Comparing different modes of delivery: a pilot evaluation of a family-focused, cognitive-behavioral intervention for anxiety-disordered children

Eur Child Adolesc Psychiatry. 2009 Apr;18(4):231-9. doi: 10.1007/s00787-008-0723-7. Epub 2009 Jan 22.


Cognitive behavior therapy delivered by trained clinicians has been shown to be an effective treatment for childhood anxiety. However, the prevalence of anxiety disorders in children and adolescents, combined with the practical and psychological obstacles that often prevent families from accessing professional help, mean that alternative ways of reaching prospective clients must be explored. This pilot study aims to compare the relative efficacy of two different modes of delivering a family-focused, cognitive-behavioral intervention for children with an anxiety disorder. The two modalities compared were: a parent-delivered program (bibliotherapy) and a clinician-delivered program (individual therapy). Twenty-seven children aged between 7 and 14, together with their parents, were randomly assigned to one of the two conditions listed above. Results at post-treatment showed a significant improvement for children in both treatment conditions in terms of diagnostic status, number of diagnoses and severity of primary diagnosis at follow-up. Children in the bibliotherapy condition demonstrated a significant improvement over time in terms of child- and parent-reported anxiety levels. No differences were found between the two treatment conditions on any outcome measure. These results were maintained at 3- and 6-month follow-up. Although a pilot study, these data suggest that a bibliotherapy format of the intervention described may have potential merit. The implications for service delivery are discussed, as are the limitations of this research.

Publication types

  • Comparative Study

MeSH terms

  • Adolescent
  • Anxiety Disorders / diagnosis
  • Anxiety Disorders / psychology
  • Anxiety Disorders / therapy*
  • Bibliotherapy / methods*
  • Child
  • Cognitive Behavioral Therapy / methods*
  • Family Therapy / methods*
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Pilot Projects
  • Severity of Illness Index