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Process Factors Associated with Improved Outcomes in CBT for Anxious Youth: Therapeutic Content, Alliance, and Therapist Actions

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Abstract

Cognitive behavioral therapy (CBT) has been established as an empirically supported treatment for anxiety in youth. Recent efforts have been underway to elucidate the evidence- based process factors that are associated with successful outcomes. These factors have included both therapy content (homework; exposure tasks) and therapy process (therapeutic alliance; therapist actions). Although exposure tasks have been identified as a key component of CBT, they are not always implemented with the greatest efficacy, in session or at home. Successful implementation of exposure tasks may rely, in part, on a strong therapeutic alliance. Furthermore, therapist actions influence the alliance and client motivation and participation in homework and exposure tasks. A review of the relevant literature indicates that additional research is needed to elucidate the interaction between therapeutic process factors, such as alliance and therapist actions, and therapeutic content, including exposure tasks.

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Acknowledgements

Preparation of this manuscript was supported by a National Institute of Health Grants HD080097 and MH086438 awarded to Philip C. Kendall.

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Authors and Affiliations

  1. Department of Psychology, Temple University, Weiss Hall, 1701 N. 13th St., Philadelphia, PA, 19122, USA

    Erika A. Crawford, Hannah E. Frank, Sophie A. Palitz, Jordan P. Davis & Philip C. Kendall

Authors
  1. Erika A. Crawford
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  2. Hannah E. Frank
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  3. Sophie A. Palitz
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  4. Jordan P. Davis
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  5. Philip C. Kendall
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Corresponding authors

Correspondence to Erika A. Crawford or Philip C. Kendall.

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Conflict of Interest

Philip C. Kendall receives royalties from the sales of materials related to the treatment of anxiety in youth, and some of these materials are mentioned in the literature reviewed.

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This article does not contain any studies with human participants or animals performed by any of the authors.

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Informed consent was obtained from all individual participants included in the study.

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No animal studies were carried out by the authors for this article.

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Crawford, E.A., Frank, H.E., Palitz, S.A. et al. Process Factors Associated with Improved Outcomes in CBT for Anxious Youth: Therapeutic Content, Alliance, and Therapist Actions. Cogn Ther Res 42, 172–183 (2018). https://doi.org/10.1007/s10608-017-9864-7

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  • DOI: https://doi.org/10.1007/s10608-017-9864-7

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