(PS3-2) A Preliminary Exploration of the Efficacy of an Exposure-only Group in Reducing Anxiety Symptomology in Adolescents

Group-based cognitive behavioral therapy (CBT) has repeatedly demonstrated efficacy for the treatment of youth anxiety disorders and obsessive-compulsive disorder (OCD). Dismantling studies suggest that exposure with response prevention (ERP) is the element of CBT most responsible for its benefits. Group-based exposure therapy may provide several advantages, including social support from peers, opportunities for modeling and peer learning, as well as improving clinical efficiency and access to care. This study provides an initial evaluation of a hospital-based, exposure-only group for adolescents with a primary diagnosis of an anxiety disorder or OCD.

The group involves one 90-minute session per week for six weeks. Evaluation of treatment efficacy included pre-post evaluation of anxiety and OCD related symptoms as well as other mechanistically important variables such as avoidance and intolerance of uncertainty. Measures included the Child Obsessive-Compulsive Impact Scale (COIS; parent and youth report, if diagnosed with OCD), the Child Anxiety Life Interference Scale (CALIS; parent and youth report), the Child Avoidance Measure – Self Report (CAMS) and the Child Avoidance Measure – Parent Report (CAMP), the Screen for Child Anxiety Related Disorders (SCARED; parent and youth report), the Intolerance of Uncertainty Scale (IUS-C-12; youth report only).

Data were analyzed from a sample of 34 participants ages 12-18 years (M = 14.74), who were primarily White (72.2%), non-Hispanic or Latino (75%), and female (69.4%; 3% of participants identified as gender non-binary). Participants attended an average of 5.41 sessions. 61% of the sample participated in this intervention as a step-down from an intensive outpatient anxiety program at the same hospital.

Youth-reported data demonstrated non-significant decreases across all outcome measures: COIS total score pre- (M = 25.00, SD = 5.66) and post-intervention (M = 3.00, SD = 1.41); t(1)= 4.40, p = 0.14), CAMS total score pre-(M = 12.56, SD = 6.48) and post-intervention (M = 10.11, SD = 4.51; t(8) = 2.07, p = 0.07); total SCARED score pre- (M = 39.17, SD = 13.61) and post-intervention (M = 34.67, SD = 12.60); t(11)= 1.55, p = 0.15), and IUS total score pre- (M = 30.67, SD = 11.53) and post-intervention (M = 30.00, SD = 13.37); t(5)= 0.38, p = 0.72).

Similarly, parent reported data demonstrated decreases in the following outcome measures: COIS total score pre- (M = 23.00, SD = 15.56) and post-intervention (M = 6.00, SD = 2.83); t(1)= 1.31, p = 0.41), CALIS total score pre- (M = 31.50, SD = 15.09) and post-intervention (M = 29.67, SD = 12.14); t(5)= 0.71, p = 0.50), and CAMP total score pre- (M = 13.00, SD = 7.21) and post-intervention (M = 11.50, SD = 6.95); t(5)= 0.42, p = 0.34). Data collection continues and future analyses will be better powered to detect pre-post differences.

Preliminary analyses do not indicate that group-based exposure-only therapy is effective for youth with anxiety disorders or OCD, however more data are required to conduct sufficiently powered analyses.