Directionality of Change in Youth Anxiety Treatment Involving Parents: An Initial Examination

Wendy K. Silverman, William M. Kurtines, James Jaccard, Armando A. Pina

Research output: Contribution to journalArticlepeer-review


This randomized clinical trial compared cognitive behavioral therapy (CBT) with minimal parent involvement to CBT with active parent involvement in a sample of 119 youths (7-16 years old; 33.6% Caucasian, 61.3% Latino) with anxiety disorders. The dynamics of change between youth anxiety and parent variables (positive-negative behaviors toward the child, conflict in the parent-youth relationship, and parental anxiety) in both treatment conditions over pretreatment, posttreatment, and 12-month follow-up were also examined. Results indicated that youth anxiety was significantly reduced with both treatments and that the dynamics of change may not solely flow from parent to youth but also from youth to parent. Findings highlight the need for research on directionality and mechanisms of change to move from evidence-based treatments toward evidence-based explanations of treatment outcome.

Original languageEnglish (US)
Pages (from-to)474-485
Number of pages12
JournalJournal of consulting and clinical psychology
Issue number3
StatePublished - Jun 2009


  • anxiety
  • children
  • cognitive behavioral therapy
  • parent involvement
  • treatment

ASJC Scopus subject areas

  • Clinical Psychology
  • Psychiatry and Mental health


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