Targeted Behavioral Therapy for childhood generalized anxiety disorder: A time-series analysis of changes in anxiety and sleep

• We examined the efficacy of Targeted Behavioral Therapy (TBT) for children with GAD.
• TBT targets anxiety/worry, intolerance of uncertainty, and sleep problems.
• Post-treatment and 3 month follow up data revealed high remission rates.
• Time-series analyses showed marked fluctuation of GAD symptoms.

This study examined the efficacy of Targeted Behavioral Therapy (TBT), a newly developed intervention targeting features of childhood generalized anxiety disorder (GAD). Using a time-series design, 4 children (7–12 years) with primary GAD were treated with TBT, which includes sleep improvement strategies, systematic desensitization for reducing intolerance of uncertainty, and in vivo exposures for anxiety. Diagnostic interviews and questionnaires were administered at baseline, post-treatment and 3 months follow-up. Anxiety symptoms and sleep characteristics/problems were rated weekly during a 4-week baseline and 14-weeks of treatment. Two children remitted at post-treatment and no child had a GAD diagnosis at follow-up. Child but not parent report revealed improvements in both worry and sleep. Despite improvements from pre- to post-assessment, considerable symptom fluctuation observed during the baseline period preclude conclusion that symptom changes are specifically attributable to the course of treatment. Overall, preliminary support is provided for the efficacy of TBT for childhood GAD.