Anxiety Disorders Clinical Trial
Official title:
Early Interventions for Anxious Children
This study will evaluate the effectiveness of school-based cognitive behavioral therapy with or without parental involvement in treating anxious children.
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 to the point 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 anxious children who meet
DSM-IV criteria or have features of 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 rating scales about their children's symptoms and their own symptoms. The
participants receiving CBT will then attend 9 weekly group sessions held in the school
buildings after school. In the parental involvement group, parents will attend 9 weekly group
parent-training sessions held at the same time as the children'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 and at
Years 1, 2, 3, and 4 post-treatment. The assessments will include repeat interviews and
rating scales. 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
treatments.
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