Cognitive mediation of cognitive-Behavioural therapy outcomes for anxiety-based school refusal

Marija Maric, David A. Heyne, David Mackinnon, Brigit M. Van Widenfelt, P. Michiel Westenberg

Research output: Contribution to journalArticle

17 Citations (Scopus)

Abstract

Background: Cognitive-behavioural therapy (CBT) has proven to be effective for anxiety-based school refusal, but it is still unknown how CBT for school refusal works, or through which mechanisms. Aims: Innovative statistical approaches for analyzing small uncontrolled samples were used to investigate the role of self-efficacy in mediating CBT outcomes for anxiety-based school refusal. Method: Participants were 19 adolescents (12 to 17 years) who completed a manual-based cognitive-behavioural treatment. Primary outcomes (school attendance; school-related fear; anxiety) and secondary outcomes (depression; internalizing problems) were assessed at post-treatment and 2-month follow-up. Results: Post-treatment increases in school attendance and decreases in fear about attending school the next day were found to be mediated by self-efficacy. Mediating effects were not observed at 2-month follow-up. Conclusions: These findings provide partial support for the role of self-efficacy in mediating the outcome of CBT for school refusal. They contribute to a small body of literature suggesting that cognitive change enhances CBT outcomes for young people with internalizing problems. Regarding methodology, the product of coefficient test appears to be a valuable way to study mediation in outcome studies involving small samples.

Original languageEnglish (US)
Pages (from-to)549-564
Number of pages16
JournalBehavioural and Cognitive Psychotherapy
Volume41
Issue number5
DOIs
StatePublished - Oct 2013

Fingerprint

Cognitive Therapy
Anxiety
Self Efficacy
Fear
Therapeutics
Outcome Assessment (Health Care)
Depression

Keywords

  • anxiety
  • Keywords: CBT
  • mediators
  • school refusal
  • self-efficacy

ASJC Scopus subject areas

  • Clinical Psychology

Cite this

Cognitive mediation of cognitive-Behavioural therapy outcomes for anxiety-based school refusal. / Maric, Marija; Heyne, David A.; Mackinnon, David; Van Widenfelt, Brigit M.; Westenberg, P. Michiel.

In: Behavioural and Cognitive Psychotherapy, Vol. 41, No. 5, 10.2013, p. 549-564.

Research output: Contribution to journalArticle

Maric, Marija ; Heyne, David A. ; Mackinnon, David ; Van Widenfelt, Brigit M. ; Westenberg, P. Michiel. / Cognitive mediation of cognitive-Behavioural therapy outcomes for anxiety-based school refusal. In: Behavioural and Cognitive Psychotherapy. 2013 ; Vol. 41, No. 5. pp. 549-564.
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