Phobic and Anxiety Disorders in Children and Adolescents: A Clinician's Guide to Effective Psychosocial and Pharmacological Interventions by Thomas H. Ollendick & John S. March

Author:Thomas H. Ollendick & John S. March
Language: eng
Format: mobi
ISBN: 9780195135947
Publisher: Oxford University Press
Published: 2003-11-30T22:00:00+00:00

Imipramine

12–18-year-olds ( N = 47)

Clinician-rated and self-reported anxiety (ARC-R and RCMAS) and depres-8 weeks of imipramine or placebo, both in

33% had SAD

sion (CDRS-R and BDI) improved for both groups; clinician-rated depression combination with CBT

Randomized DBPC

improved faster in the imipramine plus CBT group; greater and faster (Bernstein et al., 2000)

improvement in attendance was found for the imipramine plus CBT group, compared with the placebo plus CBT group

291

Fluvoxamine

6–17-year-olds ( N = 128)

Children in the fluvoxamine group had the greatest improvement in clinician-8 weeks of medication or placebo, in

59% had SAD

rated anxiety symptoms (PARS); more children in the active treatment group combination with supportive psychotherapy

Randomized DBPC

had a positive response to treatment (76%), compared with the placebo group (Research Unit on Pediatric Psychopharma-

(29%), on global ratings (CGI).

cology [RUPP] Anxiety Study Group, 2001)

Note. ARC-R = Anxiety Rating for Children–Revised; BDI = Beck Depression Inventory; BPRS-C = Brief Psychiatric Rating Scale for Children; CDI = Children’s Depression Inventory; CDRS-R = Children’s Depression Rating Scale–Revised; CDS = Children’s Depression Scale; CGAS = Children’s Global Assessment Scale; CGI = Clinician Global Impressions; CPRS = Conners Parent Rating Scale; DBPC = double-blind placebo controlled; PARS = Pediatric Anxiety Rating Scale.

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assessment and treatment

are presented to the children, and they are given supportive psychotherapy without any specific encouragement or instructions to manage behavioral avoidance of school and anxious thoughts. The researchers found that children in both the CBT and educational-support treatments reported decreased symptoms of anxiety by the end of treatment. Both groups significantly increased their school attendance over the course of treatment, but there were no significant differences between the groups. Later analyses found that, compared with children with other anxiety diagnoses, children with a primary diagnosis of SAD showed more improvement in school attendance by the end of the study, with no differences between the treatment conditions (C. G. Last & C. Hansen, personal communication, October 2000).

Mendlowitz et al. (1999) examined the role of parental involvement in CBT treatment of anxiety disorders by using a 12-session group therapy format. Parent-child dyads were randomly assigned to one of three treatment conditions including parent and child intervention, child-only intervention, and parent-only intervention. The Coping Bear Workbook (Scapillato & Mendlowitz, 1993), an adaptation of Kendall’s (1990) Coping Cat Workbook, was used for the 12-session child treatment program and focused on identification of anxiety symptoms, relaxation training, use of coping self-statements, and self-reinforcement of coping efforts. The parent groups were primarily psychoeducational in nature, focusing on understanding of anxiety, effects of parent anxiety on children, and how to manage an anxious child. Findings showed a decrease in anxiety and depressive symptoms for all treatment groups. Children in the parent-child intervention group used more active coping strategies by the end of treatment and were viewed as more improved overall, according to parent reports. Consistent with findings from the studies conducted by Barrett (1998) and colleagues (Barrett et al., 1996), there appears to be additional benefit from parental involvement in the treatment of childhood anxiety.

Group CBT was also examined in a study conducted by Flannery-Schroeder and Kendall (2000).

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