background Cognitive behavioural therapy (cbt) is the treatment of choice for children with an anxiety disorder. However, about 35% of anxious children is still anxious after treatment. Knowledge about the effective ingredients of cbt is needed to improve this treatment.
aim To examine whether cognitive restructuring, coping and perceived control over anxious situations are mechanisms of change in cbt for children and adolescents with anxiety disorders.
method Participants were 148 children (8-18 years-old, M = 12.5 years, 57% girls) with a primary anxiety disorder. Individual treatment consisted of 12 weekly sessions cbt. Assessments were completed at pretreatment, midtreatment (after session 8) posttreatment (after session 12) and at three-month follow-up. Anxiety was assessed separately in children and parents with a semi-structured interview (adis-c) and a questionnaire (rcads). Negative and positive cognitions, coping strategies and perceived control were assessed with self-report questionnaires.
results Anxiety level decreased significantly from pretreatment to posttreatment and also from posttreatment to follow-up. After treatment 57% of the children was free of an anxiety diagnosis, at follow-up 63%. The investigated mechanisms of change (negative and positive cognitions, coping strategies and perceived control) changed from pre- to posttreatment, but then stabilised. Positive cognitions significantly increased during the first part of treatment; negative cognitions decreased during the entire treatment. Perceived control increased during the entire treatment. The results for different coping strategies were less straightforward: only three of five strategies (problem focused coping, positive thinking and avoidant coping) changed during treatment. No differences were found for two other coping strategies (distraction and support seeking strategies). The question whether cognitive restructuring, coping and perceived control over anxious situations are mechanisms of change in cbt will be answered at the conference.
conclusion The results and implications for future studies and treatment will be discussed at the congress.