Treating anxiety disorders in children and adolescents: Evidence supports cognitive behavioural therapy as an alternative to drugs
James A, Soler A, Weatherall, R
The Bottom Line:
This review of 13 randomized controlled trials found that more than half (56%) of the children and adolescents treated with cognitive behavioural therapy (CBT) showed significant reduction in their symptoms of anxiety. Of those children not receiving CBT treatment over the same period of time, only 28% showed improvement. It did not matter if the treatment was delivered to individuals, groups, or through parent/family training. Despite this positive showing, the fact that nearly half the children receiving CBT did not show significant improvement means that further research is needed. |
What problem is being addressed?
Childhood and adolescent anxiety disorders are relatively common, and severe enough to require treatment in about 6.4% all children and adolescents. Treatment with medication is known to be effective but there is increasing support for cognitive behavioural therapy(CBT), a treatment designed to make participants aware of the thinking patterns that fuel their anxiety,and teach them ways of counteracting that thinking.
What intervention is being tested?
Cognitive behavioural therapy (CBT) interventions designed for children 7 to 18 years of age and delivered to individuals, groups, or through family/parent training. The authors reviewed randomized controlled trials of CBT interventions involving community outpatient subjects only, with anxiety only mild to moderate severity. Those with simple phobia, Obsessive-Compulsive Disorder or Post-Traumatic Stress Disorder were excluded.
All the interventions involved at least 8 sessions of CBT, reported on child or in some cases child and parent assessment of anxiety symptoms, and used objective outcome measures like standardized symptom scales. Control groups were composed of children and adolescents on a wait list or those who were receiving attention but no therapy.
What is the real scientific evidence?
Cognitive behavioural therapy was found to improve symptoms of anxiety in 56% of those children and adolescents who received it. By comparison, only 28.2% of the control group children saw their anxiety symptoms improve. Findings were similar regardless of the treatment format – individual, group, or family/parent training.
The preceding is a summary of:
James A, Soler A, Weatherall R. Cognitive behavioural therapy for anxiety disorders in children and adolescents. The Cochrane Database of Systematic Reviews 2004, Issue 4. Art. No.: CD0004690.pub2.DOI: 10.1002/14651858. CD004690.pub2.
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