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This study examined whether distorted cognition changes during cognitive behavioural therapy (CBT) in children ( N  = 61; aged 7–12) with social anxiety disorder (SAD) and whether changes in distorted cognition from pre- to post-treatment predict SAD at 6-month follow-up. Baseline distorted cognition was also examined as a predictor of post-treatment outcome. Multiple informant SAD-measures were obtained pre-treatment, post-treatment and at 6-month follow-up. Children reported on interpretation bias and dysfunctional beliefs. A decrease in interpretation bias and dysfunctional beliefs was prospectively related to greater SAD change between post-treatment and 6-month follow-up. Child-reported SAD-change at post-treatment predicted greater change in dysfunctional beliefs at 6-month follow-up. Higher baseline interpretation bias predicted greater change in SAD-severity at post-treatment. Children with greater distorted cognition reductions during treatment, showed greater treatment gains at 6-month follow-up. Children who do not show this reduction may require additional efforts focused on distorted cognition to maximally benefit from treatment.

The Role of Distorted Cognitions in Mediating Treatment Outcome in Children with Social Anxiety Disorder: A Preliminary Study