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- Title
The feelings club: randomized controlled evaluation of school-based CBT for anxious or depressive symptoms.
- Authors
Manassis, Katharina; Wilansky‐Traynor, Pamela; Farzan, Nas; Kleiman, Valery; Parker, Kevin; Sanford, Mark
- Abstract
Background: Children with anxious or depressive symptoms are at risk of developing internalizing disorders and their attendant morbidity. To prevent these outcomes, school-based cognitive-behavioral therapy (CBT) has been developed, but few studies include active control conditions. We evaluated a preventive CBT program targeting internalizing symptoms relative to an activity contrast condition post-intervention and at 1-year follow-up. Methods: One thousand one hundred and thirty-nine children from Grades 3-6 from a diverse sample of schools, were screened with the Multidimensional Anxiety Scale for Children and Children's Depression Inventory. Those with t>60 on either measure were offered participation in a randomized 12-week trial, school-based group CBT versus a structured after-school activity group of equal duration. We explored several therapeutic elements as potential predictors of change. Results: One hundred and forty-eight children participated (84 boys, 64 girls; 78 CBT, 70 contrast; 57% Caucasian) and 145 completed the program. Self-reported anxious and depressive symptoms decreased significantly over time (η2=.15 and .133, respectively), with no group by time interaction. There was a trend toward fewer children meeting diagnostic criteria for an anxiety disorder on the Anxiety Disorders Interview Schedule at 1-year post-CBT than post-contrast (6/76 versus 12/69). Positive reinforcement of child behavior was associated with change in anxiety symptoms; checking homework was understood with change in depressive symptoms. Conclusions: Findings suggest that children with internalizing symptoms may benefit from both school-based CBT and structured activity programs. Replication, longer follow-up, and further studies of therapeutic elements in child CBT are indicated. ISRCTN Registry identifier: ISRCTN88858028, url: <URL>http://www.controlled-trials.com/</URL> Depression and Anxiety, 2010. © 2010 Wiley-Liss, Inc.
- Subjects
COGNITIVE therapy; RANDOMIZED controlled trials; ANXIETY in children; DEPRESSION in children; INTERNALIZING behavior; FOLLOW-up studies (Medicine); REINFORCEMENT (Psychology)
- Publication
Depression & Anxiety (1091-4269), 2010, Vol 27, Issue 10, p945
- ISSN
1091-4269
- Publication type
Article
- DOI
10.1002/da.20724