1. Children’s Perceptions of a Brief Group Cognitive Behavioral Intervention: Preliminary data and clinical implications1 Robert D. Friedberg, Ph.D., ABPP & Belal Elamir, M.D. Penn State Milton Hershey Medical Center/Penn State College of Medicine. Hershey , PA Poster presented at the 2007 World Congress of Behavioral and Cognitive Therapy, Barcelona, Spain
Introduction
Group cognitive behavior therapy is emerging as a promising intervention which is effective and efficient. Children’s perceptions of treatment are typically neglected. Thus, researchers and clinicians are left to wonder how children perceive their treatment and what they internalize from clinical sessions. This poster presents preliminary data from an innovative 8 week outpatient group which integrates skill acquisition and application. The group includes psychoeducation, self-monitoring, problem-solving, behavioral techniques, self-instruction, and exposure tasks. This poster examines children’s perceptions of the group cognitive behavioral intervention
Method: This preliminary study included 12 children who participated in the Child Anxiety Management Program (CAMP) group therapy project. There were 4 boys and 8 girls. The mean age was 10.7 yrs. Seven children were diagnosed with an anxiety spectrum disorder and five others were diagnosed with an externalizing disorder but were referred to the group due to accompanying anxious symptoms. Following each of the seven intervention sessions, children completed the end of session feedback form. The session feedback form included 2 questions on a 7 point Likert scale assessing their perception of the helpfulness of each session and how much “fun” they had in the session. A third open-ended question asked the children to summarize what they had learned from the session. Two ANOVAs with posthoc comparisons were calculated to determine which sessions were seen as most helpful and fun. T-tests were computed to discern whether gender, diagnosis, and level of attendance contributed to differences in perceptions
Results: The Within Group ANOVA revealed a significant effect for session type on fun ratings (F=4.48, df=6, p<.001). Posthoc pair wise comparisons indicated the first group (Mean= 6.04) was seen as less fun than session 2 (Mean=6.67, p<. 05)), 3 (Mean= 7, p<.01), 6 (Mean= 6.82, p<.05), and 7 (Mean=6.80, p< .05). Group 3 (Mean=7) was also seen as significantly more fun than group 5 (Mean=5.9, p<.01). A second Within Group ANOVA examining session type and helpfulness ratings approached statistical significance (F=2.09, df=6, p<.07). Although the overall F failed to reach significance, pair wise comparisons suggested that group 1 (Mean 5.71) was seen as the least helpful group compared to groups 2 (Mean= 6.5, p<.01), 3 (Mean=6.60, p<.05)), 5 (Mean=6.40, p<..05), 6 (Mean=6.55, p<. 05) and 7 (Mean=6.80, p<. 01). T-tests examining the effects of gender, diagnosis, and level of attendance failed to reach significance.
Conclusions and Implications: The data indicates that children’s perceptions of fun and helpfulness increase after the initial group session. Moreover, these ratings remained relatively high over the course of the brief treatment. Thus, the young patients found the very active aspects of treatment such as self-monitoring, cognitive restructuring, and behavioral experiments as both helpful and fun. This finding is consistent with the previous literature suggesting that if CBT approaches are made developmentally accessible and engaging children embrace treatment procedures despite their effort expended and experiencing negative emotion associated with challenging psychotherapeutic tasks (Friedberg & McClure, 2002; Gosch, Stallard, 2002, 2005).
References
Friedberg, R.D., & McClure, J.M. (2002). Clinical practice of cognitive therapy with children and adolescents: The nuts and bolts. New York: Guilford.
Gosch, E.A., Flannery-Schroeder, E., Mauro, C.F., & Compton, S.N. (2006). Principles of cognitive-behavioral therapy for anxiety disorders in children. Journal of Cognitive Psychotherapy, 20,
Stallard, P. (2002) Cognitive behaviour therapy with children and young people: A review of selective review of key issues. Behavioural and Cognitive Psychotherapy, 30,
Stallard, P. (2005). Cognitive behaviour therapy with prepubertal children. In P.J. Graham (Ed.), Cognitive behaviour therapy for children and families (2nd edition) (pp ). New York: Cambridge University Press