Program

May 09, 2014

OVERVIEW

The FRIENDS Program is designed to teach students ways to cope with their anxiety through cognitive-behavioral individual or group sessions. Two evaluations of the FRIENDS Program have been conducted. The first found the program had a significant impact on anxiety for the target population, when compared with the wait-list group. The second evaluation found the intervention significantly reduced anxiety symptoms among sixth-grade students, with effects continuing 36 months following the intervention; at 24 and 36 months post-intervention, impacts were concentrated among girls.  There was no impact on ninth-grade students, and there were no impacts on depression for either sixth- or ninth-grade students.

DESCRIPTION OF PROGRAM

Target population: Middle and high school students with clinically significant levels of anxiety

The FRIENDS Program is a cognitive-behavioral intervention for clinically anxious children.  The program can be delivered individually or in a group setting, and different versions of the program are available for children and youth.  The intervention teaches problem-solving skills as a way to cope with and manage anxiety.  The program lasts for ten, weekly, 70-minute sessions.  Two booster sessions occur after the program sessions end.  Sessions are facilitated by teachers who are assisted by clinically-trained psychology postgraduate students.  The postgraduate students participate in a one-day teacher-training workshop prior to working with the teachers.  Four parent sessions are held in the evening throughout the ten weeks of sessions.  In these sessions, participants can discuss parenting strategies and learn about the FRIENDS Program.

EVALUATION(S) OF PROGRAM

Shortt, A. L., Barrett, P. M., Fox, & T. L. (2001). Evaluating the FRIENDS program: A cognitive-behavioral group treatment for anxious children and their parents. Journal of Clinical Child Psychology, 30(4), 525-535.

Evaluated population: Seventy-one children who had been diagnosed with one or more anxiety disorders participated in the study. The majority of participants were female (59%), and the mean age was 7.85 years. The great majority of participants described themselves as Australian (92%), although there were small numbers of Europeans (7%) and Asians (1%).

Approach: Recruitment was through referrals from child mental health centers or school guidance officers, and parent recruitment through media advertising in the Brisbane metropolitan area. Upon intake, children were assessed using the Revised Children’s Manifest Anxiety Scale (RCMAS),  the Child Behavior Checklist (CBCL) and evaluated for a diagnosis of either Generalized Anxiety Disorder (n = 42), Seasonal Affective Disorder (n = 19), or Social Phobia (n = 10); 72% of the children had comorbid disorders. The participants were split into two groups; the treatment group received Family-based Group Cognitive Behavioral Therapy (FGCBT) (a child version of FRIENDS), while the other group was put on a 10-week waitlist. After treatment or the 10-week waitlist period, both groups were assessed again with the RCMAS and the CBCL. Six families dropped out of the treatment group, and one family dropped from the waitlist group, resulting in a 90% attrition rate at the 12-month follow-up.

Results: The FRIENDS program had a significant impact on anxiety diagnoses. Thirty-three participants (69%) in the treatment group exited the program diagnosis-free after post-test, compared with one child (6%) in the waitlist group. When assessed 12 months after the posttest, 32 of 47 (68%) treatment participants remained diagnosis-free. The children’s RCMAS scores were significantly lower than at posttreatment.

Barrett, P. M., Farrell, L. J., Ollendick, T. H., & Dadds, M. R. (2006). Long-term outcomes of an Australian universal prevention trial of anxiety and depression symptoms in children and youth: An evaluation of the friends program. Journal of Clinical Child and Adolescent Psychology, 35(3), 403-411.

Evaluated population: Six hundred and sixty-nine children from six schools in the metropolitan area of Brisbane, Australia. Students were in sixth and ninth grades; approximately 50% of the sample was female.  Participants’ families were middle-class in terms of socioeconomic status

Approach: Based on geographical location, six schools matched as pairs.  Within each pair, schools were randomly assigned to the intervention or control group.  At 24 and 36 months post-intervention, students were assessed for anxiety (Spence Children’s Anxiety Scale [SCAS], and the Revised Children’s Manifest Anxiety Scale [RCMAS]), and depression (Children’s Depression Inventory).

Results: At the 36-month follow-up,  among sixth-grade students there was a significant decrease in anxiety symptoms as measured by the SCAS and RCMAS for the intervention students compared with the control group.  There were no significant differences on the SCAS or RCMAS among ninth-grade students.  Intervention-group girls scored significantly lower on the RCMAS at the 12- and 24-month follow-ups compared with control-group girls.  There was no significant impact at the 36-month follow-up for girls or at any follow-up for boys.  There were no significant impacts on students’ depression.

Analysis was adjusted to account for random assignment at the school and individual level.

SOURCES FOR MORE INFORMATION

http://www.friendsinfo.net/

References

Barrett, P. M., Farrell, L. J., Ollendick, T. H., & Dadds, M. R. (2006). Long-term outcomes of an Australian universal prevention trial of anxiety and depression symptoms in children and youth: An evaluation of the friends program. Journal of Clinical Child and Adolescent Psychology, 35(3), 403-411.

Shortt, A. L., Barrett, P. M., Fox, & T. L. (2001). Evaluating the FRIENDS program: A cognitive-behavioral group treatment for anxious children and their parents. Journal of Clinical Child Psychology, 30(4), 525-535.

KEYWORDS: Children, Adolescents, Middle School, High School, Co-ed, White/Caucasian, Clinic/Provider-based, Parent/Family Component, Counseling/Therapy, Urban,        Anxiety Disorders/Symptoms, Depression/Mood Disorders

Program information last updated 5/9/14

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