Predicting outcomes for anxious children receiving group cognitive-behavioural therapy: does the type of anxiety diagnosis make a difference?

Background: Cognitive-behavioural therapy (CBT) is an efficacious treatment for anxiety disorders in children and adolescents, yet not all young people improve. Understanding predictors of treatment response can inform treatment improvements in order to enhance outcomes. Aim: The purpose of this study was to compare treatment outcomes following group-based CBT for children with different anxiety disorders (social phobia (SocP), separation anxiety disorder (SAD), generalised anxiety disorder (GAD), specific phobia (SP)) to determine whether differential outcomes from group-based CBT are related to type of diagnosis. Method: Participants were 205 clinically anxious children between 4 and 12 years of age. Treatment outcomes were assessed using clinician-rated diagnostic interviews, parent-report, and child-report symptom measures. Ninety-seven children completed a long-term follow-up assessment 6 or 12 months after treatment. Results: Children with a principal diagnosis of SocP and GAD had a poorer post-treatment outcome compared to children with a principal diagnosis of SP and SAD. Poorer outcomes persisted in children with a principal diagnosis of SocP by the follow-up assessment compared to children with the other anxiety disorders. Conclusions: These findings are consistent with recent studies that have found poorer outcomes from CBT for youth and adults with SocP, and emphasise the need for further research into treatments that target specific factors that could improve outcomes.