Cognitive behavioural therapy is an effective treatment for anxiety disorders in children and young people; however, many do not benefit. Behavioural exposure appears to be the critical ingredient in the treatment of anxiety disorders. Research with adults has identified innovative strategies to optimise exposure-based treatments, yet it is not clear how to optimise the effects of exposure for children and young people. This review was a preliminary exploration of the association between potential optimisation strategies and treatment procedures and outcomes for the treatment of child anxiety symptoms/disorders. We searched Psych-Info and Medline databases using a systematic search strategy and identified 29 articles. We found preliminary evidence that some specific strategies may enhance the effects of exposure, such as dropping safety behaviours, parents and therapists discouraging avoidance, and the use of homework. However, not one significant finding was replicated by another study for the same timepoint using the same methodology. To a large degree, this lack of replication reflects a limited number of studies combined with a lack of consistency across studies around conceptualisations, methodological approaches, and outcome measures making it difficult to make meaningful comparisons between studies and draw firm conclusions. Examination is needed of a wide range of theoretically-driven potential optimisation strategies using methodologically robust, preclinical studies with children and young people. Furthermore, the methods used in future research must enable comparisons across studies and explore developmental differences in the effects of particular optimisation strategies.

认知行为疗法是治疗儿童和青少年焦虑症的有效方法；然而，许多人并没有受益。行为暴露似乎是治疗焦虑症的关键因素。针对成人的研究已经确定了优化基于暴露的治疗的创新策略，但尚不清楚如何优化儿童和青少年的暴露效果。本综述初步探索了潜在的优化策略与儿童焦虑症状/障碍的治疗程序和结果之间的关联。我们使用系统检索策略检索了 Psych-Info 和 Medline 数据库，并确定了 29 篇文章。我们发现初步证据表明，一些特定策略可能会增强暴露的影响，例如放弃安全行为、父母和治疗师不鼓励回避以及使用家庭作业。然而，同一时间点使用相同方法的另一项研究并未重复任何重大发现。在很大程度上，缺乏重复性反映了研究数量有限，加上研究之间在概念、方法论和结果衡量方面缺乏一致性，使得很难在研究之间进行有意义的比较并得出明确的结论。需要使用方法论上稳健的儿童和青少年临床前研究来检查各种理论驱动的潜在优化策略。此外，未来研究中使用的方法必须能够进行不同研究的比较，并探索特定优化策略效果的发展差异。