Cognitive behavior therapy (CBT) is the most empirically supported therapy for childhood anxiety disorders (CADs) but has not reliably outperformed other credible interventions. The current study used meta-analysis to examine the frequency with which the most common treatment components are included in outcome studies and the relation of these components to symptom improvement. Seventy-five studies were identified that included youth with an anxiety disorder treated with CBT or a comparison condition. The protocols for the 111 CBT conditions generally consisted of 12, 1-h sessions delivered to the child with minimal parent inclusion. A greater amount of in-session exposure was related to significantly larger effect sizes between CBT and waitlist control across reporters (− 0.12 to − 0.15; P’s < .05) and from pre- to post-treatment for child report (− .06; P < .01). Compared to treatments that omitted relaxation, treatments that included relaxation strategies were associated with significantly smaller pre- to post-treatment effect sizes across reporters (0.38 to 0.80; P’s < .05). The current study suggests that CBT protocols for CADs that emphasize in-session exposure and do not include relaxation have the potential to improve the efficacy and effectiveness of therapy. Dismantling studies directly testing these hypotheses are needed.

中文翻译：

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指导加强 CBT 治疗儿童焦虑的荟萃分析：暴露于焦虑管理。

认知行为疗法 (CBT) 是最有经验支持的儿童焦虑症 (CAD) 疗法，但并未可靠地优于其他可靠的干预措施。目前的研究使用荟萃分析来检查最常见的治疗成分被纳入结果研究的频率以及这些成分与症状改善的关系。确定了 75 项研究，其中包括接受 CBT 或比较条件治疗的患有焦虑症的青年。111 CBT 条件的协议通常包括 12 个 1 小时的会话，这些会话交付给孩子，而父母的参与最少。更多的会话中暴露与 CBT 和跨报告者的候补名单控制之间显着更大的效应大小有关（- 0.12 至 - 0.15；P's < .05) 和从治疗前到治疗后的儿童报告 (- .06; P  < .01)。与省略放松的治疗相比，包括放松策略的治疗与报告者的治疗前后效应大小显着相关（0.38 至 0.80；P < .05）。目前的研究表明，针对 CAD 的 CBT 方案强调在会话中暴露且不包括放松，有可能提高治疗的疗效和有效性。需要拆解研究直接测试这些假设。