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The Impact of Treatment Expectations on Exposure Process and Treatment Outcome in Childhood Anxiety Disorders.

Publication ,  Journal Article
Wu, MS; Caporino, NE; Peris, TS; Pérez, J; Thamrin, H; Albano, AM; Kendall, PC; Walkup, JT; Birmaher, B; Compton, SN; Piacentini, J
Published in: J Abnorm Child Psychol
January 2020

This study examined the relationship between caregivers' and youths' treatment expectations and characteristics of exposure tasks (quantity, mastery, compliance) in cognitive-behavioral therapy (CBT) for childhood anxiety. Additionally, compliance with exposure tasks was tested as a mediator of the relationship between treatment expectations and symptom improvement. Data were from youth (N = 279; 7-17 years old) enrolled in the Child/Adolescent Anxiety Multimodal Study (CAMS) and randomized to cognitive-behavioral therapy (CBT) or the combination of CBT and sertraline for the treatment of separation anxiety disorder, generalized anxiety disorder, and social phobia. Caregivers and youth independently reported treatment expectations prior to randomization, anxiety was assessed pre- and post-treatment by independent evaluators blind to treatment condition, and exposure characteristics were recorded by the cognitive-behavioral therapists following each session. For both caregivers and youths, more positive expectations that anxiety would improve with treatment were associated with greater compliance with exposure tasks, and compliance mediated the relationship between treatment expectations and change in anxiety symptoms following treatment. Additionally, more positive parent treatment expectations were related to a greater number and percentage of sessions with exposure. More positive youth treatment expectations were associated with greater mastery during sessions focused on exposure. Findings underscore the importance of addressing parents' and youths' treatment expectations at the outset of therapy to facilitate engagement in exposure and maximize therapeutic gains.

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Published In

J Abnorm Child Psychol

DOI

EISSN

1573-2835

Publication Date

January 2020

Volume

48

Issue

1

Start / End Page

79 / 89

Location

United States

Related Subject Headings

  • Sertraline
  • Selective Serotonin Reuptake Inhibitors
  • Psychotherapeutic Processes
  • Phobia, Social
  • Patient Compliance
  • Outcome and Process Assessment, Health Care
  • Male
  • Implosive Therapy
  • Humans
  • Female
 

Citation

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Wu, M. S., Caporino, N. E., Peris, T. S., Pérez, J., Thamrin, H., Albano, A. M., … Piacentini, J. (2020). The Impact of Treatment Expectations on Exposure Process and Treatment Outcome in Childhood Anxiety Disorders. J Abnorm Child Psychol, 48(1), 79–89. https://doi.org/10.1007/s10802-019-00574-x
Wu, Monica S., Nicole E. Caporino, Tara S. Peris, Jocelyn Pérez, Hardian Thamrin, Anne Marie Albano, Philip C. Kendall, et al. “The Impact of Treatment Expectations on Exposure Process and Treatment Outcome in Childhood Anxiety Disorders.J Abnorm Child Psychol 48, no. 1 (January 2020): 79–89. https://doi.org/10.1007/s10802-019-00574-x.
Wu MS, Caporino NE, Peris TS, Pérez J, Thamrin H, Albano AM, et al. The Impact of Treatment Expectations on Exposure Process and Treatment Outcome in Childhood Anxiety Disorders. J Abnorm Child Psychol. 2020 Jan;48(1):79–89.
Wu, Monica S., et al. “The Impact of Treatment Expectations on Exposure Process and Treatment Outcome in Childhood Anxiety Disorders.J Abnorm Child Psychol, vol. 48, no. 1, Jan. 2020, pp. 79–89. Pubmed, doi:10.1007/s10802-019-00574-x.
Wu MS, Caporino NE, Peris TS, Pérez J, Thamrin H, Albano AM, Kendall PC, Walkup JT, Birmaher B, Compton SN, Piacentini J. The Impact of Treatment Expectations on Exposure Process and Treatment Outcome in Childhood Anxiety Disorders. J Abnorm Child Psychol. 2020 Jan;48(1):79–89.
Journal cover image

Published In

J Abnorm Child Psychol

DOI

EISSN

1573-2835

Publication Date

January 2020

Volume

48

Issue

1

Start / End Page

79 / 89

Location

United States

Related Subject Headings

  • Sertraline
  • Selective Serotonin Reuptake Inhibitors
  • Psychotherapeutic Processes
  • Phobia, Social
  • Patient Compliance
  • Outcome and Process Assessment, Health Care
  • Male
  • Implosive Therapy
  • Humans
  • Female