Findings of a meta-analysis published in the Journal of Anxiety Disorders suggested that cognitive behavioral therapy (CBT) that targets pediatric anxiety had benefits that generalized to other life areas, such as social skills and depressive symptoms.
Although the reduction of anxiety symptoms is a central goal of this type of CBT, more important, the authors proposed, are the improvements in a child’s general functioning.
The authors searched the PsychInfo and Medline databases for English-language, randomized controlled trials of anxiety-focused CBT that reported on secondary outcomes, in which participants were <19 years old and had a primary anxiety diagnosis. Treatment had to be face-to-face, and study quality was assessed with the Clinical Trials Assessment Measure.
A total of 42 studies were included, although not every study was included in each analysis of secondary outcomes. These analyses included comorbid symptoms; overall functioning; and family, social, and academic functioning. The authors coded parental involvement as no or low involvement, moderate involvement, high involvement, or parent-mediated treatment.
Analyses revealed that the treatment effect size was comparable to that of generic CBT. The treatment appeared to have the largest effect on general functioning and also reduced depressive symptoms and externalizing behaviors (eg, anger).
The effect of parental involvement varied by domain. For anxiety symptoms, greater parental involvement seemed to have no significant effect, but involvement had a generally positive effect at follow-up.
Social competence seemed not to change from baseline to conclusion, but in follow-up, greater social competence was reported, which suggests, perhaps, that this type of improvement takes longer to emerge. Parental involvement did not appear to benefit social competence outcomes.
The authors cautioned that the effect sizes may have been overestimated, as publication bias could not be ruled out.
Kreuze L, Pijnenborg G, de Jonge Y, Nauta M. Cognitive-behavior therapy for children and adolescents with anxiety disorders: A meta-analysis of secondary outcomes. J Anxiety Disord. 2018;60:43-57.