Resilience Is Associated with Improved Emotion Regulation and Internalizing Symptoms Following Transdiagnostic Treatment in a Diverse Sample of Children

The study of child psychotherapy effectiveness is increasingly focused on identifying factors that predict positive outcomes. While prior studies suggest children’s resilience (i.e., self-esteem, social-support, and self-efficacy) may enhance the effectiveness of cognitive behavioral therapy (CBT), these findings are inconsistent, and it is unclear if these results extend to children from diverse racial/ethnic and socioeconomic (SES) backgrounds. This study aims to 1) evaluate associations between pre-treatment self-efficacy, self-esteem, and social support, and post-treatment internalizing symptoms and emotion regulation, and; 2) examine differences in treatment response between predominantly racial/ethnic minority and low SES youth, and predominantly White and high-SES youth. 252 children ages 7–12 years completed the Resilience Builder Program® (RBP), a group intervention, at either schools comprised of predominantly economically marginalized, ethnic/racial minority youth or at a private therapy practice, comprised of predominantly high-SES, White youth. Results showed that children in both settings significantly improved in internalizing symptoms and emotional control following participation in the RBP intervention. In the combined sample, pre-treatment social support was associated with greater improvement in post-treatment internalizing symptoms, and pre-treatment self-efficacy was associated with greater improvement in post-treatment emotional control. For children in the school setting only, higher baseline self-esteem and social support were associated with greater improvements in post-treatment internalizing symptoms and emotional control, respectively. Findings suggest that social support and self-esteem may be particularly important in enhancing treatment response for children from underrepresented ethnic/racial backgrounds and high poverty families. Highlights Internalizing symptoms and emotion regulation significantly improved after RBP intervention. Greater pre-treatment social support and self-efficacy were associated with greater improvements in post-treatment internalizing symptoms and emotional control, respectively. In underrepresented youth, higher pre-treatment self-esteem was associated with improved post-treatment internalizing symptoms, and higher pre-treatment social support was associated with greater emotional control.