None listed
Conditions
Brief summary
Social anxiety is one of the most prevalent anxiety disorders in both children and adults, with mean onset age in childhood. Historically, treatment programs for anxiety disorders in youth have been generic, which means that children have received the same intervention regardless of the type of anxiety disorder diagnosed. These generic cognitive behavioural treatment programs have shown good efficacy, with 50-60% of children achieving remission immediately after treatment, and 70% achieving remission after a few months. Despite the widespread use of generic anxiety management programs for young people, some evidence is beginning to suggest that specific anxiety management programs – that is, programs developed for a specific disorder – may show better efficacy. However, to date, this evidence comes only from cross-study comparisons through meta-analyses. Direct comparison between generic and specific anxiety management programs within the one randomised trial has not been conducted. Theoretical models of the maintenance of social anxiety disorder among adults (Clark & Wells, 1995; Rapee & Heimberg, 1997) have guided research and adult treatments for the past 20 years. More recently emerging research about the key cognitive and behavioural processes that underpin social anxiety in children predicts specific targets to build on within treatment to create specific treatments and optimise efficacy. We have recently developed a modified version of our widely used youth anxiety program, Cool Kids. This modification includes strategies to specifically target cognitive and behavioural processes that maintain social anxiety. The primary aim of the current study is to evaluate the efficacy of a specific, theoretically-derived intervention for social anxiety disorder in young people compared against generic child anxiety treatment, which is current best practice.
Interventions
Condition 1: 10 sessions of CBT over 12 weeks – Cool Kids Program
Condition 2: 10 sessions of CBT over 12 weeks – Cool Kids Program with amended skills directly derived from models of the maintenance of social anxiety. The program includes the same cognitive and behavioural strategies as condition 1 and has been amended to also include exposure to subtle avoidance, attention processes, and target self-perception biases.
CBT sessions include psychoeducation about anxiety and social anxiety, an
Condition 1: 10 sessions of CBT over 12 weeks – Cool Kids Program Condition 2: 10 sessions of CBT over 12 weeks – Cool Kids Program with amended skills directly derived from models of the maintenance of social anxiety. The program includes the same cognitive and behavioural strategies as condition 1 and has been amended to also include exposure to subtle avoidance, attention processes, and target self-perception biases. CBT sessions include psychoeducation about anxiety and social anxiety, and skills to manage anxiety. Skills focus on thinking styles and behavioural responses to anxiety. Sessions include both children and parents (less parental involvement for adolescents) and are delivered individually (to each family). 10 sessions are ideally delivered weekly, except for weeks 9 and 11 where there is a break from CBT sessions. Sessions are approximately 50 minutes in duration. Participants are provided with a parent and child workbook. Therapists are provisional psychologists completing postgraduate training in clinical psychology with prior experience treating anxiety, registered psychologists or clinical psychologists. Treatment will be delivered at the Centre for Emotional Health Clinic at Macquarie University, Sydney Australia Treatment integrity will be assessed by independent raters by watching therapy sessions and coding for adherence or violations from the treatment manuals.
Sponsors
Professor Ronald Rapee
Study design
Allocation
Randomised controlled trial
Intervention model
Parallel
Primary purpose
Treatment
Masking
Blinded (masking used) (Subject, Outcomes Assessor)
Eligibility
Sex/Gender
All
Age
7 Years to 17 Years
Healthy volunteers
No
Inclusion criteria
DSM-5 diagnosis of social anxiety disorder
Exclusion criteria
1.. Social anxiety that is more than 2 CSR point less severe than another DSM-5 anxiety diagnosis or an unwillingness by family to work primarily on the social anxiety. 2. Primary disorder is not an anxiety disorder 3. Current risk (active suicidal risk, abuse/neglect, unmanaged psychotic symptoms, 2 weeks of consistent school refusal with no intention or plan to return to school) 4. Concurrent psychological therapy or not on a stable dose of psycho-pharmacological medication (i.e. stable for 2 months prior to assessment and intent to stay on same dose) 5. Diagnosis of Autism Spectrum Disorder 6. Child requires significant assistance within the classroom or child is not in mainstream schooling 7. Inpatient
Outcome results
None listed