The Effectiveness of Child-Parent Interventions for Children and Adolescents with Anxiety Disorders: A Systematic Review and Meta-Analysis

Anxiety disorders are the most prevalent psychiatric disorders in childhood (Hirshfeld-Becker & Biederman, 2002; Walkup & Ginsburg, 2002), occuring in approximately twenty percent of the population (APA, 2000; Langley Lindsey, Bergman & Piacentini, 2002). Children and adolescents with anxiety disorders often experience many detrimental effects such as low-self esteem, issues with social and family relationships, and a decrease in overall functioning, including academic performance. In addition, if left untreated or unrecognized, anxiety disorders in childhood often lead to more severe symptoms in adulthood including depression, substance abuse, suicidal ideation, and other comorbid anxiety disorders. Evidence suggests that anxiety disorders are transmitted intergenerationally, with 60 to 80 percent of parents with anxiety disorders having children with anxiety disorders (Last, Hersen, Kazdin, Orvaschel & Perrin, 1991; Merikangas, Dieker & Szatmari, 1998), which can further exacerbate anxious symptoms. With children and parents cohabitating with anxious symtoms and passing down anxious symptoms to the next generation, the need exists to explore effective family based interventions.

The present study is a systematic review and meta-analysis that explores the effectiveness of child-parent interventions for childhood anxiety disorders. The research located during the literature search was coded for inclusionary criteria and resulted in eight qualifying individual randomized controlled trials (RCT) with a total of 710 participating children and adolescents (440 completer data). Statistical information from the studies were meta-analyzed using Hedges’ g via CMA software [Version 2]. Results of the meta-analysis yielded a small, positive effect size of 0.263 (SE=0.103, 95% CI= 0.062 to 0.465) favoring child-parent cognitive behavioral interventions over individual and group cognitive behavioral therapy.  Results were homogeneous indicating that any variance in effect size can be confidently attributed to sampling error (Q=7.728, df=7, p=0.357).

Social workers and other treatment professionals must utilize the most effective interventions to help relieve symptoms of childhood anxiety disorders, thereby improving present and future functioning. The present study contributes the most up-to-date information available with respect to effective treatments for childhood anxiety disorders. The present study can be used to help guide current practices when working with children and adolescents with anxiety disorders and guide future areas for research.