Evidence map›Paper›PMID 31628568›Full record

SynthesisClinical child and family psychology review2020

A Meta-analysis to Guide the Enhancement of CBT for Childhood Anxiety: Exposure Over Anxiety Management.

Stephen P H Whiteside, Leslie A Sim, Allison S Morrow, Wigdan H Farah, Daniel R Hilliker, M Hassan Murad, Zhen Wang

Registry-linked trialOpen access · greenAbstract readComparative StudyMeta-Analysis
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Clinical child and family psychology review, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT07228143 (Stepped Care Cognitive Behavioral Therapy for Children and Adolescents With Anxiety), which is not on this map. Cited by 75 papers, 8 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
75citing papers in PubMed, 8 pooled it
19.5field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT07228143 narecruitingnot on this mapstarted 2026, after this paper: background citation

Stepped Care Cognitive Behavioral Therapy for Children and Adolescents With Anxiety

TypeinterventionalSponsorAndrew WieseRan2026 to 2028Enrolled106ConditionsGeneralized Anxiety Disorder (GAD), Social Anxiety Disorder (SAD), Separation Anxiety Disorder, Specific PhobiaArmsRelaxation and Mentorship Training (RMT), Stepped Care Targeting Exposure and Parenting for Anxiety (STEP-A)
3 · Its place in the literature

Who cites it

75 citing papers in PubMed, 8 syntheses or guidelines pooled it, 180 citations in OpenAlex.

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15 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 2 institutions in 1 country.

Stephen P H WhitesideDepartment of Psychiatry and Psychology, Mayo Clinic, Mayo Bldg West 11, 200 First St., SW, Rochester, MN, 55905, USA. whiteside.stephen@mayo.edu.ORCID 0000-0002-3248-5992
Leslie A SimDepartment of Psychiatry and Psychology, Mayo Clinic, Mayo Bldg West 11, 200 First St., SW, Rochester, MN, 55905, USA.
Allison S MorrowRobert D. and Patricia E. Kern Center for Science of Health Care Delivery, Mayo Clinic, Rochester, MN, USA.
Wigdan H FarahRobert D. and Patricia E. Kern Center for Science of Health Care Delivery, Mayo Clinic, Rochester, MN, USA.
Daniel R HillikerDepartment of Psychiatry and Psychology, Mayo Clinic, Mayo Bldg West 11, 200 First St., SW, Rochester, MN, 55905, USA.
M Hassan MuradRobert D. and Patricia E. Kern Center for Science of Health Care Delivery, Mayo Clinic, Rochester, MN, USA.
Zhen WangRobert D. and Patricia E. Kern Center for Science of Health Care Delivery, Mayo Clinic, Rochester, MN, USA.
Mayo Clinic in Arizona · USMayo Clinic · US

Funding

AHRQ HHS HHSA290201500013I
6 · The paper itself

Abstract

Cognitive behavior therapy (CBT) is the most empirically supported therapy for childhood anxiety disorders (CADs) but has not reliably outperformed other credible interventions. The current study used meta-analysis to examine the frequency with which the most common treatment components are included in outcome studies and the relation of these components to symptom improvement. Seventy-five studies were identified that included youth with an anxiety disorder treated with CBT or a comparison condition. The protocols for the 111 CBT conditions generally consisted of 12, 1-h sessions delivered to the child with minimal parent inclusion. A greater amount of in-session exposure was related to significantly larger effect sizes between CBT and waitlist control across reporters (- 0.12 to - 0.15; P's < .05) and from pre- to post-treatment for child report (- .06; P < .01). Compared to treatments that omitted relaxation, treatments that included relaxation strategies were associated with significantly smaller pre- to post-treatment effect sizes across reporters (0.38 to 0.80; P's < .05). The current study suggests that CBT protocols for CADs that emphasize in-session exposure and do not include relaxation have the potential to improve the efficacy and effectiveness of therapy. Dismantling studies directly testing these hypotheses are needed.

Indexed as

Cognitive Behavioral TherapyImplosive TherapyOutcome and Process Assessment, Health CareRelaxation TherapyAnxiety DisordersChildHumansChildhood anxiety disordersCognitive behavior therapyExposure therapyLiterature reviewRelaxation

Identifiers

PMID31628568
PMCPMC9005063
OpenAlexW2980786259

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.