Family Intervention for Child and Adolescent Anxiety: A Meta-analytic Review of Therapy Targets, Techniques, and Outcomes.

Parent- and family-level correlates of youth anxiety are well-documented, and they highlight potential targets for family-focused intervention. Although family-based approaches for treating youth anxiety generally are considered efficacious for achieving symptom reduction, they vary in format and approach and it remains unclear whether they offer an advantage over individual child treatment. To better understand the current state of the evidence, we used meta-analytic methods to examine the therapeutic approaches described in existing family interventions for child and adolescent anxiety, whether they mapped to the major mechanisms proposed in the literature, and the timeline along which relevant parent/family variables were measured. We examined how these mechanism-focused family interventions performed in RCTs relative to individual child CBT and whether they shifted symptoms and relevant parenting behaviors. A total of 11 randomized controlled trials (RCTs) compared individual cognitive behavior therapy (CBT) to CBT+ a family component (CBT + FAM) and included a youth anxiety measure at pre- and post-treatment; only half of these (n=6) also included a parent/family functioning measure at both pre- and post-treatment (across both primary and secondary outcome papers). Only a single study included anxiety measures at a mid-treatment time point, and none included parent measures at a mid-treatment time point. Findings are discussed in terms of design considerations and advancing the field of family intervention for youth anxiety.