Safety-seeking and coping behavior during exposure tasks with anxious youth.

This study examined child behavior during exposure tasks and characteristics of the exposure tasks as related to outcomes when treating anxious youth. Participants (aged 7-13) were 87 anxiety-disordered children (37 girls; 50 boys) and their parents (84 mothers; 70 fathers) who completed a 16-session cognitive-behavioral therapy. Videotapes of exposure-based sessions were coded for (a) child use of safety-seeking behavior (SSB) and (b) coping behavior (CB) during exposure, (c) characteristics of the exposure tasks, and (d) child anxiety during exposure. Results indicated that child use of SSB, but not CB, during exposure was significantly predictive of poorer outcome. SSB was greater during exposure tasks for treatment nonresponders than for responders, whereas CB was greater for treatment responders. SSB increased over the course of exposure-based sessions, whereas CB remained stable. Child anxiety during exposure tasks and most exposure task characteristics were not significantly predictive of outcome.