The Impact of Treatment Expectations on Exposure Process and Treatment Outcome in Childhood Anxiety Disorders
| Autor: | Boris Birmaher, Nicole E. Caporino, Tara S. Peris, Hardian Thamrin, Jocelyn Perez, Anne Marie Albano, Monica S. Wu, John T. Walkup, Scott N. Compton, John Piacentini, Philip C. Kendall |
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| Rok vydání: | 2020 |
| Předmět: |
Male
050103 clinical psychology 6.6 Psychological and behavioural Phobia Anxiety Developmental psychology Anxiety Separation Sertraline Developmental and Educational Psychology Childhood anxiety Psychology Child Outcome Pediatric 05 social sciences Separation anxiety disorder Combined Modality Therapy Anxiety Disorders Psychiatry and Mental health Outcome and Process Assessment Health Care Mental Health Serotonin Uptake Inhibitors Female medicine.symptom Selective Serotonin Reuptake Inhibitors 050104 developmental & child psychology Clinical psychology medicine.drug medicine.medical_specialty Pediatric Research Initiative Randomization Generalized anxiety disorder Psychotherapeutic Processes Adolescent Clinical Trials and Supportive Activities Implosive Therapy Developmental & Child Psychology Outcome and Process Assessment Article Compliance (psychology) Separation Exposure Social Clinical Research Behavioral and Social Science medicine Humans 0501 psychology and cognitive sciences Cognitive Behavioral Therapy Public health Evaluation of treatments and therapeutic interventions Phobia Social Expectations medicine.disease Brain Disorders Health Care Treatment Patient Compliance Mind and Body |
| Zdroj: | Journal of abnormal child psychology, vol 48, iss 1 J Abnorm Child Psychol |
| Popis: | OBJECTIVE: This study examined the relationship between caregivers’ and youths’ treatment expectations and characteristics of exposure tasks (quantity, mastery, compliance) in cognitive-behavioral therapy (CBT) for childhood anxiety. Additionally, compliance with exposure tasks was tested as a mediator of the relationship between treatment expectations and symptom improvement. METHOD: Data were from youth (N= 279; 7–17 years old) enrolled in the Child/Adolescent Anxiety Multimodal Study (CAMS) and randomized to cognitive-behavioral therapy (CBT) or the combination of CBT and sertraline for the treatment of separation anxiety disorder, generalized anxiety disorder, and social phobia. Caregivers and youth independently reported treatment expectations prior to randomization, anxiety was assessed at pre- and post-treatment by independent evaluators blind to treatment condition, and exposure characteristics were recorded by the cognitive-behavioral therapists following each session. RESULTS: For both caregivers and youths, more positive expectations that anxiety would improve with treatment were associated with greater compliance with exposure tasks, and compliance mediated the relationship between treatment expectations and change in anxiety symptoms following treatment. Additionally, more positive parent treatment expectations were related to a greater number and percentage of sessions with exposure. More positive youth treatment expectations were associated with greater mastery during sessions focused on exposure. CONCLUSIONS: Findings underscore the importance of addressing parents’ and youths’ treatment expectations at the outset of therapy to facilitate engagement in exposure and maximization of therapeutic gains. |
| Databáze: | OpenAIRE |
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