Until now little was known about why some anxious children do well with therapy while others do not, says lead author Melissa Crawford, a doctoral student in the Department of Human Development and Applied Psychology at the Ontario Institute for Studies in Education of the University of Toronto. "We know family relationships are integral to children's mental health, so our finding that anxious children with troubled families improve less with treatment was not surprising," she says.
Crawford and co-author Dr. Katharina Manassis of U of T's psychiatry department and the Hospital for Sick Children based their research, funded by the Ontario Mental Health Foundation, on 61 children aged eight to 12 who were receiving treatment at the hospital's anxiety disorders clinic. Children who felt their families were dysfunctional or their parents were frustrated and stressed had poorer treatment outcomes, as did children whose parents had psychological disorders themselves. Crawford says there are several explanations for these findings. "It's possible that family dysfunction maintains children's anxiety, which hinders their response to treatment. Or children may perceive that they are the cause of their parents' stress and negative family interactions, which in turn may exacerbate their anxiety."
These findings confirm the importance of including parents in the treatment process for anxious children, she says. "Therapists must address issues within the family that may be contributing to and maintaining child anxiety. It's likely that addressing these family factors will, in turn, increase the effectiveness of the treatment."
CONTACT: Melissa Crawford, OISE/UT, mcrawford@oise.utoronto.ca or Megan Easton, U of T public affairs, 416-978-5949, megan.easton@utoronto.ca
Journal of the American Academy of Child & Adolescent Psychiatry