S., ... & Jaccard, J. (2014). Attention bias modification treatment for children with anxiety disorders who do not respond to cognitive behavioral therapy: A case series. Journal of Anxiety Disorders, 28(2), 154-159.
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Bowyer, L., Wallis, J., & Lee, D. (2014). Developing a compassionate mind to enhance trauma-focused CBT with an adolescent female: A case study. Behavioural and Cognitive Psychotherapy, 42(2), 248-254.
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Carlson, J. S., Kratochwill, T. R., & Johnston, H. F. (1999). Sertraline treatment of 5 children diagnosed with selective mutism: A single-case research trial. Journal of Child and Adolescent Psychopharmacology, 9(4), 293-306.
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Chevalier, L. L. (2020). Evaluation of a treatment of sleep-related problems in children with anxiety using a multiple baseline design (Doctoral dissertation, Boston University).
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Choate, M. L., Pincus, D. B., Eyberg, S. M., & Barlow, D. H. (2005). Parent-child interaction therapy for treatment of separation anxiety disorder in young children: A pilot study. Cognitive and Behavioral Practice, 12(1), 126-135.
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Chorpita, B. F., Albano, A. M., Heimberg, R. G., & Barlow, D. H. (1996). A systematic replication of the prescriptive treatment of school refusal behavior in a single subject. Journal of Behavior Therapy and Experimental Psychiatry, 27(3), 281-290.
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Cooper-Vince, C. E., Chou, T., Furr, J. M., Puliafico, A. C., & Comer, J. S. (2016). Videoteleconferencing early child anxiety treatment: A case study of the internet-delivered PCIT CALM (I-CALM) program. Evidence-Based Practice in Child and Adolescent Mental Health, 1(1), 24-39.
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Cowart, M. J., & Ollendick, T. H. (2011). Attention training in socially anxious children: a multiple baseline design analysis. Journal of Anxiety Disorders, 25(7), 972-977.
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Cunningham, M. J., Wuthrich, V. M., Rapee, R. M., Lyneham, H. J., Schniering, C. A., & Hudson, J. L. (2009). The Cool Teens CD-ROM for anxiety disorders in adolescents. European Child & Adolescent Psychiatry, 18(2), 125-129.
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Eckshtain, D., & Gaynor, S. T. (2009). Assessing outcome in cognitive behavior therapy for child depression: An illustrative case series. Child & Family Behavior Therapy, 31(2), 94-116.
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Ehrenreich, J. T., Goldstein, C. R., Wright, L. R., & Barlow, D. H. (2009). Development of a unified protocol for the treatment of emotional disorders in youth. Child & Family Behavior Therapy, 31(1), 20-37.
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Ehrenreich-May, J., Simpson, G., Stewart, L. M., Kennedy, S. M., Rowley, A. N., Beaumont, A., ... & Wood, J. J. (2020). Treatment of anxiety in older adolescents and young adults with autism spectrum disorders: A pilot study. Bulletin of the Menninger Clinic, 84(2), 105-136.
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Eisen, A. R., & Silverman, W. K. (1998). Prescriptive treatment for generalized anxiety disorder in children. Behavior Therapy, 29(1), 105-121.
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Eisen, A. R., Raleigh, H., & Neuhoff, C. C. (2008). The unique impact of parent training for separation anxiety disorder in children. Behavior Therapy, 39(2), 195-206.
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Esveldt-Dawson, K., Wisner, K. L., Unis, A. S., Matson, J. L., & Kazdin, A. E. (1982). Treatment of phobias in a hospitalized child. Journal of Behavior Therapy and Experimental Psychiatry, 13(1), 77-83.
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Farrell, S. P., Hains, A. A., & Davies, W. H. (1998). Cognitive behavioral interventions for sexually abused children exhibiting PTSD symptomatology. Behavior Therapy, 29(2), 241-255.
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Farrell, L. J., Kershaw, H., & Ollendick, T. (2018). Play-modified one-session treatment for young children with a specific phobia of dogs: a multiple baseline case series. Child Psychiatry & Human Development, 49(2), 317-329.
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Farrell, L. J., Miyamoto, T., Donovan, C. L., Waters, A. M., Krisch, K. A., & Ollendick, T. H. (2021). Virtual reality one-session treatment of child-specific phobia of dogs: A controlled, multiple baseline case series. Behavior Therapy, 52(2), 478-491.
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Feather, J. S. (2006). Trauma-focused cognitive behavioural therapy for abused children with. New Zealand Journal of Psychology, 35(3).
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Feather, J. S., & Ronan, K. R. (2009). Trauma‐focused CBT with maltreated children: A clinic‐based evaluation of a new treatment manual. Australian Psychologist, 44(3), 174-194.
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Fernandez, S., DeMarni Cromer, L., Borntrager, C., Swopes, R., Hanson, R. F., & Davis, J. L. (2013). A case series: Cognitive-behavioral treatment (exposure, relaxation, and rescripting therapy) of trauma-related nightmares experienced by children. Clinical Case Studies, 12(1), 39-59.
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Frame, C., Matson, J. L., Sonis, W. A., Fialkov, M. J., & Kazdin, A. E. (1982). Behavioral treatment of depression in a prepubertal child. Journal of Behavior Therapy and Experimental Psychiatry, 13(3), 239-243.
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Francis, D., Hudson, J. L., Kohnen, S., Mobach, L., & McArthur, G. M. (2021). The effect of an integrated reading and anxiety intervention for poor readers with anxiety. PeerJ, 9, e10987.
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Gaynor, S. T., & Harris, A. (2008). Single-participant assessment of treatment mediators: Strategy description and examples from a behavioral activation intervention for depressed adolescents. Behavior Modification, 32(3), 372-402.
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Geuke, G. G., Maric, M., Miočević, M., Wolters, L. H., & de Haan, E. (2019). Testing mediators of youth intervention outcomes using single‐case experimental designs. New directions for child and adolescent development, 2019(167), 39-64.
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Girling-Butcher, R. D., & Ronan, K. R. (2009). Brief cognitive-behavioural therapy for children with anxiety disorders: Initial evaluation of a program designed for clinic settings. Behaviour Change, 26(1), 27-53.
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Goodall, B., Chadwick, I., McKinnon, A., Werner‐Seidler, A., Meiser‐Stedman, R., Smith, P., & Dalgleish, T. (2017). Translating the cognitive model of PTSD to the treatment of very young children: A single case study of an 8‐year‐old motor vehicle accident survivor. Journal of Clinical Psychology, 73(5), 511-523.
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Hagopian, L. P., & Slifer, K. J. (1993). Treatment of separation anxiety disorder with graduated exposure and reinforcement targeting school attendance: A controlled case study. Journal of Anxiety Disorders, 7(3), 271-280.
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Heard, P. M., Dadds, M. R., & Conrad, P. (1992). Assessment and treatment of simple phobias in children: Effects on family and marital relationships. Behaviour Change, 9(2), 73-82.
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Hendriks, L., de Kleine, R. A., Heyvaert, M., Becker, E. S., Hendriks, G. J., & van Minnen, A. (2017). Intensive prolonged exposure treatment for adolescent complex posttraumatic stress disorder: a single‐trial design. Journal of Child Psychology and Psychiatry, 58(11), 1229-1238.
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Howard, B. L., & Kendall, P. C. (1996). Cognitive-behavioral family therapy for anxiety-disordered children: A multiple-baseline evaluation. Cognitive Therapy and Research, 20(5), 423-443.
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Jacob, M., L. Keeley, M., Ritschel, L., & Craighead, W. E. (2013). Behavioural activation for the treatment of low‐income, African American adolescents with major depressive disorder: a case series. Clinical Psychology & Psychotherapy, 20(1), 87-96.
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Jarrett, M. A., & Ollendick, T. H. (2012). Treatment of comorbid attention-deficit/hyperactivity disorder and anxiety in children: A multiple baseline design analysis. Journal of Consulting and Clinical Psychology, 80(2), 239.
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Kane, M. T., & Kendall, P. C. (1989). Anxiety disorders in children: A multiple-baseline evaluation of a cognitive-behavioral treatment. Behavior Therapy, 20(4), 499-508.
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Leger, E., Ladouceur, R., Dugas, M. J., & Freeston, M. H. (2003). Cognitive-behavioral treatment of generalized anxiety disorder among adolescents: A case series. Journal of the American Academy of Child & Adolescent Psychiatry, 42(3), 327-330.
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Leigh, E., & Clark, D. M. (2016). Cognitive therapy for social anxiety disorder in adolescents: a development case series. Behavioural and Cognitive Psychotherapy, 44(1), 1-17.
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Lewis, K. M., Amatya, K., Coffman, M. F., & Ollendick, T. H. (2015). Treating nighttime fears in young children with bibliotherapy: Evaluating anxiety symptoms and monitoring behavior change. Journal of Anxiety Disorders, 30, 103-112.
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Lumpkin, P. W., Silverman, W. K., Weems, C. F., Markham, M. R., & Kurtines, W. M. (2002). Treating a heterogeneous set of anxiety disorders in youths with group cognitive behavioral therapy: A partially nonconcurrent multiple-baseline evaluation. Behavior Therapy, 33(1), 163-177.
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Malboeuf-Hurtubise, C., Lacourse, E., Herba, C., Taylor, G., & Amor, L. B. (2017). Mindfulness-based intervention in elementary school students with anxiety and depression: a series of n-of-1 trials on effects and feasibility. Journal of Evidence-Based Complementary & Alternative Medicine, 22(4), 856-869.
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Maric, M., De Haan, E., Hogendoorn, S. M., Wolters, L. H., & Huizenga, H. M. (2015). Evaluating statistical and clinical significance of intervention effects in single-case. experimental designs: An SPSS method to analyze univariate data. Behavior Therapy, 46(2), 230–241.
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Mayer-Brien, S., Turgeon, L., & Lanovaz, M. J. (2017). Effects of a parent training programme for the treatment of young children with separation anxiety disorder. The Cognitive Behaviour Therapist, 10.
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Nakamura, B. J., Pestle, S. L., & Chorpita, B. F. (2009). Differential sequencing of cognitive-behavioral techniques for reducing child and adolescent anxiety. Journal of Cognitive Psychotherapy, 23(2), 114-135.
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Nelissen, I., Muris, P., & Merckelbach, H. (1995). Computerized exposure and in vivo exposure treatments of spider fear in children: Two case reports. Journal of Behavior Therapy and Experimental Psychiatry, 26(2), 153-156.
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Neuhoff, C. C. (2006). Prescriptive treatment for separation anxiety disorder: child therapy versus parent training (Doctoral dissertation, Fairleigh Dickinson University).
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O'Reilly, M., McNally, D., Sigafoos, J., Lancioni, G. E., Green, V., Edrisinha, C., ... & Didden, R. (2008). Examination of a social problem-solving intervention to treat selective mutism. Behavior Modification, 32(2), 182-195.
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Oar, E. L., Farrell, L. J., & Ollendick, T. H. (2015). One session treatment for specific phobias: An adaptation for paediatric blood–injection–injury phobia in youth. Clinical Child and Family Psychology Review, 18(4), 370-394.
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Olivier, E., de Roos, C., & Bexkens, A. (2021). Eye movement desensitization and reprocessing in young children (ages 4–8) with posttraumatic stress disorder: A multiple-baseline evaluation. Child Psychiatry & Human Development, 53, 1391-1404.
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Ollendick, T. H. (1995). Cognitive behavioral treatment of panic disorder with agoraphobia in adolescents: A multiple baseline design analysis. Behavior Therapy, 26(3), 517-531.
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Ollendick, T. H., Hagopian, L. P., & Huntzinger, R. M. (1991). Cognitive-behavior therapy with nighttime fearful children. Journal of Behavior Therapy and Experimental Psychiatry, 22(2), 113-121.
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Ollendick, T., Muskett, A., Radtke, S. R., & Smith, I. (2021). Adaptation of one-session treatment for specific phobias for children with autism spectrum disorder using a non-concurrent multiple baseline design: A preliminary investigation. Journal of Autism and Developmental Disorders, 51(4), 1015-1027.
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Ortega, M. L. (2012). The generalization of verbal speech across multiple settings for children with selective mutism: A multiple-baseline design pilot study (Doctoral dissertation). Available from ProQuest Dissertations & Theses Global database. (UMI No. 3460734).
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Ooi, Y. P., Raja, M., Sung, S. C., Fung, D. S., & Koh, J. B. (2012). Application of a web-based cognitive-behavioural therapy programme for the treatment of selective mutism in Singapore: a case series study. Singapore Medical Journal, 53(7), 446-450.
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Pasquinelli, S. (2009). The efficacy of treating adolescent depression with Interpersonal Psychotherapy for Adolescents (IPT-A) in the school setting (Doctoral. Dissertation, Duquesne University, Pittsburg, USA). Retrieved from: https://dsc.duq.edu/etd/1024/.
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Pathak, S., Johns, E. S., & Kowatch, R. A. (2005). Adjunctive quetiapine for treatment-resistant adolescent major depressive disorder: A case series. Journal of Child & Adolescent Psychopharmacology, 15(4), 696-702.
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Quero, S., Nebot, S., Rasal, P., Breton-Lopez, J., Banos, R. M., & Botella, C. (2014). Information and communication technologies in the treatment of small animals phobia in childhood. Behavioral Psychology-Psicología Conductual, 22(2), 257-276.
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Radtke, S. R., Muskett, A., Coffman, M. F., & Ollendick, T. H. (2022). Bibliotherapy for specific phobias of dogs in young children: a pilot study. Journal of child and family studies, 32, 373-383.
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Ravid, A., Lagbas, E., Johnson, M., & Osborne, T. L. (2021). Targeting co-sleeping in children with anxiety disorders using a modified bedtime pass intervention: A case series using a hanging criterion design. Behavior Therapy, 52(2), 298-312.
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Reuland, M. M., & Teachman, B. A. (2014). Interpretation bias modification for youth and their parents: A novel treatment for early adolescent social anxiety. Journal of Anxiety Disorders, 28(8), 851-864.
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Ruiz García, A., & Valero Aguayo, L. (2020). INTERVENCIÓN MEDIANTE EXPOSICIÓN MULTIMEDIA EN UN CASO DE FOBIA INFANTIL A LAS AVISPAS. Behavioral Psychology/Psicología Conductual, 28(2).
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Saigh, P. A. (1987). In vitro flooding of childhood posttraumatic stress disorders: A systematic replication. Professional School Psychology, 2(2), 135.
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Salazar, D. M., Ruiz, F. J., Ramírez, E. S., & Cardona-Betancourt, V. (2020). Acceptance and commitment therapy focused on repetitive negative thinking for child depression: a randomized multiple-baseline evaluation. The Psychological Record, 70(3), 373-386.
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Santucci, L. C., Ehrenreich, J. T., Trosper, S. E., Bennett, S. M., & Pincus, D. B. (2009). Development and preliminary evaluation of a one-week summer treatment program for separation anxiety disorder. Cognitive and Behavioral Practice, 16(3), 317-331.
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Simons, M., & Vloet, T. D. (2018). Emetophobia–a metacognitive therapeutic approach for an overlooked disorder. Zeitschrift für Kinder-und Jugendpsychiatrie und Psychotherapie, 46, 57-66.
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Storch, E. A., Nadeau, J. M., Rudy, B., Collier, A. B., Arnold, E. B., Lewin, A. B., ... & Murphy, T. K. (2015). A case series of cognitive-behavioral therapy augmentation of antidepressant medication for anxiety in children with autism spectrum disorders. Children's Health Care, 44(2), 183-198.
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Suveg, C., Kendall, P. C., Comer, J. S., & Robin, J. (2006). Emotion-focused cognitive-behavioral therapy for anxious youth: A multiple-baseline evaluation. Journal of Contemporary Psychotherapy, 36(2), 77-85.
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Taylor, L. K., & Weems, C. F. (2011). Cognitive-behavior therapy for disaster-exposed youth with posttraumatic stress: results from a multiple-baseline examination. Behavior Therapy, 42(3), 349-363.
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Tolin, D. F., Whiting, S., Maltby, N., Diefenbach, G. J., Lothstein, M. A., Hardcastle, S., ... & Gray, K. (2009). Intensive (daily) behavior therapy for school refusal: A multiple baseline case series. Cognitive and Behavioral Practice, 16(3), 332-344.
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Unterhitzenberger, J., Eberle-Sejari, R., Rassenhofer, M., Sukale, T., Rosner, R., & Goldbeck, L. (2015). Trauma-focused cognitive behavioral therapy with unaccompanied refugee minors: a case series. BMC psychiatry, 15(1), 1-9.
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Waters, A. M., Donaldson, J., & Zimmer-Gembeck, M. J. (2008). Cognitive–behavioural therapy combined with an interpersonal skills component in the treatment of generalised anxiety disorder in adolescent females: A case series. Behaviour Change, 25(1), 35-43.
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Yorke, J., Nugent, W., Strand, E., Bolen, R., New, J., & Davis, C. (2013). Equine-assisted therapy and its impact on cortisol levels of children and horses: A pilot study and meta-analysis. Early Child Development and Care, 183(7), 874-894.