CBT for anxiety disorders in children: A systematic review and meta-analysis
Öst, Lars-Göran
Dep. of Psychology, Stockholm University, Sweden
Much less research has been done on anxiety disorders in children and adolescents compared to the large number of studies in adults. However, during the last decade there has been a very large increase of research in this area. A search in the common data bases yielded a total of 85 randomized clinical trials (totaling almost 5600 patients) with the following distribution: Specific phobia 12, Social phobia 12, Panic disorder with agoraphobia 1, OCD 11, PTSD 14, Separation anxiety 1, and the mixed diagnoses Generalized anxiety disorder, Separation anxiety and Social phobia 34. The meta-analysis generally found good treatment effects that were maintained at follow-up. Applying the APA Task Force criteria for empirically supported treatments showed that there is at least one well-established treatment for each anxiety disorder; Specific phobia: Exposure in-vivo and One-session treatment, Social phobia: Social effectiveness training for children, OCD: Exposure and response prevention, PTSD: Trauma focused CBT for children and parents, and Mixed diagnoses: CBT for children (both individually and in groups) and CBT for children and parents. Another three treatments are fulfilling criteria for probably efficacious: Prolonged exposure for adolescents in PTSD, Panic control treatment for adolescents in Panic disorder, and a disorder-specific CBT for children with Separation Anxiety. The conclusion that can be drawn is that, irrespective of anxiety disorder, there are effective CBT treatments that will result in a majority of the treated children losing their diagnosis and not relapsing at follow-up a year or longer after treatment.