Reducing Anxiety in Middle School and High School Students: A Comparison of Cognitive-Behavioral Therapy and Relaxation Training Approaches

Abstract

This study compared the effectiveness of two group treatment procedures in reducing adolescent anxiety in a school setting. The interventions included group cognitive-behavioral treatment, group relaxation training, and study skills (control group). Participants were students in Grades 5-12 who were parent, teacher, or school personnel nominated. The adolescents had to exhibit T scores of > 60 on an anxiety scale of the Youth Self Report for ages 11-18 or Multidimensional Anxiety Scale for Children (MASC), self-report rating scales, a parent rating scale or teacher report form for ages 6-18 of the Child Behavior Checklist (CBCL). Measurements were collected at preintervention, postintervention, and a 6-week follow up for the treatment groups. The control group was assessed at preintervention and postintervention only. The data gathered consisted of an overall student anxiety scale score from the MASC, and anxious/ depressed, anxiety problems, and internalizing problems scale scores from the student, teacher, and parent CBCL rating scales.All three groups exhibited lower scores from preintervention to postintervention on the student self-reported MASC. No differences were found among the groups in the reduction of teacher or parent reported anxiety levels from preintervention to postintervention except on the parent ratings of the CBCL anxious/depressed scale. A statistically significant group by time interaction indicated that the students in the CBT group showed significantly lower posttest scores than the relaxation and study skills groups. The significant interaction of group by time from preintervention to postintervention on the parent CBCL anxious/depressed scale score was expanded to the follow-up measure; however, no significant interaction between group and time was found. The main effect of time was significant and post hoc comparisons of the anxious/depressed scale found that the CBT and relaxation groups were significantly lower at postintervention than at preintervention and significantly lower at follow up than at preintervention. However, the sample was not significantly different from postintervention to follow up.The results were discussed in relation to the research literature on cognitive-behavioral treatment of fears and related anxieties in children and adolescents.