Effectiveness of a Cognitive Behavioral Therapy-Based Indicated Prevention Program for Children with Elevated Anxiety Levels: a Randomized Controlled Trial

Manon L. A. van Starrenburg,Rowella C. M. W. Kuijpers,Giel J. M. Hutschemaekers,Marloes Kleinjan,Rutger C. M. E. Engels

doi:10.1007/s11121-016-0725-5

Manon L. A. van Starrenburg, Rowella C. M. W. Kuijpers + Show 3 more

Open Access

https://doi.org/10.1007/s11121-016-0725-5

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Abstract

Childhood anxiety is a problem not only because of its negative consequences on the well-being of children but also because of its adverse effects on society and its role in mental disorders later in life. Adequate prevention might be the key in tackling this problem. The effectiveness of Coping Cat, as an indicated CBT-based prevention program in Dutch primary school children, was assessed by means of a randomized controlled trial. In total, 141 children aged 7–13 with elevated levels of anxiety and their mothers were included and randomly assigned to an intervention group and a waiting list control group. After screening, all participants completed baseline, post-intervention, and 3-month follow-up assessments. The results showed that Coping Cat, as an indicated prevention program, reduces children’s self-reported anxiety symptoms, with Cohen’s effect size d of 0.66 at the 3-month follow-up. A moderating effect was found for baseline anxiety level; specifically, children with high levels of baseline anxiety who received the Coping Cat program had lower anxiety levels at follow-up compared to children with high levels of anxiety in the control condition. No moderating effects of gender or age were found. An unexpected decline in anxiety levels from screening to pre-assessment was found in both groups, and this decline was stronger in the experimental group. These promising results warrant the implementation of Coping Cat as an indicated prevention program.

Highlights

Anxiety disorders are among the most prevalent mental disorders among children and adolescents (Kroes et al 2001; Tuebert and Pinquart 2011; Verhulst et al 1997)
The aim of the present study was to evaluate the effectiveness of Coping Cat as an indicated prevention program in Dutch primary school children with elevated levels of anxiety
The results showed that from the start of the training to the 3month follow-up assessment, children’s self-reported anxiety levels decreased significantly more in the experimental group compared to the control group

Summary

Introduction

Anxiety disorders are among the most prevalent mental disorders among children and adolescents (Kroes et al 2001; Tuebert and Pinquart 2011; Verhulst et al 1997). About 75% of anxiety disorders have an onset between 11 and 21 years of age (Kessler et al 2005). Anxiety disorders can have detrimental consequences, both short and long term, on emotional and social functioning of children (Regier et al 1998). When childhood anxiety disorders are left untreated, they are known to persist into adulthood (Reef et al 2009), which prolongs the affected individuals’ suffering and increases health care costs (Bodden et al 2008). The early onset of anxiety disorders and associated negative effects as well as the high number of youths not receiving the treatment, highlights the need for early screening and prevention

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