Cited by 366Child and Adolescent Psychosocial and Emotional DevelopmentAnxiety, Depression, Psychometrics, Treatment, Cognitive ProcessesChild Therapy and Development

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Cognitive-Behavioral Group Treatments in Childhood Anxiety Disorders: The Role of Parental Involvement

MENDLOWITZ, SANDRA L., MANASSIS, KATHARINA, BRADLEY, SUSAN, SCAPILLATO, DONNA, MIEZITIS, SOLVEIGA, SHAW, BRIAN E·1999·Journal of the American Academy of Child & Adolescent Psychiatry

DOI 10.1097/00004583-199910000-00010

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Abstract

Objectives This study examined (1) the effect of a cognitive-behavioral group intervention on anxiety, depression, and coping strategies in school-age children (aged 7-12 years) with Axis I anxiety disorders; and (2) the effect of parental involvement on treatment outcomes.Method Parents and children (N = 62) were randomly assigned to one of three 12-week treatment conditions: parent and child intervention, child-only intervention, and parent-only intervention. Child anxiety, depression, and coping strategies were assessed before and after treatment.Results All treatment groups reported fewer symptoms of anxiety and depression posttreatment and changes in their use of coping strategies. Children in the parent and child intervention used more active coping strategies posttreatment compared with children in the other 2 treatment conditions. Parents in this treatment condition reported a significantly greater improvement in their children's emotional well-being than parents in the other treatment conditions.Conclusions Cognitive-behavioral group interventions reduced symptoms of anxiety and depression in school-age children with anxiety disorders. Concurrent parental involvement enhanced the effect on coping strategies. Further investigation is needed to corroborate the effectiveness of such short-term interventions and the maintenance of treatment effects.

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Self-citation
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Background
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Background
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“For example, the protocol has proven to be both transportable and adaptable to other cultures such as in Australia (e.g. Barrett et al., 1996) and Canada (Mendlowitz et al., 1999).”
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Background
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Background
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What Is the Evidence for Evidence-Based Treatments? A Hard Look at Our Soft Underbelly
Jensen, P. S., Weersing, V. R., Hoagwood, K., & Goldman, E. E. (2005) · Mental Health Services Research · doi:10.1007/s11020-005-1965-3 · Cited by 139
“Four studies met both criteria (Dishion & Andrews, 1995; Mendlowitz et al., 1999; Murray et al., 2003; Wayland, 2003), thus yielding a total of 52 rather than 56 (29 + 27) studies.”
Result
Components of Cognitive Behavioral Therapy Related to Outcome in Childhood Anxiety Disorders
Ale, C. M., McCarthy, D. M., Rothschild, L. M., & Whiteside, S. P. H. (2015) · Clinical Child and Family Psychology Review · doi:10.1007/s10567-015-0184-8 · Cited by 142
“…WL G Community SoP 50 13–17 Masia Warner et al. (2007) CBT versus AP G Community SoP 32 14–16 Melfsen et al. (2011) CBT versus WL I Mixed SoP 44 8–14 Mendlowitz et al. (1999) CBT-child versus CBT-parent versus CBT- both versus WL G Clinic CADs 102 7–12 Mifsud and Rapee (2005) CBT versus WL G…”
Background
Effectiveness of cognitive behavioral therapy (CBT) for child and adolescent anxiety disorders across different CBT modalities and comparisons: a systematic review and meta-analysis
Sigurvinsdóttir, A. L., Jensínudóttir, K. B., Baldvinsdóttir, K. D., Smárason, O., & Skarphedinsson, G. (2020) · Nordic Journal of Psychiatry · doi:10.1080/08039488.2019.1686653 · Cited by 130
Treatments that work with children: Empirically supported strategies for managing childhood problems.
Christophersen, E. R., & Mortweet, S. L. (2001) · American Psychological Association eBooks · doi:10.1037/10405-000 · Cited by 132
Disorder-specific Effects of CBT for Anxious and Depressed Youth: A Meta-analysis of Candidate Mediators of Change
Chu, B. C., & Harrison, T. (2007) · Clinical Child and Family Psychology Review · doi:10.1007/s10567-007-0028-2 · Cited by 135
The Effect of Parent Involvement in the Treatment of Anxiety Disorders in Children: A Meta-Analysis
Thulin, U., Svirsky, L., Serlachius, E., Andersson, G., & Öst, L.-G. (2014) · Cognitive Behaviour Therapy · doi:10.1080/16506073.2014.923928 · Cited by 124
“…2006), 2. individually without the child (Deblinger et al., 1996; King et al., 2000; Nauta et al., 2001, 2003), 3. in groups with their children (Barrett, 1998; Mendlowitz et al., 1999; Spence et al., 2000), and 4. in groups without their children (Mendlowitz et al., 1999; Öst et al., in press).”
BackgroundInfluential
Family Treatment of Child Anxiety: Outcomes, Limitations and Future Directions
Creswell, C., & Cartwright‐Hatton, S. (2007) · Clinical Child and Family Psychology Review · doi:10.1007/s10567-007-0019-3 · Cited by 132
“The results to date present a very mixed picture, with some studies reporting statistically significant improvements from the addition of a family component (e.g. Barrett, Dadds, & Rapee, 1996; Heyne et al., 2002; Mendlowitz et al., 1999) and others reporting no added value of FCBT over and above CCBT (e.”
BackgroundMethodResultInfluential
Cognitive-behavioural therapy for young children with anxiety disorders: Comparison of a Child + Parent condition versus a Parent Only condition
Waters, A. M., Ford, L. A., Wharton, T. A., & Cobham, V. E. (2009) · Behaviour Research and Therapy · doi:10.1016/j.brat.2009.04.008 · Cited by 119
“Mendlowitz et al. (1999) showedreductions inanxietyanddepressive symptoms in anxious children receiving parentþ child, child-only, and parent-only focused interventions compared to a Wait-list Control condition.”
MethodResult
What are the active ingredients in cognitive and behavioral psychotherapy for anxious and depressed children? A meta-analytic review
Spielmans, G. I., Pasek, L. F., & McFall, J. P. (2007) · Clinical Psychology Review · doi:10.1016/j.cpr.2006.06.001 · Cited by 121
Separation Anxiety Disorder in Children and Adolescents
Masi, G., Mucci, M., & Millepiedi, S. (2001) · CNS Drugs · doi:10.2165/00023210-200115020-00002 · Cited by 119
Treatment of childhood anxiety disorders: a preliminary comparison between cognitive-behavioral group therapy and a psychological placebo intervention
Muris, P., Meesters, C. M. G., & van Melick, M. (2002) · Journal of Behavior Therapy and Experimental Psychiatry · doi:10.1016/s0005-7916(02)00025-3 · Cited by 120
CBT for adolescents with anxiety: mature yet still developing
Kendall, P. C., & Peterman, J. S. (2015) · American Journal of Psychiatry · doi:10.1176/appi.ajp.2015.14081061 · Cited by 115
Exposure-Based Cognitive-Behavioral Treatment for Phobic and Anxiety Disorders: Treatment Effects and Maintenance for Hispanic/Latino Relative to European-American Youths
Piña, A., Silverman, W. K., Fuentes, R., Kurtines, W. M., & Weems, C. F. (2003) · Journal of the American Academy of Child & Adolescent Psychiatry · doi:10.1097/00004583-200310000-00008 · Cited by 121
Behavioral parenting interventions for child disruptive behaviors and anxiety: What's different and what's the same
Forehand, R., Jones, D. J., & Parent, J. M. (2012) · Clinical Psychology Review · doi:10.1016/j.cpr.2012.10.010 · Cited by 133
“2Two studies (Mendlowitz et al., 1999; Rapee, 2000) were excluded based on this criterion.”
Background
School-Based Intervention: Examining a Universal Approach to Anxiety Management
Barrett, P. M., & Pahl, K. M. (2006) · Australian Journal of Guidance and Counselling · doi:10.1375/ajgc.16.1.55 · Cited by 127
“, 1997) and group formats (Shortt, Barrett, & Fox, 2001; Flannery-Schroeder & Kendall, 2000; Mendlowitz et al., 1999; Silverman et al., 1999), with treatment response rates across studies ranging from 60% and 95% diagnosis-free following treatment.”
Background
The efficacy of a social skills group intervention for improving social behaviors in children with high functioning autism spectrum disorders
DeRosier, M. E., Swick, D. C., Davis, N. O., McMillen, J. S., & Matthews, R. (2011) · Journal of Autism and Developmental Disorders · doi:10.1007/s10803-010-1128-2 · Cited by 113
“By supporting and reinforcing positive changes, enhancing communication, and modeling positive attitudes towards treatment, parent involvement can significantly enhance treatment efficacy (Kolivas et al. 2008; Mendlowitz et al. 1999).”
Background
Family Cognitive Behavioral Therapy for Children and Adolescents With Clinical Anxiety Disorders
Bögels, S. M., & Siqueland, L. (2006) · Journal of the American Academy of Child & Adolescent Psychiatry · doi:10.1097/01.chi.0000190467.01072.ee · Cited by 110
Clinical presentation and treatment outcome for children with comorbid externalizing and internalizing symptoms
Chase, R. M., & Eyberg, S. M. (2007) · Journal of Anxiety Disorders · doi:10.1016/j.janxdis.2007.03.006 · Cited by 107
“Recent CBT studies have suggested that parent involvement in the treatment of child anxiety may enhance outcome (Eisen, Engler, & Geyer, 1998; Mendlowitz et al., 1999; Silverman & Berman, 2001).”
Background
Dichotic Listening and Response Inhibition in Children With Comorbid Anxiety Disorders and ADHD
Manassis, K., Tannock, R., & Barbosa, J. (2000) · Journal of the American Academy of Child & Adolescent Psychiatry · doi:10.1097/00004583-200009000-00015 · Cited by 108
Self-citation
Computer-Assisted CBT for Child Anxiety: The Coping Cat CD-ROM
Khanna, M. S., & Kendall, P. C. (2008) · Cognitive and Behavioral Practice · doi:10.1016/j.cbpra.2008.02.002 · Cited by 106
Parental Involvement: Contribution to Childhood Anxiety and Its Treatment
Wei, C., & Kendall, P. C. (2014) · Clinical Child and Family Psychology Review · doi:10.1007/s10567-014-0170-6 · Cited by 116
“Still other studies did not find significant differences between parent-involved CBT and child-focused CBT (Barrett 1998; Bodden et al. 2008; Mendlowitz et al. 1999; Nauta et al. 2001, 2003; Siqueland et al. 2005; Spence et al. 2000; Waters et al. 2009).”
Background
Effectiveness of Modular CBT for Child Anxiety in Elementary Schools
Chiu, A. W., Langer, D. A., McLeod, B., Har, K., Drahota, A., Galla, B. M., Jacobs, J., Ifekwunigwe, M., & Wood, J. (2013) · School psychology quarterly · doi:10.1037/spq0000017 · Cited by 96
“…diagnosis of SAD, SP, or GAD; (b) no psychiatric medication use or stable use of psychiatric medication for at least 1 month at the time of the pretreatment assessment; and (c) if medication was being used, families agreed to maintain that dose throughout the study (cf. Mendlowitz et al., 1999).”
Method
Manual-Driven Group Cognitive-Behavioral Therapy for Adolescents With Obsessive-Compulsive Disorder: A Pilot Study
Thienemann, M., Martin, J. L., CREGGER, B., THOMPSON, H. B., & Dyer-Friedman, J. (2001) · Journal of the American Academy of Child & Adolescent Psychiatry · doi:10.1097/00004583-200111000-00004 · Cited by 94
Parental Anxiety in the Treatment of Childhood Anxiety: A Different Story Three Years Later
Cobham, V. E., Dadds, M. R., Spence, S. H., & McDERMOTT, B. M. (2010) · Journal of Clinical Child & Adolescent Psychology · doi:10.1080/15374411003691719 · Cited by 98
“Mendlowitz and colleagues ( 1999 ) reported that parents in their family-focused condition reported significantly greater improvements in children's emotional well-being.”
Background
Comorbid mental disorders and substance use disorders: epidemiology, prevention and treatment
Proudfoot, M. T. H. (2004) · Cited by 88
Considerations in the use of exposure with children
Bouchard, S., Mendlowitz, S. L., Coles, M. E., & Franklin, M. (2004) · Cognitive and Behavioral Practice · doi:10.1016/s1077-7229(04)80007-5 · Cited by 87
Self-citation
Group and Individual Cognitive-Behavioral Treatments for Youth With Anxiety Disorders: 1-Year Follow-Up
Flannery-Schroeder, E. C., Choudhury, M. S., & Kendall, P. C. (2005) · Cognitive Therapy and Research · doi:10.1007/s10608-005-3168-z · Cited by 94
“Research on the efficacy of GCBT is emerging (e.g., Barrett, 1998; Manassis et al., 2002; Mendlowitz et al., 1999; Silverman et al., 1999).”
Cognitive Change and Enhanced Coping: Missing Mediational Links in Cognitive Behavior Therapy with Anxiety-Disordered Children
Prins, P. J. M., & Ollendick, T. H. (2003) · Clinical Child and Family Psychology Review · doi:10.1023/a:1023730526716 · Cited by 86
No need to worry: the promising future of child anxiety research
Kendall, P. C., Settipani, C. A., & Cummings, C. M. (2012) · Journal of Clinical Child & Adolescent Psychology · doi:10.1080/15374416.2012.632352 · Cited by 82
“, 1997), group CBT (e.g., Barrett, 1998; Flannery-Schroeder & Kendall, 2000; Mendlowitz et al., 1999), and social effectiveness training (e.”
Background
Efficacy of psychosocial group intervention for children with chronic illness and their parents
Scholten, L., Willemen, A. M., Last, B. F., Maurice-Stam, H., van Dijk, E. M., Ensink, E., Zandbelt, N., van der Hoop-Mooij, A., Schuengel, C., & Grootenhuis, M. A. (2013) · PEDIATRICS · doi:10.1542/peds.2012-2222 · Cited by 82
Safety-Seeking and Coping Behavior During Exposure Tasks with Anxious Youth
Hedtke, K. A., Kendall, P. C., & Tiwari, S. (2009) · Journal of Clinical Child & Adolescent Psychology · doi:10.1080/15374410802581055 · Cited by 86
“…across the world supporting the efficacy of CBT for anxious youth (e.g., Barrett, 1998; Barrett, Dadds, & Rapee, 1996; Cobham, Dadds, & Spence, 1998; Flannery-Schroeder & Kendall, 2000; Kendall, 1994; Kendall et al., 1997; Manassis et al., 2002; Mendlowitz et al., 1999; Silverman et al., 1999).”
Background
Alliance, technology, and outcome in the treatment of anxious youth
Chu, B. C., Choudhury, M. S., Shortt, A. L., Pincus, D. B., Creed, T. A., & Kendall, P. C. (2004) · Cognitive and Behavioral Practice · doi:10.1016/s1077-7229(04)80006-3 · Cited by 84
Setting the research and practice agenda for anxiety in children and adolescence: A topic comes of age
Kendall, P. C., & Ollendick, T. H. (2004) · Cognitive and Behavioral Practice · doi:10.1016/s1077-7229(04)80008-7 · Cited by 80
The feelings club: randomized controlled evaluation of school-based CBT for anxious or depressive symptoms
Manassis, K., Wilansky-Traynor, P., Farzan, N., Kleiman, V., Parker, K., & Sanford, M. (2010) · Depression and Anxiety · doi:10.1002/da.20724 · Cited by 79
“It utilizes cognitive restructuring and is derived from the earlier evaluated ‘‘Coping Bear’’ manual for child anxiety disorders,([22,23]) with principles identical to other extensively evaluated anxiety programs, such as Coping Cat.”
MethodSelf-citation
Practitioner Review: Psychological Management of Anxiety Disorders in Childhood
Dadds, M. R., & Barrett, P. M. (2001) · Journal of Child Psychology and Psychiatry · doi:10.1111/1469-7610.00798 · Cited by 87
Prevention of depression in childhood and adolescence
Mendelson, T., & Tandon, S. D. (2016) · Child and Adolescent Psychiatric Clinics of North America · doi:10.1016/j.chc.2015.11.005 · Cited by 77
Parent Training Interventions for Children with Autism Spectrum Disorders
Brookman-Frazee, L. I., Vismara, L. A., Drahota, A., Stahmer, A. C., & Openden, D. (2009) · Springer eBooks · doi:10.1007/978-1-4419-0088-3_14 · Cited by 79
One-Year Follow-up of Family versus Child CBT for Anxiety Disorders: Exploring the Roles of Child Age and Parental Intrusiveness
Wood, J. J., McLeod, B. D., Piacentini, J. C., & Sigman, M. (2009) · Child Psychiatry & Human Development · doi:10.1007/s10578-009-0127-z · Cited by 86
“For adolescents, the effect of intervention group on composite anxiety change scores was robust (F [1, 19] = 7.52, p \ 0.01), with FCBT outperforming CCBT, but for children, the effect was nonsignificant (F [1, 13 ] = 0.23, p = 0.64).”
Influential
Cognitive biases in childhood anxiety disorders: Do interpretive and judgment biases distinguish anxious youth from their non-anxious peers?
Cannon, M. F., & Weems, C. F. (2010) · Journal of Anxiety Disorders · doi:10.1016/j.janxdis.2010.05.008 · Cited by 83
“…and self-reward (e.g., Barrett, 1998; Barrett, Dadds, & Rapee, 1996; Flannery-Schroeder & Kendall, 2000; Kendall, 1994; Kendall et al., 1997; Mendlowitz et al., 1999; Rapee, Abbott, & Lyneham, 2006; Silverman et al., 1999; Spence, Holmes, March, & Lipp, 2006; see Silverman, Pina, &…”

Authors: MENDLOWITZ, S. L., MANASSIS, K., BRADLEY, S., SCAPILLATO, D., MIEZITIS, S., & SHAW, B. E.
Affiliations: University of Toronto (CA)
Corresponding author: MENDLOWITZ, SANDRA L.
Venue: Journal of the American Academy of Child & Adolescent Psychiatry
Publisher: Elsevier BV
Published: 1999-10
Volume: 38
Issue: 10
Pages: 1223-1229
ISSN: 0890-8567 (ISSN-L)
DOI: 10.1097/00004583-199910000-00010
OpenAlex: W2082066759
Cited by: 365
References: 23
Citations by year: 2026: 3 · 2025: 4 · 2024: 4 · 2023: 2 · 2022: 5 · 2021: 9 · 2020: 6 · 2019: 9 · 2018: 5 · 2017: 12 · 2016: 15 · 2015: 15 · 2014: 20 · 2013: 22 · 2012: 18
FWCI: 15.84
Type: journal article
Language: en
Open access: closed
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations: Journal of the American Academy of Child & Adolescent Psychiatry (publishedVersion)
PubMed (publishedVersion)
Topics: Social Sciences › Psychology › Clinical Psychology › Child and Adolescent Psychosocial and Emotional Development
Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
Social Sciences › Psychology › Clinical Psychology › Child Therapy and Development
Keywords: group cognitive behavioral therapy, childhood anxiety disorders, parental involvement, parent-child intervention, childhood depression, coping strategies, elementary school students, treatment outcomes, emotional well-being
MeSH terms: Adaptation, Psychological, Anxiety, Anxiety Disorders, Child, Depression, Family Therapy, Female, Humans, Male, Parent-Child Relations, Psychotherapy, Group, Cognitive Behavioral Therapy

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Cognitive-Behavioral Group Treatments in Childhood Anxiety Disorders: The Role of Parental Involvement

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