A "whole family" approach to combatting child anxiety
Wood JJ, Piacentini JC, Southam-Gerow M, Chu BC, Sigman M
The Bottom Line:
Cognitive Behavioral Therapy (CBT) is known to be effective in treating childhood anxiety disorders. Family-focused cognitive behavioural therapy (FCBT) is a form of CBT that involves the whole family, but there have been few studies on its effectiveness relative to CBT alone. This study found FCBT to work better than CBT to reduce symptoms of anxiety, as reported by the parents and therapists who were involved. On the other hand, the children who participated found no difference between the 2 treatments, and both groups improved on all outcomes that were measured. |
What problem is being addressed?
Anxiety is a serious problem for about 6% of all children, many of whom find it difficult to go to school or make friends. Without intervention, anxiety disorder can persist into adulthood and affect a person’s relationships and ability to hold a job.
What intervention is being tested?
Family-focused CBT (also known as FCBT) is a form of cognitive behavioural therapy (CBT) that involves the whole family. CBT has been found to be beneficial in the treatment of child anxiety disorders. It helps the child identify and counteract the thoughts that fuel the anxiety, using relaxation techniques, rewards and gradual exposure to feared situations to help lessen the anxious feelings. In FCBT, parents assist the process by helping their child learn coping skills and support their child during the gradual exposure to a feared situation.
This study compared the effectiveness of FCBT to CBT alone in 40 children, aged 6 to 13 years, who had a diagnosis of social anxiety disorder (also known as social phobia), or general anxiety disorder. The children were split into two groups: one group received CBT; the other group received FCBT. Each child had 12 to 16 CBT sessions with a therapist, each lasting 60 to 80 minutes. In FCBT, the child was alone with the therapist for 15-30 minutes; a primary parent was included in the therapy for the remainder of the session.
What is the real scientific evidence?
Overall, the evidence suggests that FCBT was more effective in treating anxiety disorders than CBT alone, although some of the results were mixed.
Both the parents and the therapists (who were unaware which therapy each child received) reported that FCBT was better than CBT in reducing anxiety symptoms in the children, although both treatment groups improved on all measures.
The children themselves reported no difference between the two therapies, which was consistent with the results of 6 previous studies.
The preceding is a summary of:
Wood JJ, Piacentini JC, Southam-Gerow M, Chu BC, Sigman M. Family Cognitive Behavioral Therapy for Child Anxiety Disorders. Journal of the American Academy of Child and Adolescent Psychiatry 2006, 45(3): 314-321.
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