An effectiveness study of individual vs. group cognitive behavioral therapy for anxiety disorders in youth

Gro Janne H Wergeland; Krister W Fjermestad; Carla E Marin; Bente Storm-Mowatt Haugland; Jon Fauskanger Bjaastad; Kristin Oeding; Ingvar Bjelland; Wendy K Silverman; Lars-Göran Ost; Odd E Havik; Einar R Heiervang

doi:10.1016/j.brat.2014.03.007

An effectiveness study of individual vs. group cognitive behavioral therapy for anxiety disorders in youth

Behav Res Ther. 2014 Jun:57:1-12. doi: 10.1016/j.brat.2014.03.007. Epub 2014 Mar 31.

Affiliations

¹ Anxiety Research Network, Haukeland University Hospital, N-5021 Bergen, Norway; Department of Clinical Medicine, Faculty of Medicine and Dentistry, University of Bergen, N-5021 Bergen, Norway; Department of Child and Adolescent Psychiatry, Haukeland University Hospital, N-5021 Bergen, Norway. Electronic address: gjwergeland@gmail.com.
² Anxiety Research Network, Haukeland University Hospital, N-5021 Bergen, Norway; Frambu Resource Centre for Rare Disorders, N-1404 Siggerud, Norway.
³ Child Study Center, Yale University School of Medicine, 230 South Frontage Road, New Haven, CT 06520, USA.
⁴ Anxiety Research Network, Haukeland University Hospital, N-5021 Bergen, Norway; Regional Centre for Child and Youth Mental Health and Child Welfare, Uni Health, Uni Research, N-5020 Bergen, Norway.
⁵ Anxiety Research Network, Haukeland University Hospital, N-5021 Bergen, Norway; Regional Centre for Child and Youth Mental Health and Child Welfare, Uni Health, Uni Research, N-5020 Bergen, Norway; Division of Psychiatry, Stavanger University Hospital, N-4068 Stavanger, Norway.
⁶ Anxiety Research Network, Haukeland University Hospital, N-5021 Bergen, Norway; Department of Child and Adolescent Psychiatry, Haukeland University Hospital, N-5021 Bergen, Norway.
⁷ Department of Clinical Medicine, Faculty of Medicine and Dentistry, University of Bergen, N-5021 Bergen, Norway; Department of Child and Adolescent Psychiatry, Haukeland University Hospital, N-5021 Bergen, Norway.
⁸ Anxiety Research Network, Haukeland University Hospital, N-5021 Bergen, Norway; Department of Clinical Psychology, Faculty of Psychology, University of Bergen, N-5020 Bergen, Norway; Department of Psychology, University of Stockholm, SE-106 91 Stockholm, Sweden.
⁹ Anxiety Research Network, Haukeland University Hospital, N-5021 Bergen, Norway; Department of Clinical Psychology, Faculty of Psychology, University of Bergen, N-5020 Bergen, Norway.
¹⁰ Anxiety Research Network, Haukeland University Hospital, N-5021 Bergen, Norway; Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, N-0315 Oslo, Norway; Division of Mental Health and Addiction, Oslo University Hospital, N-0424 Oslo, Norway.

PMID: 24727078
DOI: 10.1016/j.brat.2014.03.007

Abstract

Objective: Conducted a randomized controlled trial to investigate the effectiveness of cognitive behavioral therapy (CBT), and compared the relative effectiveness of individual (ICBT) and group (GCBT) treatment approaches for anxiety disorders in children and adolescents.

Methods: Referred youth (N = 182, M age = 11.5 years, range 8-15 years, 53% girls) with separation anxiety, social phobia, or generalized anxiety disorder were randomly assigned to ICBT, GCBT or a waitlist control (WLC) in community clinics. Pre-, post-, and one year follow-up assessments included youth and parent completed diagnostic interview and symptom measures. After comparing CBT (ICBT and GCBT combined) to WLC, ICBT and GCBT were compared along diagnostic recovery rates, clinically significant improvement, and symptom measures scores using traditional hypothesis tests, as well as statistical equivalence tests.

Results: Significantly more youth lost all anxiety disorders after CBT compared to WLC. Full diagnostic recovery rate was 25.3% for ICBT and 20.5% in GCBT, which was not significantly different. There was continued lack of significant differences between ICBT and GCBT at one year follow-up. However, equivalence between GCBT and ICBT could only be demonstrated for clinical severity rating of the principal anxiety disorder and child reported anxiety symptoms post-treatment.

Conclusion: Findings support the effectiveness of CBT compared to no intervention for youth with anxiety disorders, with no significant differences between ICBT and GCBT. However, the relatively low recovery rates highlight the need for further improvement of CBT programs and their transportability from university to community settings.

Keywords: Anxiety; Children; Cognitive behavioral therapy; Effectiveness; Treatment.

Publication types

Randomized Controlled Trial
Research Support, Non-U.S. Gov't

MeSH terms

Adolescent
Anxiety Disorders / therapy*
Child
Cognitive Behavioral Therapy / methods*
Female
Humans
Male
Patient Compliance
Psychiatric Status Rating Scales
Psychotherapy, Group
Treatment Outcome