Evaluation of the Hong Kong friends intervention program for childhood anxiety.


This research investigated the effectiveness of a cognitive-behavioural intervention program (FRIENDS) in Hong Kong for reducing anxiety symptoms in children. The goal of FRIENDS is to increase resilience in children for coping with everyday problems and stresses. Its effectiveness has been established in a variety of research settings, but only limited research has been completed for the Hong Kong program. Participants were ethnic Chinese (n=8) or Western expatriate children (n=25) who received either a 12-week FRIENDS intervention called Fun FRIENDS (for children ages 4-6) or FRIENDS for Life (for children ages 7-9), or children with anxiety problems who participated in a no-treatment control condition (ethnic Chinese n=2 and nonChinese=10). Before and following the intervention or the no treatment waiting period, participants were interviewed to establish diagnosis based on the Anxiety Disorders Interview Schedule – IV (ADIS-IV). Participants and their parents also completed standardized measures of anxiety symptoms (Spence’s Anxiety Scales), and a measure of socio-emotional and behavioural difficulties (Strengths and Difficulties Questionnaire). Mixed measure ANOVA analyses revealed that the FRIENDS program yielded significant reductions in total anxiety levels and overall stress for both age groups relative to the control sample, with larger effect sizes among Fun FRIENDS (Ages 4-6) participants relative to the FRIENDS for Life (Ages 7-9) group. Based on the ADIS-IV, the percentage of children meeting criteria for probable Social Phobia diminished from 86.8% at pretest to 47.8% at posttest for the younger Fun FRIENDS group and from 64% at pre-test to 38% at post-test for the older FRIENDS for Life group. For Generalised Anxiety Disorder, 30.4% of the younger participants met criteria at pretest and 13.04% participants met criteria at posttest, and 48% of the older participants met diagnostic criteria at pretest compared with 38% at posttest. This study provides support for the efficacy of the FRIENDS programs for reducing anxiety symptoms and associated socio-emotional problems among children in Hong Kong. The findings also provide support for the value of early intervention during preschool and early primary school.