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Published in: Child and Adolescent Psychiatry and Mental Health 1/2021

01-12-2021 | Behavioural Therapy | Research article

Classroom-based cognitive behavioural therapy: a large-scale non-randomised controlled trial of the ‘Journey of the Brave’

Authors: Yuko Urao, Ikuyo Ohira, Takako Koshiba, Shin-ichi Ishikawa, Yasunori Sato, Eiji Shimizu

Published in: Child and Adolescent Psychiatry and Mental Health | Issue 1/2021

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Abstract

Background

In Japan, ‘Journey of the Brave’, a cognitive behavioural therapy (CBT)-based anxiety preventive education programme, was previously developed and its effectiveness examined in two small-scale controlled trials. These studies had some limitations, including a small number of participants and not having regular classroom teachers as programme facilitators. Therefore, we conducted a large-scale controlled trial, with teachers as programme implementers.

Methods

Twenty-seven elementary schools participated: 1622 and 1123 children were allocated to the intervention and control groups, respectively. The intervention group received a programme comprising ten 45-min sessions, while the control group underwent the regular school curriculum. Anxiety symptoms among participants were assessed using the Spence Children’s Anxiety Scale (SCAS) at three stages (pre-intervention, post-intervention, and follow-up).

Results

Following primary analysis, estimated mean changes in SCAS from baseline to follow-up were − 4.91 (95% CI − 5.91, − 3.90) in the intervention group and − 2.53 (95% CI − 3.52, − 1.54) in the control group; the group difference was 2.37 (95% CI 1.42, 3.33, p < 0.0001). Children in the intervention group showed significant reduction in their anxiety score versus children in the control group.

Conclusions

The results showed a statistically significant anxiety score reduction in the intervention group, thus verifying the programme’s effectiveness.
Trial registration The University Hospital Medical Information Network (UMIN): UMIN000032517. Registered 10 May 2018—Retrospectively registered, https://​upload.​umin.​ac.​jp/​cgi-open-bin/​ctr_​e/​ctr_​view.​cgi?​recptno=​R000037083
Literature
6.
go back to reference Nail JE, Christofferson J, Ginsburg GS, Drake K, Kendall PC, McCracken JT, et al. Academic impairment and impact of treatments among youth with anxiety disorders. Child Youth Care Forum. 2015;44(3):327–42.CrossRef Nail JE, Christofferson J, Ginsburg GS, Drake K, Kendall PC, McCracken JT, et al. Academic impairment and impact of treatments among youth with anxiety disorders. Child Youth Care Forum. 2015;44(3):327–42.CrossRef
9.
go back to reference Öst LG, Treffers PD. Onset, course, and outcome for anxiety. Anxiety disorders in children and adolescents: research, assessment and intervention. Cambridge: Cambridge University Press; 2001. Öst LG, Treffers PD. Onset, course, and outcome for anxiety. Anxiety disorders in children and adolescents: research, assessment and intervention. Cambridge: Cambridge University Press; 2001.
16.
go back to reference DeKlyen M, Greenberg MT. Attachment and psychopathology in childhood. In: Cassidy PR, Shaver, editors. Handbook of attachment: theory, research, and clinical applications. New York: The Guilford Press; 2008. p. 637–65. DeKlyen M, Greenberg MT. Attachment and psychopathology in childhood. In: Cassidy PR, Shaver, editors. Handbook of attachment: theory, research, and clinical applications. New York: The Guilford Press; 2008. p. 637–65.
29.
37.
go back to reference Urao Y, Yoshinaga N, Asano K, Ishikawa R, Tano A, Sato Y, Shimizu E. Effectiveness of a cognitive behavioural therapy-based anxiety prevention programme for children: a preliminary quasi-experimental study in Japan. Child Adolesc Psychiatry Ment Health. 2016;10(1):1–12. https://doi.org/10.1186/s13034-016-0091-x.CrossRef Urao Y, Yoshinaga N, Asano K, Ishikawa R, Tano A, Sato Y, Shimizu E. Effectiveness of a cognitive behavioural therapy-based anxiety prevention programme for children: a preliminary quasi-experimental study in Japan. Child Adolesc Psychiatry Ment Health. 2016;10(1):1–12. https://​doi.​org/​10.​1186/​s13034-016-0091-x.CrossRef
38.
41.
go back to reference Muris P, Schmidt H, Merckelbach H. Correlations among two self-report questionnaires for measuring DSM-defined anxiety disorder symptoms in children: the screen for Child Anxiety Related Emotional Disorders and the Spence Children’s Anxiety Scale. Person Individ Differ. 2000;28:333–46.CrossRef Muris P, Schmidt H, Merckelbach H. Correlations among two self-report questionnaires for measuring DSM-defined anxiety disorder symptoms in children: the screen for Child Anxiety Related Emotional Disorders and the Spence Children’s Anxiety Scale. Person Individ Differ. 2000;28:333–46.CrossRef
Metadata
Title
Classroom-based cognitive behavioural therapy: a large-scale non-randomised controlled trial of the ‘Journey of the Brave’
Authors
Yuko Urao
Ikuyo Ohira
Takako Koshiba
Shin-ichi Ishikawa
Yasunori Sato
Eiji Shimizu
Publication date
01-12-2021
Publisher
BioMed Central
Published in
Child and Adolescent Psychiatry and Mental Health / Issue 1/2021
Electronic ISSN: 1753-2000
DOI
https://doi.org/10.1186/s13034-021-00374-6

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