TY - JOUR
T1 - Child and Adolescent Adherence With Cognitive Behavioral Therapy for Anxiety
T2 - Predictors and Associations With Outcomes
AU - Lee, Phyllis
AU - Zehgeer, Asima
AU - Ginsburg, Golda S.
AU - McCracken, James
AU - Keeton, Courtney
AU - Kendall, Philip C.
AU - Birmaher, Boris
AU - Sakolsky, Dara
AU - Walkup, John
AU - Peris, Tara
AU - Albano, Anne Marie
AU - Compton, Scott
N1 - Publisher Copyright:
© 2017, Copyright © 2017 Society of Clinical Child & Adolescent Psychology.
PY - 2019/3/29
Y1 - 2019/3/29
N2 - Cognitive behavioral therapy (CBT) for anxiety disorders is effective, but nonadherence with treatment may reduce the benefits of CBT. This study examined (a) four baseline domains (i.e., demographic, youth clinical characteristics, therapy related, family/parent factors) as predictors of youth adherence with treatment and (b) the associations between youth adherence and treatment outcomes. Data were from 279 youth (7–17 years of age, 51.6% female; 79.6% White, 9% African American), with Diagnostic and Statistical Manual of Mental Disorders (4th ed., text rev.) diagnoses of separation anxiety disorder, generalized anxiety disorder, and/or social phobia, who participated in CBT in the Child/Adolescent Anxiety Multimodal Study. Adherence was defined in three ways (session attendance, therapist-rated compliance, and homework completion). Multiple regressions revealed several significant predictors of youth adherence with CBT, but predictors varied according to the definition of adherence. The most robust predictors of greater adherence were living with both parents and fewer youth comorbid externalizing disorders. With respect to outcomes, therapist ratings of higher youth compliance with CBT predicted several indices of favorable outcome: lower anxiety severity, higher global functioning, and treatment responder status after 12 weeks of CBT. Number of sessions attended and homework completion did not predict treatment outcomes. Findings provide information about risks for youth nonadherence, which can inform treatment and highlight the importance of youth compliance with participating in therapy activities, rather than just attending sessions or completing homework assignments.
AB - Cognitive behavioral therapy (CBT) for anxiety disorders is effective, but nonadherence with treatment may reduce the benefits of CBT. This study examined (a) four baseline domains (i.e., demographic, youth clinical characteristics, therapy related, family/parent factors) as predictors of youth adherence with treatment and (b) the associations between youth adherence and treatment outcomes. Data were from 279 youth (7–17 years of age, 51.6% female; 79.6% White, 9% African American), with Diagnostic and Statistical Manual of Mental Disorders (4th ed., text rev.) diagnoses of separation anxiety disorder, generalized anxiety disorder, and/or social phobia, who participated in CBT in the Child/Adolescent Anxiety Multimodal Study. Adherence was defined in three ways (session attendance, therapist-rated compliance, and homework completion). Multiple regressions revealed several significant predictors of youth adherence with CBT, but predictors varied according to the definition of adherence. The most robust predictors of greater adherence were living with both parents and fewer youth comorbid externalizing disorders. With respect to outcomes, therapist ratings of higher youth compliance with CBT predicted several indices of favorable outcome: lower anxiety severity, higher global functioning, and treatment responder status after 12 weeks of CBT. Number of sessions attended and homework completion did not predict treatment outcomes. Findings provide information about risks for youth nonadherence, which can inform treatment and highlight the importance of youth compliance with participating in therapy activities, rather than just attending sessions or completing homework assignments.
UR - http://www.scopus.com/inward/record.url?scp=85018158923&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85018158923&partnerID=8YFLogxK
U2 - 10.1080/15374416.2017.1310046
DO - 10.1080/15374416.2017.1310046
M3 - Article
C2 - 28448176
AN - SCOPUS:85018158923
SN - 1537-4416
VL - 48
SP - S215-S226
JO - Journal of Clinical Child and Adolescent Psychology
JF - Journal of Clinical Child and Adolescent Psychology
IS - sup1
ER -