Social anxiety disorder (SAD) is a prevalent and continual psychiatric disorder in children and adolescents, characterized by significant impairment in social functioning and academic performance. Cognitive-behavioral therapy (CBT) has been identified as an effective treatment for SAD, and recent research highlights the potential of school-based CBT interventions to address this issue. This blog delves into the findings of a systematic review on school-based CBT for children and adolescents with SAD or social anxiety symptoms, providing actionable insights for practitioners.
Understanding the Research
The systematic review titled "School-based cognitive-behavioural therapy for children and adolescents with social anxiety disorder and social anxiety symptoms: A systematic review" analyzed seven studies involving 2558 participants aged 6–16 years. The review aimed to evaluate the effectiveness of CBT interventions conducted in school settings. The studies included in the review utilized three main CBT programs: FRIENDS, Super Skills for Life (SSL), and Skills for Academic and Social Success (SASS).
Key Findings
- School-based CBT interventions showed minor effects in reducing social anxiety symptoms in 86% of the selected studies.
- FRIENDS, SSL, and SASS programs were more effective than control conditions in primary and secondary schools.
- Parental involvement was generally low, with no significant evaluation of its impact on treatment outcomes.
- There were inconsistencies in the implementation process and fidelity measures, limiting the generalizability of results.
Implications for Practitioners
For practitioners looking to implement school-based CBT programs, the following recommendations can help improve outcomes:
1. Enhance Parental Involvement
Low parental involvement was a common issue in the reviewed studies. To address this, practitioners can use assessment tools like the Parental Involvement in Therapy Scale (PITS) to measure and enhance parental engagement. Increased parental involvement can improve the effectiveness of CBT interventions.
2. Standardize Implementation and Fidelity Measures
Inconsistencies in the implementation process and fidelity measures were noted across studies. Practitioners should adhere to standardized training protocols, provide comprehensive leader manuals, and ensure regular supervision to maintain the quality and consistency of CBT programs.
3. Utilize Comprehensive Outcome Assessments
Most studies relied on self-report measures, which can be subjective. Practitioners should incorporate multiple assessment tools, including clinician-administered scales and parent/teacher reports, to obtain a more accurate evaluation of treatment outcomes.
4. Focus on Long-Term Follow-Up
While short-term improvements were noted, long-term follow-up assessments were often lacking. Practitioners should aim to conduct follow-up assessments at 12 months or beyond to gauge the sustained impact of CBT interventions.
Future Research Directions
To further advance the field, future research should consider the following:
- Include larger, more representative sample sizes to enhance the generalizability of findings.
- Implement studies in diverse settings, including rural communities and different cultural contexts.
- Ensure robust randomization and blinding methods to reduce bias.
- Investigate the role of parental involvement in greater depth using validated assessment tools.
To read the original research paper, please follow this link: School-based cognitive-behavioural therapy for children and adolescents with social anxiety disorder and social anxiety symptoms: A systematic review.
