Do Anxiety-Disordered Children Need to Come Into the Clinic for Efficacious Treatment?

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, 09 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.