Skip to main content
Log in

Preliminary Study of Resilience-Based Group Therapy for Improving the Functioning of Anxious Children

  • Original Paper
  • Published:
Child & Youth Care Forum Aims and scope Submit manuscript

Abstract

Background

There is a lack of research examining the feasibility of group psychotherapy interventions for anxious children in private clinical service settings. Furthermore, no research to date has examined the effectiveness of resilience-based interventions for helping children with anxiety disorders.

Objective

The present study aims to examine the effectiveness of a resilience-based cognitive behavioral therapy (CBT) group psychotherapy, the Resilience Builder Program® (RBP), for improving the social, emotional, and family functioning of anxious children in a private clinical setting.

Methods

Participants consisted of 22 children with an anxiety disorder aged 7–12 (81.8 % generalized anxiety disorder; M age = 9.93; 63 % male) enrolled at a private psychotherapy practice in RBP, a 12-week manualized group treatment that targets social competence using resilience skills (i.e., affect and behavior regulation, flexibility/adaptability, social problem-solving, proactive orientation)

Results

Following the completion of RBP, results showed that parents and teachers reported significant decreases in problem behavior. In addition, parents reported significant decreases in depressive symptoms and improved family functioning domains of problem behaviors and communication. Teachers reported reduced internalizing symptoms, somatic problems, and socially odd behaviors, as well as improvements in communication skills and resilience. Moreover, children reported significant improvement in their positive and negative emotions, as well as their emotional control.

Conclusions

Findings from the present study suggest preliminary support for the effectiveness of RBP for improving anxious children’s social, emotional, and family functioning.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Subscribe and save

Springer+ Basic
EUR 32.99 /Month
  • Get 10 units per month
  • Download Article/Chapter or Ebook
  • 1 Unit = 1 Article or 1 Chapter
  • Cancel anytime
Subscribe now

Buy Now

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1

Similar content being viewed by others

References

  • Aduen, P., Rich, B. A., Sanchez, L., O’Brien, K., & Alvord, M. K. (in press). Resilience Builder Program therapy addresses core social deficits in youth with high functioning autism spectrum disorder. Journal of Psychological Abnormalities in Children.

  • Alvord, M. K., & Grados, J. J. (2005). Enhancing resilience in children: A proactive approach. Professional Psychology: Research and Practice, 36, 238–245.

    Article  Google Scholar 

  • Alvord, M. K., Zucker, B., & Grados, J. J. (2011). Resilience Builder Program for children and adolescents: Enhancing social competence and self-regulation, a cognitive behavioral group approach. Champaign, IL: Research Press.

    Google Scholar 

  • Asay, T. P., Lambert, M. J., Gregersen, A. T., & Goates, M. K. (2002). Using patient-focused research in evaluating treatment outcome in private practice. Journal of Clinical Psychology, 58, 1213–1225.

    Article  PubMed  Google Scholar 

  • Barrington, J., Prior, M., Richardson, M., & Kathleen, A. (2005). Effectiveness of CBT verses standard treatment for childhood anxiety disorders in a community clinic setting. Behaviour Change, 22, 29–43. doi:10.1007/s10488-013-0469-5.

    Article  Google Scholar 

  • Baum, N. L., Cardozo, B. L., Pat-Horenczyk, R., Ziv, Y., Blanton, C., Reza, A., et al. (2013). Training teachers to build resilience in children in the aftermath of war: A cluster randomized trial. Child & Youth Care Forum, 42, 339–350. doi:10.1007/s10566-013-9202-5.

    Article  Google Scholar 

  • Bernstein, G. A., Layne, A. E., & Tennison, D. M. (2005). School-based interventions for anxious children. Journal of the American Academy of Child and Adolescent Psychiatry, 44, 1118–1127. doi:10.1097/01.chi.0000177323.40005.a1.

    Article  PubMed Central  PubMed  Google Scholar 

  • Boulet, J., & Boss, M. W. (1991). Reliability and validity of the brief symptom inventory. Psychological Assessment, 3, 433–437. doi:10.1037//1040-3590.3.3.433.

    Article  Google Scholar 

  • Brunwasser, S. M., Gillham, J. E., & Kim, E. S. (2009). A meta-analytic review of the Penn Resiliency Program’s effect on depressive symptoms. Journal of Consulting and Clinical Psychology, 77, 1042–1054.

    Article  PubMed  Google Scholar 

  • Choudhury, M. A., Pimentel, S. S., & Kendall, P. C. (2003). Childhood anxiety disorders: Parent-child (dis)agreement using a structured interview for the DSM-IV. Journal of the American Academy of Child and Adolescent Psychiatry, 42, 957–964.

    Article  PubMed  Google Scholar 

  • Cohen, J. (1988). Statistical power analysis for the behavioral sciences (2nd ed.). Hillsdale, NJ: Lawrence Earlbaum Associates.

    Google Scholar 

  • Crawford, A. M., & Manassis, K. (2011). Anxiety, social skills, friendship quality, and peer victimization: An integrated model. Journal of Anxiety Disorders, 25, 924–931. doi:10.1016/j.janxdis.2011.05.005.

    Article  PubMed  Google Scholar 

  • Cribbie, R. A. (2003). Pairwise multiple comparisons: New yardstick, new results. The Journal of Experimental Education, 71, 251–265. doi:10.1348/000711003321645412.

    Article  Google Scholar 

  • Dadds, M. R., Holland, D. E., Spence, S. H., Laurens, K. R., Mullins, M., & Barrett, P. M. (1999). Early intervention and prevention of anxiety disorders in children: Results at 2-year follow-up. Journal of Consulting and Clinical Psychology, 67, 145–150.

    Article  PubMed  Google Scholar 

  • De Los Reyes, A., & Kazdin, A. E. (2005). Informant discrepancies in the assessment of childhood psychopathology: A critical review, theoretical framework, and recommendations of further study. Psychological Bulletin, 131, 483–509. doi:10.1037/0033-2909.131.4.483.

    Article  PubMed  Google Scholar 

  • Department of Health and Human Services (1999). Mental health: A report of the Surgeon general Rockville, MD.

  • Derogatis, L. R., & Melisaratos, M. (1983). The brief symptom inventory: An introductory report. Psychological Medicine, 13, 595–605.

    Article  PubMed  Google Scholar 

  • Ehrenreich, J. T., Micco, J. A., Fisher, P. H., & Warner, C. M. (2009). Assessment of relevant parenting factors in families of anxious children: The family assessment clinician-rated interview (FACI). Child Psychiatry and Human Development, 40, 331–342. doi:10.1007/s10578-009-0128-y.

    Article  PubMed  Google Scholar 

  • Ehrenreich-May, J., Southam-Gerow, M. A., Hourigan, S. E., Wright, L. R., Pincus, D. B., & Weisz, J. R. (2011). Characteristics of anxious and depressed youth seen in two different clinical contexts. Administration and Policy In Mental Health, 38, 398–411. doi:10.1007/s10488-010-0328-6.

    Article  PubMed  Google Scholar 

  • Epstein, N. B., Baldwin, L. M., & Bishop, D. S. (1983). The McMaster family assessment device. Journal of Marital and Family Therapy, 9, 171–180.

    Article  Google Scholar 

  • Erdlen, R. J. J., & Rickrode, M. R. (2007). Social skills groups with youth: A cognitive behavioral perspective. In R. W. Christner, J. L. Stewart, A. Freeman, R. W. Christner, J. Stewart, & A. Freeman (Eds.), Handbook of cognitive-behavior group therapy with children and adolescents: Specific settings and presenting problems (pp. 485–506). New York: Routledge/Taylor & Francis.

    Google Scholar 

  • Flannery-Schroeder, E., Choudhury, M. S., & Kendall, P. C. (2005). Group and individual cognitive-behavioral treatments for youth with anxiety disorders: 1-year follow-up. Cognitive Therapy and Research, 29, 253–259.

    Article  Google Scholar 

  • Fraser, E., & Pakenham, K. I. (2008). Evaluation of a resilience-based intervention for children of parents with mental illness. Australian and New Zealand Journal of Psychiatry, 42, 1041–1050. doi:10.1080/00048670802512065.

    Article  PubMed  Google Scholar 

  • Ginsburg, G. S., La Greca, A. M., & Silverman, W. K. (1998). Social anxiety in children with anxiety disorders: Relation with social and emotional functioning. Journal of Abnormal Child Psychology, 26, 175–185.

    Article  PubMed  Google Scholar 

  • Ginsburg, G. S., Lambert, S. F., & Drake, K. L. (2004). Attributions of control, anxiety sensitivity, and panic symptoms among adolescents. Cognitive Therapy and Research, 28, 745–763.

    Article  Google Scholar 

  • Gresham, F. M., & Elliott, S. N. (2008). Social skills improvement system. Minneapolis, MN: Pearson Assessments.

  • Grills, A. E, & Ollendick, T. H. (2003). Multiple informant agreement and the anxiety disorders interview schedule for parents and children. Journal of the American Academy of Child and Adolescent Psychiatry, 42, 30–40.

    Google Scholar 

  • Hjemdal, O., Aune, T., Reinfjell, T., Stiles, T. C., & Friborg, O. (2007). Resilience as a predictor of depressive symptoms: A correlation study with young adolescents. Clinical Child Psychology and Psychiatry, 12, 91–104.

    Article  PubMed  Google Scholar 

  • Hudson, J. L., Rapee, R. M., Deveney, C., Schniering, C. A., Lyneham, H. J., & Bovopoulos, N. (2009). Cognitive-behavioral treatment versus an active control for children and adolescents with anxiety disorders: A randomized trial. Journal of the American Academy of Child and Adolescent Psychiatry, 48, 533–544. doi:10.1097/CHI.0b013e31819c2401.

    Article  PubMed  Google Scholar 

  • Hughes, A. A., Hedtke, K. A., & Kendall, P. C. (2008). Family functioning in families of children with anxiety disorders. Journal of Family Psychology, 22, 325–328. doi:10.1037/0893-3200.22.2.325.

    Article  PubMed  Google Scholar 

  • Jacobson, N. S., & Truax, P. (1991). Clinical significance: A statistical approach to defining meaningful change in psychotherapy research. Journal of Consulting and Clinical Psychology, 59, 12–19.

    Article  PubMed  Google Scholar 

  • Kabacoff, R. I., Miller, I. W., Bishop, D. S., Epstein, N. B., & Keitner, G. I. (1990). A psychometric study of the McMaster family assessment device in psychiatric, medical, and nonclinical samples. Journal of Family Psychology, 3, 431–439.

    Article  Google Scholar 

  • Kazdin, A. E. (2008). Evidence-based treatment and practice: New opportunities to bridge clinical research and practice, enhance the knowledge base, and improve patient care. American Psychologist, 63, 146–159. doi:10.1037/0003-066X.63.3.146.

    Article  PubMed  Google Scholar 

  • Kendall, P. C. (Ed.). (2006). Child and adolescent therapy: Cognitive-behavioral procedures (3rd ed.). New York: The Guilford Press.

    Google Scholar 

  • Kendall, P., Chansky, T., Kane, M., Kim, R., Kortlander, E., Ronan, K., et al. (1992). Anxiety disorders in youth: Cognitive-behavioral interventions. Needham Heights, MA: Allyn & Bacon.

    Google Scholar 

  • Kim, D. H., & Yoo, I. Y. (2010). Factors associated with resilience of school age children with cancer. Journal of Paediatrics and Child Health, 46, 431–436. doi:10.1111/j.1440-1754.2010.01749.x.

    Article  PubMed  Google Scholar 

  • Liber, J. M., Van Widenfelt, B. M., Utens, E. M. W. J., Ferdinand, R. F., Van der Leeden, A. J. M., Van Gastel, W., et al. (2008). No differences between group verses individual treatment of childhood anxiety disorders in a randomized clinical trial. Journal of Child Psychology and Psychiatry, 49, 886–893.

    Article  PubMed  Google Scholar 

  • Lumpkin, P. W., Silverman, W. K., Weems, C. F., Markam, M. R., & Kurtines, W. M. (2002). Treating a heterogeneous set of anxiety disorders in youth with group cognitive-behavioral therapy: A partially nonconcurrent multiple-baseline evaluation. Behavior Therapy, 33, 163–177.

    Article  Google Scholar 

  • Manassis, K., Wilansky-Traynor, P., Farzan, N., Kleiman, V., Parker, K., & Sanford, M. (2010). The feelings club: Randomized controlled evaluation of school-based CBT for anxious or depressive symptoms. Depression and Anxiety, 27, 945–952.

    Article  PubMed  Google Scholar 

  • Marchand, E., Stice, E., Rohde, P., & Becker, C. B. (2011). Moving from efficacy to effectiveness trials in prevention research. Behaviour Research and Therapy, 49, 32–41. doi:10.1016/j.brat.2010.10.008.

    Article  PubMed  Google Scholar 

  • Martel, M. M., Nigg, J. T., Wong, M. M., Fitzgerald, H. E., Jester, J. M., Puttler, L. I., et al. (2007). Childhood and adolescent resiliency, regulation, and executive functioning in relation to adolescent problems and competence in a high-risk sample. Development and Psychopathology, 19, 541–563.

    Article  PubMed  Google Scholar 

  • Mendlowitz, S. L., Manassis, K., Bradley, S., Scapillato, D., Miezitis, S., & Shaw, B. F. (1999). Cognitive-behavioral group treatments in childhood anxiety disorders: The role of parental involvement. Journal of American Academy of Child and Adolescent Psychiatry, 38, 1223–1229.

    Article  Google Scholar 

  • Naglieri, J. A., Goldstein, S., & LeBuffe, P. (2010). Study of resilience factors and situational impairment. Journal of Psychoeducational, 28, 349–356.

    Article  Google Scholar 

  • National Institute of Mental Health. (2008). Child and adolescent effectiveness research in clinical practice and community settings: Needs, challenges, and opportunities. In National Institute of Mental Health. Retrieved Oct 6, 2013, from http://www.nimh.nih.gov/research-priorities/scientific-meetings/2008/child-and-adolescent-effectiveness-research-in-clinical-practice-and-community-settings/index.shtml.

  • Reynolds, C. R., & Kamphaus, R. W. (2004). Manual: Behavior assessment system for children-second edition. Circle Pines, MN: American Guidance Service.

    Google Scholar 

  • Rich, B. A., Hensler, M., Rosen, H. R., Watson, C., Schmidt, J., Sanchez, L., et al. (in press). Attrition from therapy effectiveness research among youth in a clinical service setting. Administration and Policy in Mental Health and Mental Health Services Research.

  • Rich, B. A., Nigro, C., Watson, C., Rosen, H. R., Sanchez, L., O’Brien, K., et al. (2013). Improved functioning in children with attention deficit hyperactivity disorder following treatment with the Resilience Builder Program® in a clinical service setting (submitted).

  • Scharfstein, L., Alfano, C., Beidel, D., & Wong, N. (2011). Children with generalized anxiety disorder do not have peer problems, just fewer friends. Child Psychiatry and Human Development, 42, 712–723. doi:10.1007/s10578-011-0245-2.

    Article  PubMed  Google Scholar 

  • Shortt, A. L., Barrett, P. M., & Fox, T. L. (2001). Evaluating the FRIENDS program: A cognitive-behavioral group treatment for anxious children and their parents. Journal of Clinical Child Psychology, 30, 525–535.

    Article  PubMed  Google Scholar 

  • Silverman, W. K., & Ginsburg, G. S. (1998). Anxiety disorders. In T. H. Ollendick & M. Hersen (Eds.), Handbook of child psychopathology (pp. 239–268). New York: Plenum.

    Chapter  Google Scholar 

  • Silverman, W. K., Kurtines, W. M., Ginsburg, G. S., Weems, C. F., Lumpkin, P. W., & Carmichael, D. H. (1999). Treating anxiety disorders in children with group cognitive-behavioral therapy: A randomized clinical trial. Journal of Consulting and Clinical Psychology, 67, 995–1003.

    Article  PubMed  Google Scholar 

  • Sim, L., Whiteside, S. P., Dittner, C. A., & Mellon, M. (2006). Effectiveness of a social skills training program with school age children: Transition to a clinical setting. Journal of Child and Family Studies, 15, 409–418.

    Article  Google Scholar 

  • Smith-Boydson, J. M., & Nelson, T. D. (2008). Adoption of evidence-based treatments in community settings: Obstacles and opportunities. In R. G. Steele, T. D. Elkin, & M. C. Roberts (Eds.), Handbook of evidence-based therapies for children and adolescents: Bridging science and practice. New York: Springer.

    Google Scholar 

  • Southam-Gerow, M. A., Rodriguez, A., Chorpita, B. F., & Daleiden, E. L. (2012). Dissemination and implementation of evidence based treatments for youth: Challenges and recommendations. Professional Psychology: Research and Practice, 43, 527–534. doi:10.1037/a0029101.

    Article  Google Scholar 

  • Southam-Gerow, M. A., Weisz, J. R., & Kendall, P. C. (2003). Youth with anxiety disorders in research and service clinics: Examining client differences and similarities. Journal of Clinical Child and Adolescent Psychology, 32, 375–385.

    Article  PubMed  Google Scholar 

  • Stallard, P., Simpson, N., Anderston, S., Hibbert, S., & Osborn, C. (2007). The FRIENDS emotional health programme: Initial findings from a school-based project. Child and Adolescent Mental Health, 12, 32–37. doi:10.1111/j.1475-3588.2006.00421.x.

    Article  Google Scholar 

  • Stevens, J., Kelleher, K. J., Ward-Estes, J., & Hayes, J. (2006). Perceived barriers to treatment and psychotherapy attendance in child community mental health centers. Community Mental Health Journal, 42, 449–458.

    Article  PubMed  Google Scholar 

  • Substance Abuse and Mental Health Services Administration (2012). Mental Health United States 2010. Rockville, MD.

  • Suveg, C., Zeman, J., Flannery-Schroeder, E., & Cassano, M. (2005). Emotion socialization in families of children with an anxiety disorder. Journal of Abnormal Child Psychology, 33, 145–155.

    Article  PubMed  Google Scholar 

  • Tobon, J. I., Eichstedt, J. A., Wolfe, V. V., Phoenix, E., Brisebois, S., Zayed, R. S., et al. (2011). Group cognitive-behavioral therapy for anxiety in a clinic setting: Does child involvement predict outcome? Behavior Therapy, 42, 306–322. doi:10.1016/j.beth.2010.08.008.

    Article  PubMed  Google Scholar 

  • Victor, A. M., Bernat, D. H., Bernstein, G. A., & Layne, A. E. (2007). Effects of parent and family characteristics on treatment outcome of anxious children. Journal of Anxiety Disorders, 21, 835–848.

    Article  PubMed Central  PubMed  Google Scholar 

  • Walden, T. A., Harris, V. S., & Catron, T. F. (2003). How I Feel: A self-report measure of emotional arousal and regulation for children. Psychological Assessment, 15, 399–412.

    Article  PubMed  Google Scholar 

  • Weisz, J. R., Chorpita, B. F., Palinkas, L. A., Schoenwald, S. K., Miranda, J., Bearman, S. K., et al. (2012). Testing standard and modular designs for psychotherapy treating depression, anxiety, and conduct problems in youth. Archives of General Psychiatry, 69, 274–282.

    Article  PubMed  Google Scholar 

  • Weisz, J. R., Doss, A. J., & Hawley, K. M. (2005). Youth psychotherapy outcome research: A review and critique of the evidence base. Annual Review of Psychology, 56, 337–363.

    Article  PubMed  Google Scholar 

  • Werner, E. E., & Smith, R. S. (2001). Journeys from childhood to midlife: Risk, resilience, and recovery. Ithaca, NY: Cornell University Press.

    Google Scholar 

Download references

Conflict of interest

Dr. Mary Alvord is a co-author of the book Resilience Builder Program for children and adolescents which is a manualized curriculum of the social competence program. She receives royalty from the sale of the book, published by Research Press. No other conflicts are noted.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Brendan A. Rich.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Watson, C.C., Rich, B.A., Sanchez, L. et al. Preliminary Study of Resilience-Based Group Therapy for Improving the Functioning of Anxious Children. Child Youth Care Forum 43, 269–286 (2014). https://doi.org/10.1007/s10566-013-9238-6

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10566-013-9238-6

Keywords

Navigation