• By Laura Whybra
  • Posted on Tuesday 28th January, 2014

When therapy works, the results are lasting

strong>Some people respond well to cognitive behavioral therapy. Some don’t. A recent study found that kids with anxiety who responded well to CBT were still doing better up to two decades later than kids who didn’t respond well to treatment in childhood. Research at Temple University in Pennsylvania found that children whose anxiety was successfully treated by cognitive behavioral therapy (CBT) in childhood were less likely to develop alcohol dependence, drug addiction and panic disorders in later life. By contrast, those who were treated but who did not respond successfully to CBT were more likely to experience substance misuse problems and anxiety disorders. However, compared to the general population, children who had anxiety disorders were more likely to experience nicotine dependence and generalized anxiety disorders as adults – regardless of whether they responded well to CBT or not. “Childhood anxiety disorders may serve as a gateway disorder for later substance misuse,” the researchers concluded. Anxiety: a big public health problemAnxiety is common in both adults and youths. Roughly 10-20% of children in US report “distressing levels of anxiety.” Anxiety disorders can have important long-term implications, including depression, suicidal thinking, and substance misuse. CBT is considered an effective treatment for childhood anxiety disorders. CBT is a talking therapy that aims to change how participants think about a situation, in order to change how they act. Typically, 5 to 20 weekly sessions lasting between 30 and 60 minutes each take place. CBT helps participants make sense of overwhelming problems by breaking them down into smaller parts. Several clinical trials have demonstrated the effectiveness of CBT for anxious children. But long-term studies of the role that early anxiety treatment might play as children grow up have been scarce. Although follow-up research has been carried out (from one to seven years after treatment), longer follow-ups are uncommon. How does treatment of anxiety in children relate to their adult outcomes? As CBT participants grow up The Temple University researchers tracked down adults who had received CBT treatment for anxiety as children, and assessed their mental health 7 to 19 years after treatment. The participants were aged 7-14 at the time of treatment and 18-32 in the latest follow-up. Self-report measures and diagnostic interviews were used to assess their anxiety, depression, and substance use. Substance use and misuse included alcohol, drugs, and nicotine. Of 150 individuals who were eligible for this follow-up study, 66 (44%) were located and agreed to participate. For many of these young adults who were treated for anxiety as children, poor mental health persisted into adulthood. A large minority of the study participants – 44% - had an anxiety disorder as adults. Just over a quarter also met the criteria for depressive disorder, and 42% had a substance use disorder. Compared with a control group from the general population, both successful and unsuccessfully treated groups had higher rates of nicotine dependence and generalized anxiety disorders. Researchers also compared successfully and unsuccessfully treated patients. They found that those individuals who did not respond successfully to CBT for an anxiety disorder in childhood had higher rates of panic disorder, alcohol dependence and drug abuse in adulthood. Those individuals who responded well to CBT during childhood were less likely to develop these disorders. Overall, the results of this study say little about whether CBT is an effective long-term treatment for anxiety. However, they do suggest that in those cases where CBT works for children, the benefits can be lasting.*************Reference: Benjamin, C.L., Harrison, J.P., Settipani, C.A., Brodman, D.M, & Kendall, P.C. (2013). Anxiety and related outcomes in young adults 7 to 19 years after receiving treatment for child anxiety. Journal of Counseling and Clinical Psychology. DOI: 10.1037/a0033048

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