An Open Trial of a Culturally-Adapted Exposure-based Cognitive Behavioral Therapy for Anxiety Disorders in Mexican Origin Youth

Authors: Armando A. Pina, Argero A. Zerr, and Ian K. Villalta.

Background:
This open trial reports data about the effects of a culturally-adapted CBT program for Mexican origin youth with anxiety disorders (Mean age = 10 years).

Methods:
A total of 10 clinic-referred youth and their parents were invited to receive a 12-session program. Prior to treatment, the Anxiety Disorders Interview Schedule for Children (ADIS-IV:C/P, Silverman & Albano, 1996), Child Behavior Checklist (CBCL; Achenbach, 2001), and Revised Children’s Manifest Anxiety Scale (RCMAS, Reynolds & Richmond, 1978) were administered. All youth met criteria for a primary anxiety disorder based on the ADIS-IV:C/P and 90% were within the clinical range on the CBCL Internalizing scale. Treatment was delivered in English (n = 6) or both English and Spanish (n = 4); and the child and parent were seen conjointly by the therapist during every session. Youth and parents reported weekly ratings of anxiety severity/interference using the ADIS-IV:C/P’s Feelings Thermometer prior to each treatment session. At the end of treatment, the ADIS-IV:C/P was re-administered by an independent diagnostician, parents completed the CBCL, youth the RCMAS, and both youth and parents completed a survey of treatment satisfaction.

Results:
At post treatment, none of the children met criteria for their primary diagnosis. Parents reported substantial improvement on the CBCL Internalizing [t(9)=3.87, p < .01; d=1.2], and also youth on the RCMAS [t(9)=4.28, p < .01; d=1.3]. These findings were substantiated by youth and parents’ weekly ratings of anxiety severity/interference using the Feelings Thermometer (see Figure 1). None of the families unilaterally terminated treatment, although one family asked that treatment be discontinued prematurely (at Session 10). On the survey of treatment satisfaction, youths’ mean score was 3.26 and parents’ 3.79 (on a 4- point scale) suggesting high satisfaction.

Conclusion: These data suggest that the culturally adapted exposure-based CBT program appears to be a promising treatment for anxious Mexican origin youth.