Cognitive-Behavioral Therapy for Child Anxiety: Long-Term Follow-Up and Predictors of Long-Term Outcomes

Anxiety and its disorders are highly prevalent in childhood and adolescence, and are associated with impairment in social and academic functioning. Empirical evidence has accumulated demonstrating the efficacy of cognitive-behavioral therapy (CBT) for youth anxiety disorders delivered in individual, group, and parent formats. This dissertation study compared two of these formats, a youth only individual format, and two types of parental involvement formats to answer questions related to the long-term diagnostic outcomes and psychosocial functioning outcomes of youth who receive CBT for anxiety disorders. Specifically, this dissertation sought to compare individual and parent involvement to determine whether targeting parenting behaviors associated with youth anxiety produces significantly lower levels of psychopathology at a follow-up evaluation.The sample consisted of 173 youth and their parents who completed a follow-up evaluation one to seven years following treatment for youth anxiety disorders. Research questions were examined using regression analyses within a structural equation modeling framework. Results indicate that youth who demonstrated positive treatment gains at post treatment continued to maintain these gains at the long-term follow-up period one to seven years following treatment. Treatment condition significantly predicted ratings of youth anxiety symptoms at follow-up according to parent ratings, indicating lower youth anxiety symptom ratings for participants in the parent-involved conditions compared to participants in the youth only condition. Youth in the parent-involved conditions were also rated higher on social functioning at follow-up on the parent report, as compared to youth in the individual treatment condition. The study findings are discussed in terms of treatment design and clinical implications for the treatment of youth anxiety and its disorders