Youth anxiety treatment

Psychological intervention for anxiety disorders in children and adolescents. Treatment studies should distinguish diagnostic remission, symptom change, global improvement and everyday functioning, as well as immediate outcomes and maintenance. A successful multicomponent intervention establishes an effect of that package under the tested conditions, not the necessity of each included technique.

Strategies intended to recognise, tolerate or regulate anxiety, including coping routines, relaxation and breathing exercises. These should be distinguished from targeted tests of threat predictions. Whether a technique supports approach or becomes a perceived safety requirement depends on its use, and efficacy of a CBT package does not isolate the technique's effect.^[ref]

Recognising and describing emotional experiences. Performance on an emotion-label task and ability to use that understanding in everyday situations are distinct outcomes.

Deliberate alteration or attention to breathing. In an anxiety intervention its proposed function should be specified and assessed rather than presuming that any reduction in arousal changes the meaning assigned to bodily sensations.

An activity intended to reduce muscular tension or physiological arousal. A reduction in immediate arousal is a different endpoint from durable change in an anxiety disorder.

Caregivers may facilitate access and practice, receive information, change accommodation, or receive treatment for their own difficulties. These roles imply different mechanisms and should be compared against the same adequate child treatment when testing augmentation. Parent-only treatment and adding parent sessions to child treatment answer different questions.^[ref]

A therapist supports a caregiver in delivering structured CBT activities with their child. Guidance includes reviewing practice and overcoming barriers, rather than merely distributing information. Evidence for a specified guided programme does not establish that an unsupported manual has the same effect.^[ref]

A parent-based treatment that targets accommodation and supportive responses to a child's anxiety. A randomised trial compared it with child CBT using prespecified noninferiority criteria; the tested age range and margins constrain the conclusion.^[ref]

Anxiety experienced by a parent, distinguished from the child's symptoms and from parental accommodation. It may affect burden and participation, but association with child difficulty does not establish that treating it necessarily augments child treatment.^[ref]