Hudson et al. (2015). Comparing outcomes for children with different anxiety disorders following cognitive behavioural therapy.” – Article summary

The recovery rate of CBT for anxiety disorders is approximately 60%. Treatment tries to treat underlying constructs of anxiety even though different anxiety disorders exist and are often highly heterogeneous. However, there may be a differential response to different treatments per disorder as this is the case with adults.

The presence of social anxiety disorder at pre-treatment leads to slower rate of change and poorer diagnostic outcomes at post-treatment and follow-up compared to children with other anxiety disorders. This is not affected by age or comorbid depression.

Children with SAD may have poorer diagnostic outcomes because the group setting is more aversive for them. Next, children with SAD have often shown behavioural inhibition since infancy and this may make it more resistant to change. It may thus be necessary to have a longer treatment programme for children with SAD. The presence of SAD may also make the therapeutic relationship more problematic. Children with SAD may have impairments in interpersonal interactions and this may impact the successful execution of exposure tasks. This may lead to exposure having the opposite effect of the one desired. Social situations are also more ambiguous making it more difficult to see whether one’s initial interpretation was false or not.

Children with SAD may need a more tailored programme that helps them disconfirm their negative social expectations (e.g. equip children with social skills prior to exposure).

For a family-based group CBT, children with GAD were more likely to experience remission immediately following treatment and showed a greater reduction in diagnostic severity. While this holds for mother-reported symptoms, this does not necessarily hold for child-reported symptoms. Children with OCD had a better outcome on clinician-rated diagnostic severity compared to other anxiety disorders but did not differ across diagnostic remission or child or mother-reported symptom change.