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BENEFITS OF CHILD-FOCUSED ANXIETY TREATMENTS FOR PARENTS AND FAMILY FUNCTIONING

Authors


  • Contract grant sponsor: National Institute of Mental Health; Contract grant numbers: U01 MH064089, U01 MH064092, U01 MH064003, U01 MH063747, U01 MH064107, U01 MH064088.

Correspondence to: Courtney P. Keeton, Division of Child & Adolescent Psychiatry, The Johns Hopkins University School of Medicine, 550 N. Broadway, Suite 201A, Baltimore, MD 21205. E-mail: ckeeton@jhmi.edu

Abstract

Background

To examine (1) changes in parent (global psychological distress, trait anxiety) and family (dysfunction, burden) functioning following 12 weeks of child-focused anxiety treatment, and (2) whether changes in these parent and family factors were associated with child's treatment condition and response.

Methods

Participants were 488 youth ages 7–17 years (50% female; mean age 10.7 years) who met DSM-IV-TR criteria for social phobia, separation anxiety, and/or generalized anxiety disorder, and their parents. Youth were randomly assigned to 12 weeks of “Coping Cat” individual cognitive-behavioral therapy (CBT), medication management with sertraline (SRT), their combination (COMB), or medication management with pill placebo (PBO) within the multisite Child/Adolescent Anxiety Multimodal Study (CAMS). At pre- and posttreatment, parents completed measures of trait anxiety, psychological distress, family functioning, and burden of child illness; children completed a measure of family functioning. Blinded independent evaluators rated child's response to treatment using the Clinical Global Impression-Improvement Scale at posttreatment.

Results

Analyses of covariance revealed that parental psychological distress and trait anxiety, and parent-reported family dysfunction improved only for parents of children who were rated as treatment responders, and these changes were unrelated to treatment condition. Family burden and child-reported family dysfunction improved significantly from pre- to posttreatment regardless of treatment condition or response.

Conclusions

Findings suggest that child-focused anxiety treatments, regardless of intervention condition, can result in improvements in nontargeted parent symptoms and family functioning particularly when children respond successfully to the treatment.

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