Evaluating the Effectiveness of Early Cognitive Behavioral Therapy With or Without Parental Involvement in Treating Children With Anxiety Disorders

• Composite Clinician Severity Rating (CSR) on the Anxiety Disorders Interview Schedule (ADIS) for DSM-IV criteria for primary anxiety diagnosis [ Time Frame: Measured at Months 3 and 6 and Years 1, 2, 3, and 4 post-treatment ] [ Designated as safety issue: No ]
  

• Multidimensional Anxiety Scale for Children, Scale for Child Anxiety Related Emotional Disorders, Clinical Global Impressions, Family Adaptability and Cohesion Evaluation Scale II, and Behavior Assessment System for Children [ Time Frame: Measured at Months 3 and 6 and Years 1, 2, 3, and 4 post-treatment ] [ Designated as safety issue: No ]
  

Anxiety disorders are among the most common disorders in children. Although anxiety is a normal part of growing up, the worrying experienced by children with anxiety disorders can persist so far that day-to-day functioning becomes difficult. Physical symptoms of anxiety disorders include a constant sense of worry or stress, headache, nausea, sweating, shaking, and inability to concentrate. Early identification of anxiety disorders is important to prevent progression of the disorder into a chronic issue. Cognitive behavioral therapy (CBT), which focuses on behavioral and thinking modifications, has been shown to be the most effective treatment for anxiety disorders. This study will evaluate the effectiveness of school-based CBT with or without parental involvement in treating children with anxiety disorders, including separation anxiety disorder, generalized anxiety disorder, and social phobia.

Participants in this single blind study will be randomly assigned by school to one of three treatment groups: CBT for children only, CBT for children plus parent training, and no treatment control. Each child and parent participant will first undergo an interview, lasting between 1 and 1.5 hours, about the child's symptoms. Additionally, parents will complete forms about their own symptoms. The participants receiving CBT will then attend 9 weekly sessions held in the school buildings after school. In the parental involvement group, parents will attend 9 weekly group training sessions held at the same time as the child's CBT group sessions. During the children's CBT sessions, participants will learn techniques to identify feelings of worry, relax, modify negative thoughts, break down difficult situations into smaller achievable steps, reward themselves for trying hard, and maintain treatment gains. For the parent training group, early sessions will focus on normalizing anxiety during childhood, learning about anxiety, and identifying when their children are feeling anxious. The middle sessions will teach parents the same anxiety management skills being taught to their children and ways to help their children to apply the steps at home. The latter sessions will instruct parents on ways to encourage their children's behaviors in anxiety provoking situations. After completing the 9-week program, participants will attend 2 follow-up booster sessions at Months 1 and 3 post-treatment. Follow-up assessments will occur at Months 3 and 6, possibly at Month 12, and at Years 1, 2, 3, and 4 post-treatment. The assessments will include repeat interviews and forms. At the end of the 6-month follow-up assessment, participants in the no treatment control group will have the opportunity to participate in the CBT group treatment.