New Support for Cognitive Behavioral Therapy
CBT Helps Half of Kids With Anxiety Disorders
Oct. 19, 2005 -- Cognitive behavioral therapy helps children and teens
suffering from anxiety disorders.
That's the judgment of a Cochrane review, widely considered the
gold-standard rating system for medical treatments. Cochrane reviews evaluate
whether clinical studies provide enough first-rate evidence to say a treatment
Cognitive behavioral therapy -- or CBT -- is a brief form of psychotherapy.
Using specific, step-by-step techniques, it teaches patients skill sets that
allow them to change the ways they think and act.
CBT treatments for anxiety, for example, teach patients skills to help them
deal with anxiety-provoking situations. Patients are then gradually exposed --
either in imagination or in real life -- to the things that make them anxious
Psychiatrist Anthony James, MD, senior lecturer at the University of Oxford
in England, and colleagues analyzed 13 clinical studies of CBT in children and
teens with mild-to-moderate anxiety disorders. The results:
- 56% of children and teens got better, vs. 28% of kids in untreated
- Children and teens treated with CBT averaged 58% fewer symptoms of
- Three kids must be treated with CBT to cure one case of anxiety
"Cognitive-behavioral therapy does work for children with anxiety
disorders," James tells WebMD. "It probably compares favorably with the
effects of drug treatment. CBT probably should be offered as a first-line
treatment where therapists are available to deliver it."
James says the studies offer "robust" support for CBT as a treatment
for pediatric anxiety. He gets no argument from Jennifer Hagman, MD, associate
professor of psychiatry with the University of Colorado Health Sciences Center
and co-director of the eating disorders treatment program at The Children's
"Fifty percent improvement in symptoms is really pretty good,"
Hagman says. "In clinical practice, patients do very well with
goal-oriented therapy that teaches specific skills. And the outcomes are very
strong in the studies where a consistent approach is used."
While CBT clearly benefits patients, James warns that it is not a
"There is no panacea," he says. "Cognitive behavioral therapy is
a collaborative treatment that does appear to work in all of its various
formats. But there is still room for improvement. A good percentage of patients
do not improve. That may be the group for whom combined CBT and drug therapy is
Hagman points to recent clinical trials suggesting that, at least for some
Best When Parents Involved
Does your child suffer from an anxiety disorder? Children with anxiety
problems may or may not act like anxious adults.
"Kids are more likely to have physical symptoms from anxiety
disorders," Hagman says. "They have stomachaches or headaches;
sometimes with vomiting or diarrhea. But they can look very worried, very
stressed, and can have panic syndromes just as adults do."