Commentary
SPECIAL SERIES: Intensive Cognitive-Behavioral Treatments for Child and Adolescent Anxiety Disorders

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Abstract

This special series on intensive treatments for anxiety disorders in youth reminds us that these are challenging conditions and there is much more work to be done to address some of the limitations to and challenges of treating anxiety disorders in children using CBT. The treatments described in this series are intensive in their delivery and represent innovation on the part of the investigators. Most consistently, these treatments manipulated the time element to deliver the usual number of sessions within a shorter span of time (e.g., 15 sessions in 3 to 4 weeks for school refusal and OCD) or to maximize treatment within a shorter number of sessions (e.g., phobia, separation anxiety, and panic). This commentary presents ideas on certain highlights from each paper and implications for dissemination to the community.

Section snippets

A Model CBT Protocol

Davis, Ollendick, and Öst (2009) present a detailed overview of the application of one-session treatment (OST) of specific phobia in children and highlight specific challenges and issues in transporting this treatment to community settings. Evidence for OST with adults as well as in children is mounting, and these authors wrestle with some of the main barriers to dissemination and uptake of OST: third-party payers, fitting 180 minutes into the 50-minute model, and treatment acceptability.

Tackling Treatment-Resistant Conditions

An often heard concern of CBT clinicians in practice involves receiving a referral for a patient who has failed a medication trial or an alternative psychotherapy, and now they are seeking relief with CBT. And, some patients present with a prior failed attempt at CBT, which, upon inquiry, may not have been CBT at all, but some therapist’s “version” of CBT garnered through inadequate training or some other means. And yes, some patients will not respond to the best of CBT provided by the best of

CBT in Nontraditional Settings: Camp and School Contexts

Santucci and colleagues (2009) describe a summer camp analogue that holds promise for addressing the most common of the childhood anxiety disorders, the triad of separation, social, and generalized anxiety disorders. Collectively, these conditions result in significant disruption in the child’s normal routines and capabilities, from sleeping alone in their beds to attending school each day to eagerly going off to birthday parties and play dates. Although these authors focused exclusively on

Dealing With Development

In the final report in this series, Angelosante and colleagues (2009; thiss issue) describe an 8-day intensive treatment program for adolescents with panic disorder. Similar to other protocols described in this series, the authors manipulated the time element by having longer, intensive sessions compacted into 1 week of treatment. This intensive program is based on the Mastery of Anxiety and Panic for Adolescents (Pincus, Ehrenreich, & Mattis, 2008) program, which itself is an evidence-based,

Summing Up

In conclusion, the next steps in refining the innovations in treatments for childhood anxiety disorders presented in each of these protocols are best accomplished through collaboration with community partners. The investigators and their teams are commended for their innovation and creativity in addressing, either directly or indirectly, the complexities of these disorders and adapting the treatments for different ages, contexts, and degrees of difficulty. The most consistent and concerning

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Copyright © 2009 Published by Elsevier Ltd.