Do anxiety-disordered children need to come into the clinic for efficacious treatment?

J Consult Clin Psychol. 2012 Jun;80(3):465-76. doi: 10.1037/a0028205. Epub 2012 Apr 30.


Objective: This study compared 3 experimental conditions: wait-list, therapist-supported bibliotherapy, and individual therapy, in the treatment of child anxiety.

Method: Participants were 55 children (25 girls and 30 boys), aged 7 to 14 years diagnosed with an anxiety disorder, and their parents. Families were assigned using a modified random assignment process to 1 of the 3 conditions. The intervention evaluated in the 2 active treatment conditions was a family-focused, cognitive-behavioral program.

Results: At posttreatment, participants in both treatment conditions had improved significantly on both diagnostic and questionnaire outcome measures compared with participants in the wait-list condition, with no differences demonstrated between the treatment conditions. Thus, at posttreatment, 0% of children in the wait-list condition were anxiety diagnosis free, compared with 95% in the therapist-supported bibliotherapy condition and 78.3% in the individual therapy condition. There was no significant difference between diagnostic status at posttreatment between the 2 treatment conditions. Participants assigned to a treatment condition were reassessed at 3-month and 6-month follow-up. Treatment gains were maintained in both conditions across the follow-up period.

Conclusion: In light of the fact that more than 80% of anxiety-disordered children never receive treatment, these data suggest that therapist-supported bibliotherapy represents a cost-effective means of reaching a greater number of anxious children.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adolescent
  • Anxiety Disorders / psychology
  • Anxiety Disorders / therapy*
  • Bibliotherapy / methods*
  • Child
  • Cognitive Behavioral Therapy / methods*
  • Family Therapy / methods*
  • Female
  • Humans
  • Male
  • Surveys and Questionnaires
  • Treatment Outcome