Cited by 984Anxiety, Depression, Psychometrics, Treatment, Cognitive ProcessesChild and Adolescent Psychosocial and Emotional DevelopmentPsychological Treatments and Assessments

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Therapy for youths with anxiety disorders: A second randomized clincal trial.

Kendall, Philip C., Flannery-Schroeder, Ellen, Panichelli-Mindel, Susan M., Southam-Gerow, Michael, Henin, Aude, Warman, Melissa·1997·Journal of Consulting and Clinical Psychology

DOI 10.1037/0022-006x.65.3.366

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Abstract

Ninety-four children (aged 9-13 years) with anxiety disorders were randomly assigned to cognitive behavioral treatment or waiting-list control. Outcomes were evaluated using diagnostic status, child self-reports, parent and teacher reports, cognitive assessment and behavioral observation: maintenance was examined using 1-year follow-up data. Analyses of dependent measures indicated significant improvements over time, with the majority indicating greater gains for those receiving treatment. Treatment gains returned cases to within nondeviant limits (i.e., normative comparisons) and were maintained at 1-year follow-up. Client age and comorbid status did not moderate outcomes. A preliminary examination of treatment segments suggested that the enactive exposure (when it follows cognitive-educational training) was an active force in beneficial change. Discussion includes suggestions for future research.

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Method
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“…M anuscript N IH -PA Author M anuscript N IH -PA Author M anuscript and concurrent validity (Lyneham, Abbott, & Rapee, 2007; Silverman, Saavedra, & Pina, 2001; Wood et al., 2002), and has been shown to be sensitive to treatment change (Hudson et al., 2009; Kendall, 1994; Kendall et al., 1997).”
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InfluentialSelf-citation
Cognitive behavioural therapy for anxiety disorders in children and adolescents
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Cognitive behavioural therapy for anxiety disorders in children and adolescents
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“In sum, this study supports further research on PCIT for children with comorbid MR and ODD and contributes to emerging evidence that comorbidity may not lessen the efficacy of evidencebased interventions (Brown, Anthony, & Barlow, 1995; Kendall et al., 1997).”
Result
Child/Adolescent Anxiety Multimodal Study (CAMS): rationale, design, and methods
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BackgroundResultSelf-citation
The Pediatric Anxiety Rating Scale (PARS): Development and Psychometric Properties
Riddle, M., Ginsburg, G. S., Walkup, J., Labellarte, M. J., Pine, D. S., Davies, M., Greenhill, L., Sweeney, M., KLEIN, R. G., Abikoff, H., et al. (2002) · Institutional Research Information System University of Turin (University of Turin) · doi:10.1097/01.chi.0000020259.43550.f4 · Cited by 331
“, the ADIS-C, assess severity of individual anxiety disorders and have been used as an outcome measure in treatment studies (Kendall et al., 1997; Silverman et. al., 1999).”
Method
The Efficacy of an Internet-Based Cognitive-Behavioral Therapy Intervention for Child Anxiety Disorders
March, S., Spence, S. H., & Donovan, C. L. (2009) · Journal of Pediatric Psychology · doi:10.1093/jpepsy/jsn099 · Cited by 315
“of treatment (Barrett, Dadds, & Rapee, 1996; Kendall, 1994; Kendall et al., 1997), with effects maintained up to several years later (Barrett, Duffy, Dadds, & Rapee, 2001; Kendall & Southam-Gerow, 1996).”
Background
Treating Anxiety With Mindfulness: An Open Trial of Mindfulness Training for Anxious Children
Semple, R. J., Reid, E. F. G., & Miller, L. (2005) · Journal of Cognitive Psychotherapy · doi:10.1891/jcop.2005.19.4.379 · Cited by 326
Family Cognitive Behavioral Therapy for Child Anxiety Disorders
Wood, J. J., Piacentini, J. C., Southam‐Gerow, M. A., Chu, B. C., & Sigman, M. (2006) · Journal of the American Academy of Child & Adolescent Psychiatry · doi:10.1097/01.chi.0000196425.88341.b0 · Cited by 318
“Cognitive-behavioral therapy (CBT) has been found to be efficacious in the treatment of child anxiety disorders in recent randomized, controlled trials (RCTs; e.g., Flannery-Schroeder and Kendall, 2000; Kendall et al., 1997).”
MethodSelf-citation
One-session treatment of specific phobias in youth: A randomized clinical trial in the United States and Sweden
Ollendick, T. H., Öst, L.-G., Reuterskiöld, L., Costa, N., Cederlund, R., Sirbu, C., Davis, T. E., & Jarrett, M. A. (2009) · Journal of Consulting and Clinical Psychology · doi:10.1037/a0015158 · Cited by 310
“These recovery rates are similar to those obtained in CBT trials with other anxiety disorders (cf. Barrett, Dadds, & Rapee, 1996; Kendall, 1994; Kendall et al., 1997) and specifically with phobic disorders treated with contingency management plus exposure procedures (Silverman et al., 1999).”
Result
Randomized Controlled Trial: Multimodal Anxiety and Social Skill Intervention for Adolescents with Autism Spectrum Disorder
White, S. W., Ollendick, T. H., Albano, A. M., Oswald, D. P., Johnson, C. R., Southam‐Gerow, M. A., Kim, I., & Scahill, L. D. (2012) · Journal of Autism and Developmental Disorders · doi:10.1007/s10803-012-1577-x · Cited by 330
“…therapy (CBT) programs are effective across Social Phobia (SoP), Specific Phobia (SP), Separation Anxiety Disorder (SAD), and Generalized Anxiety Disorder (GAD) (e.g., Barrett et al. 1996; Kendall et al. 1997, 2008; Ollendick et al. 2009; Silverman et al. 1999; Walkup et al. 2008).”
BackgroundSelf-citation
Smoothing the trail for dissemination of evidence-based practices for youth: Flexibility within fidelity.
Kendall, P., & Beidas, R. (2007) · Professional Psychology Research and Practice · doi:10.1037/0735-7028.38.1.13 · Cited by 310
“…& Kolko, 1997; Stark et al., 2006; Mufson, Dorta, & Wickramaratne, 2004; see also Weisz, McCarty, & Valeri, 2006) and for youth with anxiety disorders (e.g., Kendall et al., 1997; Pediatric OCD Treatment Study Team, 2004; see also Albano & Kendall, 2002; Piacentini, March, & Franklin, 2006).”
BackgroundSelf-citation
Review of the evidence base for treatment of childhood Psychopathology: internalizing disorders
Compton, S. N., Burns, B. J., Egger, H. L., & Robertson, E. (2002) · Journal of Consulting and Clinical Psychology · doi:10.1037/0022-006x.70.6.1240 · Cited by 308
Relation of the alliance with outcomes in youth psychotherapy: a meta-analysis
McLeod, B. D. (2011) · Clinical Psychology Review · doi:10.1016/j.cpr.2011.02.001 · Cited by 301
Prevalence and Description of Selective Mutism in a School-Based Sample
Bergman, R. L., Piacentini, J. C., & McCracken, J. T. (2002) · Journal of the American Academy of Child & Adolescent Psychiatry · doi:10.1097/00004583-200208000-00012 · Cited by 293
“” However, given the efficacy of known interventions such as cognitive-behavioral therapy (Kendall et al., 1997) and selective serotonin reuptake inhibitor medication (RUPP Anxiety Study Group, 2001) for children with related anxiety disorders and SM (Black and Uhde, 1994), and the persistence of SM in this sample, tr…”
Background
Context Matters: Schools and the “Research to Practice Gap” in Children's Mental Health
Ringeisen, H. L., Henderson, K., & Hoagwood, K. (2003) · School Psychology Review · doi:10.1080/02796015.2003.12086188 · Cited by 295
“For instance, one study attempted to tease apart specific mechanisms of action within a cognitive-behavioral intervention for childhood anxiety disorders; this study demonstrated the potential importance of a particular technique called “exposure” (Kendall et al., 1997).”
Background
Early intervention and prevention of anxiety disorders in children: Results at 2-year follow-up.
Dadds, M. R., Holland, D. E., Laurens, K. R., Mullins, M., Barrett, P. M., & Spence, S. H. (1999) · Journal of Consulting and Clinical Psychology · doi:10.1037/0022-006x.67.1.145 · Cited by 291
Impact of Comorbidity on Cognitive-Behavioral Therapy Response in Pediatric Obsessive-Compulsive Disorder
Storch, E. A., Merlo, L. J., Larson, M. J., Geffken, G. R., Lehmkuhl, H. D., Jacob, M. L., Murphy, T. K., & Goodman, W. K. (2008) · Journal of the American Academy of Child & Adolescent Psychiatry · doi:10.1097/chi.0b013e31816774b1 · Cited by 302
Group and Individual Cognitive-Behavioral Therapy for Childhood Anxiety Disorders: A Randomized Trial
Manassis, K., Mendlowitz, S. L., SCAPILLATO, D., AVERY, D., Fıksenbaum, L., Freire, M., Monga, S., & Owens, M. (2002) · Journal of the American Academy of Child & Adolescent Psychiatry · doi:10.1097/00004583-200212000-00013 · Cited by 282
“A second randomized trial replicated these results (Kendall et al., 1997).”
Result
One-session treatment of specific phobias in youths: A randomized clinical trial.
Öst, L.-G., Svensson, L., Hellström, K., & Lindwall, R. (2001) · Journal of Consulting and Clinical Psychology · doi:10.1037/0022-006x.69.5.814 · Cited by 281
Comorbidity in Childhood Anxiety Disorders and Treatment Outcome
Kendall, P. C., Brady, E. U., & Verduin, T. L. (2001) · Journal of the American Academy of Child & Adolescent Psychiatry · doi:10.1097/00004583-200107000-00013 · Cited by 288
“Some of these participants were included in two previously reported studies (Kendall, 1994; Kendall et al., 1997), but the present sample also contains participants not included in the previous published reports of outcome.”
BackgroundSelf-citation
Considering CBT with anxious youth? Think exposures
Kendall, P. C., Robin, J. A., Hedtke, K. A., Suveg, C. M., Flannery-Schroeder, E. C., & Gosch, E. A. (2005) · Cognitive and Behavioral Practice · doi:10.1016/s1077-7229(05)80048-3 · Cited by 274
Self-citation
Cognitive Behavioral Treatments for Anxiety in Children With Autism Spectrum Disorder
Wood, J. J., Kendall, P. C., Wood, K. S., Kerns, C. M., SELTZER, M. H., Small, B. J., Lewin, A. B., & Storch, E. A. (2019) · JAMA Psychiatry · doi:10.1001/jamapsychiatry.2019.4160 · Cited by 272
“Total household income <$40 000 15/72 (21) 13/71 (18) 5/19 (26)”
Self-citation
Cognitive-Behavioral Therapy for Anxiety Disorders in Youth
Seligman, L. D., & Ollendick, T. H. (2011) · Child and Adolescent Psychiatric Clinics of North America · doi:10.1016/j.chc.2011.01.003 · Cited by 263
“Most programs will have a component in which the child first monitors thoughts to identify those giving rise to symptoms, then actively disputes those thoughts first with the therapist and then with increasing independence, and then develops new more adaptive, coping thoughts.(23,37,38)”
Adult Outcomes of Pediatric Recurrent Abdominal Pain: Do They Just Grow Out of It?
Campo, J. V., Lorenzo, C. D., Chiappetta, L., Bridge, J. A., Colborn, D. K., Gartner, J. C., Gaffney, P., Kocoshis, S. A., & Brent, D. A. (2001) · PEDIATRICS · doi:10.1542/peds.108.1.e1 · Cited by 259
Toward Large-Scale Implementation of Empirically Supported Treatments for Children: A Review and Observations by the Hawaii Empirical Basis to Services Task Force
Chorpita, B. F., Yim, L. M., Donkervoet, J. C., Arensdorf, A. M., Amundsen, M. J., McGee, C., Serrano, A. C., Yates, A., Burns, J. A., & Morelli, P. T. T. (2002) · Clinical Psychology Science and Practice · doi:10.1111/j.1468-2850.2002.tb00504.x · Cited by 260
“CBT, broadly defined, was found to be superior to a waitlist or no treatment control condition in eight studies (Barrett, 1998; Barrett, Dadds, & Rapee, 1996; Goenjian et al., 1997; Graziano & Mooney, 1980; Kendall, 1994; Kendall et al., 1997; King et al., 1998, Silverman et al., 1999).”
Background
Family-based treatment of childhood anxiety disorders
Ginsburg, G. S., & Schlossberg, M. C. (2002) · International Review of Psychiatry · doi:10.1080/09540260220132662 · Cited by 281
“…have demonstrated that a short-term (10–16 weeks) course of cognitive behavioural therapy (CBT) significantly reduces anxiety in 50–80% of children (Barrett et al., 1996a; Cobham et al., 1998; Kendall, 1994; Kendall et al., 1997; Last et al., 1998; Silverman et al., 1999a; Silverman et al., 1999b).”
Background
Psychopharmacological Treatment for Very Young Children: Contexts and Guidelines
Gleason, M. M., EGGER, H. L., Emslie, G. J., Greenhill, L. L., Kowatch, R. A., Lieberman, A. F., Luby, J. L., Owens, J. A., Scahill, L. D., Scheeringa, M. S., et al. (2007) · Journal of the American Academy of Child & Adolescent Psychiatry · doi:10.1097/chi.0b013e3181570d9e · Cited by 247
“Widely used psychotherapeutic interventions can be modified to address the child_s specific clinical presentation, developmental level and language abilities, and access to therapy resources in the community (Compton et al., 2002; James et al., 2005; Kendall et al., 1997).”
Background
Therapist Alliance-Building Behavior Within a Cognitive-Behavioral Treatment for Anxiety in Youth.
Creed, T. A., & Kendall, P. C. (2005) · Journal of Consulting and Clinical Psychology · doi:10.1037/0022-006x.73.3.498 · Cited by 242
“There was a significant association between the therapist, but not the child, report of the relationship and outcome in a second sample (Creed & Kendall, 2002; Kendall et al., 1997), suggesting that gathering relationship ratings from multiple reporters is important.”
BackgroundSelf-citation
Cognitive behavioral therapy for 4- to 7-year-old children with anxiety disorders: A randomized clinical trial.
Hirshfeld-Becker, D. R., Masek, B., Henin, A., Blakely, L. R., Pollock-Wurman, R. A., McQuade, J., DePetrillo, L., Briesch, J., Ollendick, T. H., Rosenbaum, J. F., et al. (2010) · Journal of Consulting and Clinical Psychology · doi:10.1037/a0019055 · Cited by 240
Self-citation
Breathing life into a manual: Flexibility and creativity with manual-based treatments
Kendall, P. C., Chu, B. C., Gifford, A., Hayes, C., & Nauta, M. H. (1998) · Cognitive and Behavioral Practice · doi:10.1016/s1077-7229(98)80004-7 · Cited by 238
Self-citation
A Tale of Two Systems: Co-Occurring Mental Health and Substance Abuse Disorders Treatment for Adolescents
Hawkins, E. H. (2009) · Annual Review of Psychology · doi:10.1146/annurev.psych.60.110707.163456 · Cited by 233
“Cognitive-behavioral interventions are well supported in the treatment of both adolescent mental health (Barrett et al. 2001, Kazdin 1995, Kendall et al. 1997, Rohde et al. 1994) and substance use disorders (Kaminer et al. 1998, Kaminer & Burleson 1999, Liddle et al. 2001).”
Background
Flexibility Within Fidelity
KENDALL, P. C., GOSCH, E., FURR, J. M., & SOOD, E. (2008) · Journal of the American Academy of Child & Adolescent Psychiatry · doi:10.1097/chi.0b013e31817eed2f · Cited by 242
Self-citation
Anxiety Disorders and Phobias
Davis, T. E., Munson, M. S., & Reuther, E. T. (2009) · Springer eBooks · doi:10.1007/978-1-4419-0234-4_11 · Cited by 237
Comorbidity as a predictor and moderator of treatment outcome in youth with anxiety, affective, attention deficit/hyperactivity disorder, and oppositional/conduct disorders
Ollendick, T. H., Jarrett, M. A., Grills, A. E., Hovey, L. D., & Wolff, J. C. (2008) · Clinical Psychology Review · doi:10.1016/j.cpr.2008.09.003 · Cited by 256
Meta-analysis of the prospective relation between alliance and outcome in child and adolescent psychotherapy
Karver, M. S., De Nadai, A. S., Monahan, M., & Shirk, S. R. (2018) · Psychotherapy · doi:10.1037/pst0000176 · Cited by 234
Predictors and moderators of treatment response in childhood anxiety disorders: Results from the CAMS trial.
Compton, S. N., Peris, T. S., Almirall, D., Birmaher, B., Sherrill, J., Kendall, P. C., March, J. S., Gosch, E. A., Ginsburg, G. S., Rynn, M. A., et al. (2014) · Journal of Consulting and Clinical Psychology · doi:10.1037/a0035458 · Cited by 226
“, 2004; Ipser, Stein, Hawkridge, & Hoppe, 2009; James, Soler, & Weatherall, 2005; Silverman, Pina, & Viswesvaran, 2008; Walkup, Labellarte, & Ginsburg, 2002), and, in some cases, comorbid diagnoses (Barrett, 1998; Barrett, Dadds, & Rapee, 1996; Beidel et al., 2007; Kendall, 1994; Kendall et al., 1997; Silverman, Kurti…”
Self-citation
Examining Outcome Variability: Correlates of Treatment Response in a Child and Adolescent Anxiety Clinic
Southam‐Gerow, M. A., Kendall, P. C., & Weersing, V. R. (2001) · Journal of Clinical Child & Adolescent Psychology · doi:10.1207/s15374424jccp3003_13 · Cited by 227
“The interested reader is referred to the treatment manual or the randomized clinical trial reports for a description of the treatment program (Kendall, 1994; Kendall et al., 1997; Kendall, Kane, Howard, & Siqueland, 1990; see also Kendall, Chu, Gifford, Hayes, & Nauta, 1998).”
BackgroundMethodInfluentialSelf-citation
Mechanisms of action in youth psychotherapy
Weersing, V. R., & Weisz, J. R. (2002) · Journal of Child Psychology and Psychiatry · doi:10.1111/1469-7610.00002 · Cited by 224
“…(Kanfer, Karoly, & Newman, 1975; Graziano & Mooney, 1980); (b) the Coping Cat program for youth with a range of anxiety diagnoses (Kendall, 1994; Kendall et al., 1997; Barrett, Dadds, & Rapee, 1996); and (c) an extension of the Coping Cat program, including a family therapy component (Barrett…”
BackgroundMethod
Children's Mental Health as a Primary Care and Concern: A System for Comprehensive Support and Service.
Tolan, P. H., & Dodge, K. A. (2005) · American Psychologist · doi:10.1037/0003-066x.60.6.601 · Cited by 232
“For example, between 64% and 71% of children with an anxiety disorder who received the Coping Cat program (Kendall et al., 1997) showed a substantial drop in symptoms, which is commonly referred to as a clinically significant benefit.”
Background
SET-C Versus Fluoxetine in the Treatment of Childhood Social Phobia
BEIDEL, D. C., TURNER, S. M., SALLEE, F. R., AMMERMAN, R. T., CROSBY, L. A., & PATHAK, S. (2007) · Journal of the American Academy of Child & Adolescent Psychiatry · doi:10.1097/chi.0b013e318154bb57 · Cited by 223
Predictors of outcome in exposure-based cognitive and behavioral treatments for phobic and anxiety disorders in children.
Berman, S. L., Weems, C. F., Silverman, W. K., & Kurtines, W. M. (2000) · Behavior Therapy · doi:10.1016/s0005-7894(00)80040-4 · Cited by 221
The utility of measures of child and adolescent anxiety: A meta-analytic review of the Revised Children’s Manifest Anxiety Scale, the State–Trait Anxiety Inventory for Children, and the Child Behavior Checklist
Seligman, L. D., Ollendick, T. H., Langley, A. K., & Baldacci, H. B. (2004) · Journal of Clinical Child & Adolescent Psychology · doi:10.1207/s15374424jccp3303_13 · Cited by 220
School-Based Intervention for Adolescents with Social Anxiety Disorder: Results of a Controlled Study
Masia-Warner, C., Klein, R. G., Dent, H. C., Fisher, P. H., Alvir, J., Marie Albano, A., & Guardino, M. (2005) · Journal of Abnormal Child Psychology · doi:10.1007/s10802-005-7649-z · Cited by 218
“The ADIS has demonstrated sensitivity to treatment effects (Kendall et al., 1997).”
Background
Cognitive-behavioral therapy for anxiety in children diagnosed with autism spectrum disorders: Modification trends
Moree, B. N., & Davis, T. E. (2010) · Research in Autism Spectrum Disorders · doi:10.1016/j.rasd.2009.10.015 · Cited by 220
Prevention of Anxiety Symptoms in Children: Results From a Universal School-Based Trial
Essau, C. A., Conradt, J., Sasagawa, S., & Ollendick, T. H. (2011) · Behavior Therapy · doi:10.1016/j.beth.2011.08.003 · Cited by 232
“…with anxious children (Kendall, 1994), a considerable body of research has provided support for the efficacy and effectiveness of CBT in treating anxiety disorders in children and adolescents (Barrett,Dadds,&Rapee, 1996; Cobham,Dadds,& Spence, 1999; Kendall et al., 1997; Silverman et al., 1999).”
Background
Early Childhood OCD: Preliminary Findings From a Family-Based Cognitive-Behavioral Approach
Freeman, J. B., Garcia, A. M., Coyne, L. W., Ale, C. M., Przeworski, A., Himle, M. B., Compton, S. N., & Leonard, H. L. (2008) · Journal of the American Academy of Child & Adolescent Psychiatry · doi:10.1097/chi.0b013e31816765f9 · Cited by 212
An initial waitlist-controlled trial of the unified protocol for the treatment of emotional disorders in adolescents
Ehrenreich-May, J., Rosenfield, D., Queen, A. H., Kennedy, S. M., Remmes, C. S., & Barlow, D. H. (2017) · Journal of Anxiety Disorders · doi:10.1016/j.janxdis.2016.10.006 · Cited by 208
“…to limit the WL period to 8 weeks was two-fold: (1) this has been a standard waitlist time period in prior RCTs of youth anxiety treatment (e.g., Kendall et al., 1997); and (2) ethical considerations required us to waitlist-controlled trial of the unified protocol for the treatment 16),…”
Method

Authors: Kendall, P. C., Flannery-Schroeder, E., Panichelli-Mindel, S. M., Southam-Gerow, M., Henin, A., & Warman, M.
Affiliations: Temple University (US)
ORCID: Kendall, Philip C.
Flannery-Schroeder, Ellen
Venue: Journal of Consulting and Clinical Psychology
Publisher: American Psychological Association (APA)
Published: 1997
Volume: 65
Issue: 3
Pages: 366-380
ISSN: 0022-006X (ISSN-L)
1939-2117
DOI: 10.1037/0022-006x.65.3.366
OpenAlex: W2162075090
Semantic Scholar: ecea82a52c98d8dba1a94c0ed59b7f4059d20059
Cited by: 984
References: 76
Citations by year: 2026: 9 · 2025: 10 · 2024: 37 · 2023: 18 · 2022: 16 · 2021: 20 · 2020: 22 · 2019: 23 · 2018: 33 · 2017: 28 · 2016: 28 · 2015: 39 · 2014: 45 · 2013: 51 · 2012: 46
FWCI: 37.55
Type: journal article
Language: en
Open access: closed
Locations: Journal of Consulting and Clinical Psychology (publishedVersion)
PubMed (publishedVersion)
Digital Commons - PCOM (Philadelphia College of Osteopathic Medicine) (submittedVersion)
Funders: National Institutes of Health (5r01mh044042-05)
National Institute of Mental Health (MH 44042)
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 › Psychological Treatments and Assessments
Keywords: anxiety disorders, children, adolescents, cognitive behavioral therapy, treatment outcomes, maintenance therapy, comorbidities, age effects, waitlist control
MeSH terms: Adolescent, Anxiety Disorders, Child, Female, Follow-Up Studies, Humans, Male, Parent-Child Relations, Parents, Cognitive Behavioral Therapy

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Therapy for youths with anxiety disorders: A second randomized clincal trial.

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