The DOI matches its Crossref record; 124 of the 127 references it cites were found in a registry or an index.
A Meta-analysis to Guide the Enhancement of CBT for Childhood Anxiety: Exposure Over Anxiety Management
Open accessAbstract
Cognitive behavior therapy (CBT) is the most empirically supported therapy for childhood anxiety disorders (CADs) but has not reliably outperformed other credible interventions. The current study used meta-analysis to examine the frequency with which the most common treatment components are included in outcome studies and the relation of these components to symptom improvement. Seventy-five studies were identified that included youth with an anxiety disorder treated with CBT or a comparison condition. The protocols for the 111 CBT conditions generally consisted of 12, 1-h sessions delivered to the child with minimal parent inclusion. A greater amount of in-session exposure was related to significantly larger effect sizes between CBT and waitlist control across reporters (- 0.12 to - 0.15; P's < .05) and from pre- to post-treatment for child report (- .06; P < .01). Compared to treatments that omitted relaxation, treatments that included relaxation strategies were associated with significantly smaller pre- to post-treatment effect sizes across reporters (0.38 to 0.80; P's < .05). The current study suggests that CBT protocols for CADs that emphasize in-session exposure and do not include relaxation have the potential to improve the efficacy and effectiveness of therapy. Dismantling studies directly testing these hypotheses are needed.
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“and demonstrates high to moderate effects across disorders in meta-analyses, even against placebo conditions (e.g., Carpenter et al., 2018;Whiteside et al., 2020).”
From Effective—and Tolerable: Acceptance and Side Effects of Intensified Exposure for Anxiety Disorders (2023) · cites this paper as Whiteside et al., 2020
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“But the inclusion of such somatic coping strategies in pediatric CBT for anxiety has been questioned [26, 50].”
From Developing a primary care-based cognitive behavioral intervention for anxiety in children through a participatory approach: a qualitative study. (2026) · cites this paper as [50]
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“A meta-analysis showed that interventions incorporating somatic management strategies (including relaxation and breathing exercises) had smaller effect sizes than those that omitted such strategies [50].”
From Developing a primary care-based cognitive behavioral intervention for anxiety in children through a participatory approach: a qualitative study. (2026) · cites this paper as [50]
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“Moreover, there is little to no information about the quality of exposure delivery, which is likely to vary between therapists using the same protocols (i.e., POTS, 2004).”
Background
Research works printed but not linked: 7
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Epidemiology of anxiety disorders: global burden and sociodemographic associations
Javaid, S. F., Hashim, I. J., Hashim, M. J., Stip, É., Samad, A., & Ahbabi, A. A. (2023) · Middle East Current Psychiatry · doi:10.1186/s43045-023-00315-3 · Cited by 565
“Individuals in wealthier nations may face more daily pressures to achieve and portray an image of wealth and beauty to others, which can adversely affect self-image and contribute to anxiety [11].”
BackgroundAnxiety disorders in children and adolescents: A summary and overview of the literature
Rapee, R. M., Creswell, C., Kendall, P. C., Pine, D. S., & Waters, A. M. (2023) · Behaviour Research and Therapy · doi:10.1016/j.brat.2023.104376 · Cited by 227
Sharma, S., Hucker, A., Matthews, T., Grohmann, D., & Laws, K. R. (2021) · BMC Psychology · doi:10.1186/s40359-021-00658-8 · Cited by 109
“Across general populations, the efficacy of CBT for reducing symptoms of anxiety has been demonstrated; and includes the maintenance of treatment gains for up to 12 months amongst youth receiving CBT for anxiety disorders [19, 20].”
BackgroundHalldorsson, B., Hill, C., Waite, P., Partridge, K., Freeman, D., & Creswell, C. (2021) · Journal of Child Psychology and Psychiatry · doi:10.1111/jcpp.13400 · Cited by 84
“…Peris et al., 2017) and recent research has high-lighted the limited (and potential detrimental) impact of relaxation exercises (Peris et al., 2015; Whiteside et al., 2020), yet the majority of applied games for anxiety problems focused only on training relaxation, and only one (i.e., MindLight;…”
McGuire, A., Steele, R. G., & Singh, M. N. (2021) · Clinical Child and Family Psychology Review · doi:10.1007/s10567-020-00334-0 · Cited by 64
Metadata
- Authors
- Whiteside, S. P. H., Sim, L. A., Morrow, A. S., Farah, W. H., Hilliker, D. R., Murad, M. H., & Wang, Z.
- Affiliations
- Mayo Clinic (US)
- Corresponding author
- Whiteside, Stephen P. H.
- Venue
- Clinical Child and Family Psychology Review
- Published
- 2019-10-18
- Volume
- 23
- Issue
- 1
- Pages
- 102-121
- ISSN
- 1096-4037 (ISSN-L)
- 1573-2827
- PMC
- PMC9005063
- OpenAlex
- W2980786259
- Cited by
- 190
- References
- 127
- Citations by year
- 2026: 28 · 2025: 32 · 2024: 34 · 2023: 23 · 2022: 33 · 2021: 27 · 2020: 11 · 2019: 1
- FWCI
- 2.69
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Clinical Child and Family Psychology Review (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- Agency for Healthcare Research and Quality (HHSA290201500013I)
- Topics
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Social Sciences › Psychology › Clinical Psychology › Child and Adolescent Psychosocial and Emotional Development
- Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
- Keywords
- cognitive behavioral therapy, childhood anxiety disorders, relaxation techniques, treatment components, treatment efficacy, waitlist control, child-reported outcomes, parental involvement
- MeSH terms
- Anxiety Disorders, Child, Humans, Implosive Therapy, Outcome and Process Assessment, Health Care, Relaxation Therapy, Cognitive Behavioral Therapy
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