The purpose of the present study is to further develop and conduct a randomized clinical trial to evaluate a treatment approach for 9-13 yr-old anxiety-disordered children. It will compare a 16-week cognitive- behavioral (C-B) treatment with an 8-week wait-list control condition. C-B consists of skill building (8 wks) and exposure and rehearsal (8 wks). In addition to overall effects, the separate effects of the first and second segments of the treatment will be examined. The study will also assess cognitive features involved in childhood anxiety. Referred youth will be diagnosed via structured interviews. Subjects will be randomly assigned to one of the conditions, and to one of the therapists. Comorbidity will also be determined. Wait-list subjects will receive treatment after the wait period. All children will receive individual weekly, 60-minute sessions. C-B will focus on: 1. recognizing anxious thoughts and somatic reactions; 2. clarifying cognition in anxiety- provoking situations; 3. developing a coping plan; and 4. evaluating performance and self-reinforcement. Behavioral techniques such as modeling, role-play, exposure, relaxation, and reinforcement will be used. Subjects in the wait-list condition will be administered (pre-post wait period) the same measures as the treated children. Treated children will be assessed at pre-, mid-, and post-treatment, and at one-year follow-up. Treatment effects will be analyzed via 2 (conditions) X 2 (assessments) mixed factorial ANOVA. When dependent measures are highly interrelated, MANOVA will be used (ANCOVA if pretreatment differences). Assessments include children's self-reports, teacher measures, parent measures of their children and of themselves, and behavioral observations. Other measures (e.g., relationship, compliance, parental involvement), and client pretreatment characteristics (e.g., age) will be examined in relation to outcome. Specific anxiety disorders, as well as the presence of other disorders (comorbidity with depression will be used to examine differential responsiveness to treatment.
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