Differential Sequencing of Cognitive-Behavioral Techniques for Reducing Child and Adolescent Anxiety

Abstract

Treatment outcome research has rarely allowed investigators to declare how or why therapeutic techniques work. As an initial step to understand such change processes, the current study investigated the timing of positive changes typically achieved during a course of cognitive-behavioral therapy for anxiety reduction. Using an interaction element multiple-baseline design across four children (N = 4) diagnosed with selected anxiety disorders, anxiety levels, cognitive errors, and treatment outcome were repeatedly assessed as children progressed through four a priori determined treatment sequences. Results varied across reporters, dependent variables, and the order in which each treatment technique was delivered. Child-reported trends were slightly clearer than those reported by parents and suggested that exposure was a key element for triggering some (but not all) positive changes after completing self-monitoring and psychoeducation techniques.