Group- Versus Parent-Involvement CBT for Childhood Anxiety Disorders: Treatment Specificity and Long-Term Recovery Mediation

Treatment specificity and long-term recovery mediation of peer-involvement group cognitive behavioral therapy (GCBT) and parent-involvement CBT (PCBT) were investigated for youth anxiety disorders. Two hundred forty youths with primary anxiety diagnoses participated in a randomized controlled efficacy trial. Youth anxiety and peer variables/mediators (positive peer–youth relationships; social skills) and parent variables/mediators (psychological control; negative parent–youth relationships) were assessed. At posttreatment and 12-month follow-up, positive peer-youth relationships were significantly higher in GCBT than PCBT (specificity) according to youth and parent ratings. At posttreatment but not follow-up, parental psychological control was significantly lower in PCBT than GCBT (specificity) and findings varied by informants. Parental psychological control and positive peer–youth relationships were putative mediators. The two CBTs produced similar anxiety reductions through different mechanisms. CBT targets show specificity and mediation, providing insight into specific mechanisms through which GCBT and PCBT bring about anxiety reduction and guidance for streamlining these CBTs in practice.