A Pilot Investigation of Cognitive Therapy for Generalized Anxiety Disorder in Children Aged 7-17 Years

The development of treatments based on cognitive models of worry has led to improved outcomes for adults with Generalized Anxiety Disorder (GAD), and holds out the promise that similar improvements may be achieved for GAD further down the age range. The aim of the current study was to evaluate the effect of a GAD-specific, cognitive treatment in a sample of children and adolescents with GAD. Sixteen youth (7-17 years of age) who were consecutive referrals to a specialty anxiety disorders clinic, with a primary diagnosis of DSM-IV GAD, and who were not undergoing concurrent pharmacological treatment for anxiety were provided 5 to 15 session (mean = 9.7) of cognitive therapy aimed at their tolerance for uncertainty, beliefs about worry, negative problem orientation, and cognitive avoidance strategies. All participants who entered the study completed treatment and 13 (81%) lost their GAD diagnosis (not blindly assessed); two were improved but still had GAD and one experienced no improvement at all. Age, gender and number of sessions received were unrelated to diagnostic outcome but age was positively correlated (r = 0.6, P <.01) with pre-to-post reductions in worry frequency. The uncontrolled effect size for self-reported worry was 2.0 and for anxiety was 1.4. Further controlled evaluations of this cognitive treatment for GAD in children and adolescents are warranted.