A Randomized Clinical Trial Comparing Individual Cognitive Behavioral Therapy and Child-Centered Therapy for Child Anxiety Disorders
A Randomized Clinical Trial Comparing Individual Cognitive Behavioral Therapy and Child-Centered Therapy for Child Anxiety Disorders
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DOI：
10.1080/15374416.2016.1138408
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发表时间：
2018-01-01
影响因子：
4.2
通讯作者：
Ryan, Neal D.
中科院分区：
文献类型：
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作者：
Silk, Jennifer S.;Tan, Patricia Z.;Ryan, Neal D.
本研究比较了个体认知行为疗法（CBT）和以儿童为中心的支持性疗法（CCT）治疗儿童焦虑症的治疗反应率和治疗后和1年随访时的恢复率，以及情绪功能的真实测量。青少年（N = 133;年龄9-14）焦虑症（广泛性，分离和/或社交焦虑）使用2：1的比例随机分配到CBT（n = 90）或CCT（n = 43），作为积极的比较。治疗后和1年随访时的治疗反应和恢复情况由独立评估员进行评估，青少年在整个治疗过程中完成了日常情绪的生态瞬时评估。CBT和CCT中的大多数青少年被归类为治疗应答者（CBT为71.1%，CCT为55.8%），但接受CBT治疗的青少年更有可能完全康复，不再符合任何目标焦虑症的诊断标准，并且不再显示残留症状（CBT为66.7%，CCT为46.5%）。接受CBT治疗的青年还报告说，相对于接受CCT治疗的青年，在治疗的后期阶段，与最近在日常生活中经历的负面事件相关的负面情绪显着降低。此外，与CCT相比，接受CBT治疗的年轻人在1年随访时恢复的百分比显著更高（CBT为82.2%，CCT为65.1%）。这些研究结果表明，CBT的潜在好处超过支持性治疗的广度，普遍性和持久性的治疗相关的收益。
This study compared individual cognitive behavioral therapy (CBT) and a supportive child-centered therapy (CCT) for child anxiety disorders on rates of treatment response and recovery at posttreatment and 1-year follow-up, as well as on real-world measures of emotional functioning. Youth (N = 133; ages 9-14) with anxiety disorders (generalized, separation, and/or social anxiety) were randomized using a 2:1 ratio to CBT (n = 90) or CCT (n = 43), which served as an active comparison. Treatment response and recovery at posttreatment and 1-year follow-up were assessed by Independent Evaluators, and youth completed ecological momentary assessment of daily emotions throughout treatment. The majority of youth in both CBT and CCT were classified as treatment responders (71.1% for CBT, 55.8% for CCT), but youth treated with CBT were significantly more likely to fully recover, no longer meeting diagnostic criteria for any of the targeted anxiety disorders and no longer showing residual symptoms (66.7% for CBT vs. 46.5% for CCT). Youth treated with CBT also reported significantly lower negative emotions associated with recent negative events experienced in daily life during the latter stages of treatment relative to youth treated with CCT. Furthermore, a significantly higher percentage of youth treated with CBT compared to CCT were in recovery at 1-year follow-up (82.2% for CBT vs. 65.1% for CCT). These findings indicate potential benefits of CBT above and beyond supportive therapy on the breadth, generalizability, and durability of treatment-related gains.