Date of Submission

2025

Degree Type

Dissertation

Degree Name

Doctor of Psychology (PsyD)

Department

Psychology

Department Chair

Stephanie Felgoise, PhD, ABPP

First Advisor

Elizabeth Gosch, PhD, ABPP

Second Advisor

Susan Panichelli Mindel, PhD

Third Advisor

Philip C Kendall, PhD

Abstract

CBT is moderately effective in the treatment of youth anxiety, yet there remains a sizeable number of youth who remain nonresponsive at posttreatment, and less than half achieve remission. Various patient-level variables have been examined concerning differential treatment outcomes for anxious youth, but fewer studies have examined therapy process variables. Using archival data, this study aimed to identify predictors of treatment response in youth with primary anxiety disorders who completed 16-weeks of CBT at a university-based clinic. Four samples of anxious youth, aged 7-17 were included in the analysis. Regression analyses revealed that increased skill acquisition and greater change in parent-reported coping efficacy were associated with disorder-specific improvement (CGI-I), while only change in parent-reported coping efficacy was associated with posttreatment symptom severity (CGI-S), degree of clinical significance and functional impairment of anxiety symptoms (CSR), and overall anxiety level (MASC). The results of the study suggest that mastery of therapeutic skills and more reliably, growth in a patient’s confidence to navigate anxiety-provoking situations are important for treatment response, though there may be additional processes contributing to favorable outcomes. Our findings add to a relatively small body of youth process-outcome literature that examines differential outcomes for anxious youth and contributes new insights into the relationship between process variables and youth treatment outcomes. Implications for future youth process-outcome studies are also provided.

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