Effectiveness of modular CBT for child anxiety in elementary schools.
Effectiveness of modular CBT for child anxiety in elementary schools.
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DOI：
10.1037/spq0000017
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发表时间：
2013-06
期刊：
影响因子：
--
通讯作者：
Wood JJ
中科院分区：
文献类型：
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作者：
Chiu AW;Langer DA;McLeod BD;Har K;Drahota A;Galla BM;Jacobs J;Ifekwunigwe M;Wood JJ
大多数针对儿童焦虑症的认知行为疗法（CBT）的随机对照试验都是使用在研究环境中治疗的招募样本来评估治疗效果的。需要在学校环境中进行临床试验，以确定CBT在现实环境中是否有效。本研究评估了两所小学儿童焦虑症的模块化CBT计划。由教师和学校工作人员推荐的40名患有焦虑症的儿童（5-12岁）被随机分配到模块化CBT或3个月的等待名单中。临床医生与个别家庭以及教师和学校工作人员一起工作。对治疗条件不知情的评估者进行了结构化的诊断访谈，护理人员和儿童在治疗前后完成了症状检查表。主要的研究结果是临床整体印象改善量表，95.0%的CBT参与者在治疗后产生了积极的治疗反应，而等待名单参与者只有16.7%。CBT在诊断结果和护理人员报告的焦虑测量方面也优于候补名单。治疗效果并没有超出焦虑的诊断和症状。结果表明，在小学环境中提供模块化CBT可能对儿童焦虑症的治疗有效。在更大的样本中表明了研究结果的重复。
Most randomized controlled trials of cognitive–behavioral therapy (CBT) for children with anxiety disorders have evaluated treatment efficacy using recruited samples treated in research settings. Clinical trials in school settings are needed to determine if CBT can be effective when delivered in real world settings. This study evaluated a modular CBT program for childhood anxiety disorders in two elementary schools. Forty children (5–12 years old) with anxiety disorders, referred by teachers and school staff, were randomly assigned to modular CBT or a 3-month waitlist. Clinicians worked with individual families as well as teachers and school staff. Evaluators blind to treatment condition conducted structured diagnostic interviews and caregivers and children completed symptom checklists at pre- and posttreatment. The primary study outcome, the Clinical Global Impressions-Improvement scale, yielded a positive treatment response at posttreatment for 95.0% of CBT participants, as compared with only 16.7% of the waitlist participants. CBT also outperformed the waitlist on diagnostic outcomes and caregiver-report measures of anxiety. Treatment effects did not extend beyond anxiety diagnoses and symptoms. Results suggest that modular CBT delivered within the elementary school setting may be effective for the treatment of child anxiety disorders. A replication of the study results with a larger sample is indicated.