Feasibility Evaluation of Intervention for Anxiety using CBT among Secondary School Children in Pakistan: A randomized Controlled Trial

Anxiety is highly prevalent among adolescents, which can lead to serious problems in adulthood if left untreated. The global prevalence of anxiety disorders among children and adolescents is found to be 6.5%. As per the National Institutes of Health, over one-third of all adolescents between the ages of 13 and 18 will suffer from anxiety. Despite the existence of various treatments, this goes unrecognized and untreated. This highlights the critical need for indigenous, evidence-based intervention to promptly address these risk factors. Thus, the present study aimed to evaluate the acceptability and feasibility of delivering the cognitive-behavioral therapy-based intervention in a Pakistani school setting. The present study was a single-blind, two arms, feasibility randomized controlled trial which was be conducted in Urban schools of Rawalpindi. A total sample of 34 secondary school children (17 in each arm) with elevated scores of anxiety upon assessment from the four participating schools were included in the study. Randomization was done by an independent researcher. Since it was feasibility research, so no power calculations were performed, but it was ensured that the sample would be sufficient to predict the acceptance, uptake of the intervention, recruitment, and retention rates of participants for a future definitive trial. Primarily, the experimental group received therapy that comprised eight sessions and each session lasting for up to fifty minutes. Results were found to be significant with a reduction in the level of anxiety at post assessment (ηp2= .32) as well as in follow-up when compared to baseline assessment. The intervention had a positive influence on young people, with the primary result being a reduction in anxiety, and the secondary outcomes being increased self-regulation and personal adjustment. Moreover, at the end of the trial, the willing participants of the wait-list control group were also accommodated for therapy. Results of this feasibility randomized control trial will further be beneficial in the capacity building of teachers who can identify the risk factors of anxiety and be able to take precautionary measures in time.