Mediators and Moderators of Outcome in the Behavioral Treatment of Childhood Social Phobia

Objective: The current study examined mediators and moderators of treatment response among children and adolescents (ages 7-17 years) with a primary diagnosis of social phobia. Method: Participants were 88 youths participating in one of two randomized controlled treatment trials of Social Effectiveness Therapy for Children. Potential mediators included changes in observer-rated social skill and child-reported loneliness after 12 weeks of Social Effectiveness Therapy for Children. Age and depressive symptoms were examined as potential moderators. Results: Loneliness scores and social effectiveness during a role-play task predicted changes in social anxiety and overall functioning at posttreatment. Changes in social anxiety were mediated by child-reported loneliness. Outcomes were not moderated by age or depressive symptoms. Conclusions: Findings support the role of loneliness as an important mechanism of change during treatment for childhood social phobia. J. Am. Acad. Child Adolesc. Psychiatry, 2009;48(9):945-953.