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Cited by 67Youth Substance Use and School AttendancePsychological Treatments and AssessmentsAnxiety, Depression, Psychometrics, Treatment, Cognitive Processes

Cognitive mediation of cognitive-behavioural therapy outcomes for anxiety-based school refusal

Open access
Maric, Marija, Heyne, David A., MacKinnon, David P., van Widenfelt, Brigit M., Westenberg, P. Michiel·2013·Behavioural and Cognitive Psychotherapy
DOI 10.1017/s1352465812000756PMC PMC3772992
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Abstract

Background: Cognitive-behavioural therapy (CBT) has proven to be effective for anxiety-based school refusal, but it is still unknown how CBT for school refusal works, or through which mechanisms. Aims: Innovative statistical approaches for analyzing small uncontrolled samples were used to investigate the role of self-efficacy in mediating CBT outcomes for anxiety-based school refusal. Method: Participants were 19 adolescents (12 to 17 years) who completed a manual-based cognitive-behavioural treatment. Primary outcomes (school attendance; school-related fear; anxiety) and secondary outcomes (depression; internalizing problems) were assessed at post-treatment and 2-month follow-up. Results: Post-treatment increases in school attendance and decreases in fear about attending school the next day were found to be mediated by self-efficacy. Mediating effects were not observed at 2-month follow-up. Conclusions: These findings provide partial support for the role of self-efficacy in mediating the outcome of CBT for school refusal. They contribute to a small body of literature suggesting that cognitive change enhances CBT outcomes for young people with internalizing problems. Regarding methodology, the product of coefficient test appears to be a valuable way to study mediation in outcome studies involving small samples.

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  • A single treatment condition can contribute to understanding mediation processes but yields weaker evidence than studies with a control group and random assignment.

    “A single treatment condition can contribute to an understanding of mediation processes but yields weaker evidence than studies with a control group and random assignment. 28”

    From The Mediating Role of Acceptance in Multidisciplinary Cognitive-Behavioral Therapy for Chronic Pain (2015) · cites this paper as [28]

    The Method section describes a mediation analysis designed for a single treatment condition without a control group. The Discussion says that the lack of a control condition limits what can be inferred and that comparison conditions are needed for a fuller understanding of mediation. Our copy does not specifically discuss random assignment or compare the strength of evidence with randomized studies. (LLM, conf=0.82)

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  • A single group design can still contribute to an understanding of mediation processes.

    “Nevertheless, as Maric argues, a single group design can still contribute to an understanding of mediation processes, and this is evidenced by several recent investigations of mediation in single treatment groups. 28, 47, 57”

    From The Mediating Role of Acceptance in Multidisciplinary Cognitive-Behavioral Therapy for Chronic Pain (2015) · cites this paper as [28]

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Research works printed but not linked: 5

  1. Duizer L Evaluation of the Dutch Self-Efficacy Questionnaire for School Situations: convergent validity and test-retest reliability Unpublished Master thesis 2007 the Netherlands Leiden University
  2. Heyne D King NJ Tonge B Rollings S Young D Pritchard M Evaluation of child therapy and caregiver training in the treatment of school refusal Journal of the American Academy of Child and Adolescent Psychiatry 2002 41 687 695 12049443
  3. Heyne D Rollings S School Refusal 2002 Oxford Blackwell Scientific Publications
  4. Kleinknecht RA Bernstein DA Hersen M Bellack AS Fear thermometer Dictionary of Behavioural Assessment Techniques 1988 New York Pergamon Press 220 221
  5. Van der Leden S Factor Structure of the Dutch Self-Efficacy Questionnaire for School Situations. Unpublished Master thesis 2008 the Netherlands Leiden University

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Authors
Maric, M., Heyne, D. A., MacKinnon, D. P., van Widenfelt, B. M., & Westenberg, P. M.
Affiliations
  • Leiden University (NL)
  • Arizona State University (US)
ORCID
Venue
Behavioural and Cognitive Psychotherapy
Publisher
Cambridge University Press (CUP)
Published
2012-09-28
Volume
41
Issue
5
Pages
549-564
ISSN
  • 1352-4658 (ISSN-L)
  • 1469-1833
DOI
10.1017/s1352465812000756
PMC
PMC3772992
OpenAlex
W2112535838
Cited by
67
References
69
Citations by year
2025: 2 · 2024: 3 · 2023: 3 · 2022: 4 · 2021: 2 · 2020: 10 · 2019: 3 · 2018: 12 · 2017: 5 · 2016: 4 · 2015: 11 · 2014: 3 · 2013: 4 · 2012: 1
FWCI
29.54
Type
journal article
Language
en
Open access
Licence
www.cambridge.org/core/terms (unspecified)
Locations
  • Behavioural and Cognitive Psychotherapy (publishedVersion)
  • PubMed (publishedVersion)
  • Europe PMC (PubMed Central) (acceptedVersion)
  • PubMed Central (acceptedVersion)
  • Data Archiving and Networked Services (DANS) (submittedVersion)
  • Leiden Repository (Leiden University) (submittedVersion)
Funders
National Institute on Drug Abuse (R01DA009757)
Topics
  • Social Sciences › Education › Youth Substance Use and School Attendance
  • Social Sciences › Psychology › Clinical Psychology › Psychological Treatments and Assessments
  • Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
Keywords
school refusal, cognitive behavioral therapy, self-efficacy, mediation, anxiety, school attendance, adolescents, internalizing problems
MeSH terms
Adolescent, Anxiety Disorders, Child, Culture, Fear, Female, Follow-Up Studies, Humans, Inservice Training, Male, Netherlands, Personality Assessment, Phobic Disorders, Cognitive Behavioral Therapy, Self Efficacy

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