This summary describes a randomised controlled trial currently nearing completion in which we are examining the effectiveness of a group-based Acceptance and Commitment Therapy (ACT) program for children and adolescents with a primary diagnosis of anxiety disorder. For the adolescent participants an evaluation of the elements of the intervention that act as mechanisms for change is also being undertaken. This study is being conducted at the Children's Hospital at Westmead, Sydney Australia.
Methods/design: 186 young people diagnosed with an anxiety disorder and their parent/caregiver have been assigned to treatment, with 32 participants being drop-outs. After completion of baseline assessment, participants are randomised to one of three conditions (ACT, Cognitive Behaviour Therapy [CBT] or waitlist control). Those in the ACT and CBT groups receive 10 x 1.5 hour weekly group-therapy sessions using a manualised treatment program, in accordance with the relevant therapy, delivered by psychologists. Controls receive the CBT program after 10 weeks waitlisted. Repeated measures are taken immediately post-therapy, three months and two years after therapy cessation.
Treatment programs: The ACT program (Coolmind for kids, Mindchill for adolescents) is delivered using an adaptation of the Cool Kids CBT program (“Chilled” is the adolescent CBT version). Thus, while a CBT framework is used, there is no mention of controlling anxiety or cognitive restructuring. Instead of ‘detective’ or ‘realistic’ thinking, participants are taught cognitive defusion strategies using ‘mindful’ thinking. All aspects of the ACT model are incorporated into the program. Treatment manuals will be publicly available following evaluation of the results of the RCT, which should be around the middle of 2013. CBT is delivered using the Cool Kids (or adolescent Chilled) program. This program has been continuously scientifically evaluated and is one of the most highly used CBT group programs in Australia.
Discussion: To the researchers knowledge this study will be the largest trial of ACT in the treatment of children and young people to date. It will provide comprehensive data on the use of ACT for anxiety disorders and will offer evidence for mechanisms involved in the process of change. Furthermore, additional data will be obtained for the use of CBT in this population and this research will illustrate the comparative effectiveness of these two interventions, which are currently implemented widely in postmodern clinical practice
For further information please contact Dr Karen Hancock, Chief Investigator, on karen.hancock@health.nsw.gov.au