(PS3-79) Pediatric Anxiety Disorders: Therapy Process Predictors of Response to CBT

Anxiety disorders are considered the most common psychiatric disorder in childhood and adolescence. Cognitive-behavioral therapy (CBT) has shown efficacy, but some participants are non-responsive post-treatment. Past research focused on diagnostic and demographic factors, less work has addressed potential factors influencing change (i.e., therapeutic alliance, child engagement, skill acquisition, coping efficacy, and homework completion). Interrater reliability (ICC > 0.75) was obtained for the Therapist Rating Form on variables of therapeutic alliance, child engagement, and skill acquisition/mastery based on 20 randomly selected coded tapes. ICC estimates and their 95% confidence intervals will be calculated using the SPSS statistical package based on a mean-rating (k= 4), absolute-agreement, two-way mixed-effects model. Logistic regression analyses will examine the relationship between therapy process predictors (i.e., therapeutic alliance, child engagement, skill acquisition, coping efficacy, and homework completion) and treatment response status (i.e., treatment response) with 322 youth who completed CBT for anxiety at a university-based clinic in Philadelphia, PA. All data has been collected. Separate regressions will evaluate four types of treatment response assessed at post-treatment by Independent Evaluators (IEs), including (1) Clinical Global Impression – Improvement (CGI-I) scores, (2) Clinical Global Impression – Severity (CGI-S) scores, (3) Clinical Severity Rating (CSR) scores, and (4) Multidimensional Anxiety Scale (MASC) Change scores. Process variables associated with treatment response may promote the effectiveness of youth treatment. Significant findings will be integrated with recommendations for improving treatment.