CBT for Childhood Anxiety: Reviewing the State of Personalised Intervention Research

Abstract

This article presents a mini-review of the state of personalised intervention research in the field of child and adolescent anxiety. We evaluated narrative, systematic and meta-analytic reviews of key research methodologies and how they relate to current approaches for personalising CBT, specifically. Preliminary evidence of predictors (severity of primary disorder, social anxiety disorder (SoAD), comorbid depression, parental psychopathology, parental involvement and duration of treatment), moderators (type of primary disorder) and mediators (self-talk, coping, problem-solving and comorbid symptoms) of CBT outcomes provides content for several personalised approaches to treatment. Finally, we present a novel conceptual model depicting the state of personalised intervention research in childhood anxiety and propose a research agenda for continued progress.

The Management of Anxiety and Depression in Pediatrics

“…Traditionally, CBT programs adopt a generic treatment approach that uses the same set of techniques to treat separation, generalized, and social anxiety disorders in children and adolescents [5,7,9,10]. However, this non-specific CBT approach is found to be less effective for young patients with social anxiety compared to other anxiety disorders [9][10][11]. Consequently, psychotherapies specifically targeting social anxiety disorders have been developed by altering existing therapies to address social skills deficits in this population [5,7,9,12].…”

“…Among the first of these tailored therapies was cognitive behavioral group therapy for adolescents (CBGT-A), a treatment approach that incorporates social skills training (SST) into group-based CBT programs [12,13]. Standard CBT programs are more effective in treating youth anxiety when SST is added [11,12]. In contrast, social effectiveness therapy for children (SET-C) is a group-based behavioral therapy for patients with social anxiety that focuses on exposure therapy, SST, and peer generalization [2,7,9,[11][12][13].…”

“…Standard CBT programs are more effective in treating youth anxiety when SST is added [11,12]. In contrast, social effectiveness therapy for children (SET-C) is a group-based behavioral therapy for patients with social anxiety that focuses on exposure therapy, SST, and peer generalization [2,7,9,[11][12][13].…”

Stepped-care versus therapist-guided, internet-based cognitive behaviour therapy for childhood and adolescent anxiety: A non-inferiority trial

“…Such matching is typically determined based on knowledge of patient-specific factors that might be associated with treatment outcome and has received some attention in childhood anxiety. A recent review illustrated that the most common approaches to treatment personalisation were to adapt existing therapies for specific subgroups (e.g., social anxiety disorder), and to apply modular therapy where additional modules are integrated for additional problems (e.g., depression) ( Bertie and Hudson, 2021 ). Less common approaches included using individualised metrics such as probably of treatment benefit and risk indices to predict response to various treatment approaches.…”

“…Less common approaches included using individualised metrics such as probably of treatment benefit and risk indices to predict response to various treatment approaches. The review also highlighted the limitations of our current understanding of differential CBT response for childhood and adolescent anxiety, and noted a need for clearer evidence of predictors, moderators, and mediators to better inform modified interventions and potential personalised approaches ( Bertie and Hudson, 2021 ). Such evidence is even more scarce when considering ICBT interventions.…”