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A Meta-analysis to Guide the Enhancement of CBT for Childhood Anxiety: Exposure Over Anxiety Management
Open accessAbstract
Cognitive behavior therapy (CBT) is the most empirically supported therapy for childhood anxiety disorders (CADs) but has not reliably outperformed other credible interventions. The current study used meta-analysis to examine the frequency with which the most common treatment components are included in outcome studies and the relation of these components to symptom improvement. Seventy-five studies were identified that included youth with an anxiety disorder treated with CBT or a comparison condition. The protocols for the 111 CBT conditions generally consisted of 12, 1-h sessions delivered to the child with minimal parent inclusion. A greater amount of in-session exposure was related to significantly larger effect sizes between CBT and waitlist control across reporters (- 0.12 to - 0.15; P's < .05) and from pre- to post-treatment for child report (- .06; P < .01). Compared to treatments that omitted relaxation, treatments that included relaxation strategies were associated with significantly smaller pre- to post-treatment effect sizes across reporters (0.38 to 0.80; P's < .05). The current study suggests that CBT protocols for CADs that emphasize in-session exposure and do not include relaxation have the potential to improve the efficacy and effectiveness of therapy. Dismantling studies directly testing these hypotheses are needed.
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“and demonstrates high to moderate effects across disorders in meta-analyses, even against placebo conditions (e.g., Carpenter et al., 2018;Whiteside et al., 2020).”
From Effective—and Tolerable: Acceptance and Side Effects of Intensified Exposure for Anxiety Disorders (2023) · cites this paper as Whiteside et al., 2020
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“But the inclusion of such somatic coping strategies in pediatric CBT for anxiety has been questioned [26, 50].”
From Developing a primary care-based cognitive behavioral intervention for anxiety in children through a participatory approach: a qualitative study. (2026) · cites this paper as [50]
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“A meta-analysis showed that interventions incorporating somatic management strategies (including relaxation and breathing exercises) had smaller effect sizes than those that omitted such strategies [50].”
From Developing a primary care-based cognitive behavioral intervention for anxiety in children through a participatory approach: a qualitative study. (2026) · cites this paper as [50]
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Cites
Cochrane Handbook for Systematic Reviews of Interventions: Cochrane Book Series
(2008) · doi:10.1002/9780470712184 · Cited by 25,048
(2005) · PubMed · Cited by 7,011
Computing Inter-Rater Reliability for Observational Data: An Overview and Tutorial
Hallgren, K. A. (2012) · Tutorials in Quantitative Methods for Psychology · doi:10.20982/tqmp.08.1.p023 · Cited by 3,884
High agreement but low Kappa: I. the problems of two paradoxes
Feinstein, A. R., & Cicchetti, D. V. (1990) · Journal of Clinical Epidemiology · doi:10.1016/0895-4356(90)90158-l · Cited by 3,034
Maximizing exposure therapy: An inhibitory learning approach
Craske, M. G., Treanor, M., Conway, C. C., Zbozinek, T., & Vervliet, B. (2014) · Behaviour Research and Therapy · doi:10.1016/j.brat.2014.04.006 · Cited by 2,339
High agreement but low kappa: II. Resolving the paradoxes
Cicchetti, D. V., & Feinstein, A. R. (1990) · Journal of Clinical Epidemiology · doi:10.1016/0895-4356(90)90159-m · Cited by 1,838
The Cochrane Database of Systematic Reviews
Handoll, H. H. (2004) · The British Journal of Hand Therapy · doi:10.1177/175899830400900201 · Cited by 1,515
Cognitive Behavioral Therapy, Sertraline, or a Combination in Childhood Anxiety
Walkup, J. T., Albano, A. M., Piacentini, J., Birmaher, B., Compton, S. N., Sherrill, J. T., Ginsburg, G. S., Rynn, M. A., McCracken, J., Waslick, B., et al. (2008) · New England Journal of Medicine · doi:10.1056/nejmoa0804633 · Cited by 1,442
Treating anxiety disorders in children: Results of a randomized clinical trial.
Kendall, P. C. (1994) · Journal of Consulting and Clinical Psychology · doi:10.1037/0022-006x.62.1.100 · Cited by 1,376
(2004) · JAMA · doi:10.1001/jama.292.16.1969 · Cited by 1,107 · cited 1×
“Moreover, there is little to no information about the quality of exposure delivery, which is likely to vary between therapists using the same protocols (i.e., POTS, 2004).”
Background
Research works printed but not linked: 7
- Abbasi, Z., Amiri, S., & Talebi, H. (2016). The effective comparison between modular cognitive behavioral therapy (MCBT) and child-parent relationship training (CPRT) in children with separation anxiety symptoms. Social Sciences (Pakistan),11(6), 890–902. https://doi.org/10.3923/sscience.2016.890.902 . · DOI
- Khanna, M. S. (2014). A primer on internet interventions for child anxiety. The Behavior Therapist,37, 122–125.
- Olivares-Rodriguez, J., Rosa-Alcazar, A. I., & Olivares-Olivares, P. J. (2006). The relevance of the individualized attention in the treatment with adolescents under generalized social phobia. International Journal of Clinical and Health Psychology,6(3), 565–580.
- PCORI. (2018). PCORI funding announcement: Pharmacological treatment of anxiety disorders in children, adolescents and/or young adults [Press release]. Retrieved March 1, 2018, from https://www.pcori.org/sites/default/files/PCORI-PFA-2018-Cycle-1-Pediatric-Anxiety.pdf .
- Rodriguez, J. O., Alcazar, A. I., & Rodriguez, J. A. (2005). Early detection and treatment of adolescents with generalized social phobia. Psicothema,17(1), 1–8.
- Rosa-Alcazar, A. I., Boix, M. A., & Olivares-Olivares, P. J. (2013). Contributions of cognitive restructuring in the treatment of social phobia in adolescents. Behavioral Psychology/Psicologia Conductual: Revista Internacional Clinica y de la Salud Psicologia Conductual Revista Internacional de Psicologia Clinica de la Salud,21, 6–23.
- Wang, Z., Whiteside, S., Sim, L., Farah, W., Morrow, A., Alsawas, M., …, Murad, M. (2017b). Anxiety in Children. Comparative Effectiveness Review No. 192. (Prepared by the Mayo Clinic Evidence-based Practice Center under Contract No. 290-2015-00013-I.) AHRQ Publication No. 17-EHC023-EF. Rockville, MD: Agency for Healthcare Research and Quality.
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“Individuals in wealthier nations may face more daily pressures to achieve and portray an image of wealth and beauty to others, which can adversely affect self-image and contribute to anxiety [11].”
BackgroundAnxiety disorders in children and adolescents: A summary and overview of the literature
Rapee, R. M., Creswell, C., Kendall, P. C., Pine, D. S., & Waters, A. M. (2023) · Behaviour Research and Therapy · doi:10.1016/j.brat.2023.104376 · Cited by 227
Sharma, S., Hucker, A., Matthews, T., Grohmann, D., & Laws, K. R. (2021) · BMC Psychology · doi:10.1186/s40359-021-00658-8 · Cited by 109
“Across general populations, the efficacy of CBT for reducing symptoms of anxiety has been demonstrated; and includes the maintenance of treatment gains for up to 12 months amongst youth receiving CBT for anxiety disorders [19, 20].”
BackgroundHalldorsson, B., Hill, C., Waite, P., Partridge, K., Freeman, D., & Creswell, C. (2021) · Journal of Child Psychology and Psychiatry · doi:10.1111/jcpp.13400 · Cited by 84
“…Peris et al., 2017) and recent research has high-lighted the limited (and potential detrimental) impact of relaxation exercises (Peris et al., 2015; Whiteside et al., 2020), yet the majority of applied games for anxiety problems focused only on training relaxation, and only one (i.e., MindLight;…”
McGuire, A., Steele, R. G., & Singh, M. N. (2021) · Clinical Child and Family Psychology Review · doi:10.1007/s10567-020-00334-0 · Cited by 64
Pegg, S. L., Hill, K. E., Argiros, A. P., Olatunji, B. O., & Kujawa, A. (2022) · Current Psychiatry Reports · doi:10.1007/s11920-022-01384-7 · Cited by 49
Speers, A. J. H., Bhullar, N., Cosh, S., & Wootton, B. M. (2022) · Clinical Psychology Review · doi:10.1016/j.cpr.2022.102132 · Cited by 54
Weisz, J. R., Venturo‐Conerly, K. E., Fitzpatrick, O. M., Frederick, J., & Ng, M. Y. (2023) · Annual Review of Clinical Psychology · doi:10.1146/annurev-clinpsy-080921-082920 · Cited by 52
Adapting CBT for youth anxiety: Flexibility, within fidelity, in different settings
Kendall, P. C., Ney, J. S., Maxwell, C. A., Lehrbach, K. R., Jakubovic, R. J., McKnight, D. S., & Friedman, A. L. (2023) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2023.1067047 · Cited by 49
“Other research supports this notion of effectiveness, including a 2021 meta-analysis of 58 studies that showed CBT for the treatment of anxious youth in routine clinical care settings had similar outcomes to efficacy studies (38) and a 2020 meta-analysis of 75 studies that underscored the importance of using in-sessio…”
BackgroundResultEducational Accommodations for Students With Disabilities: Two Equity-Related Concerns
Lovett, B. J. (2021) · Frontiers in Education · doi:10.3389/feduc.2021.795266 · Cited by 48
“Such interventions typically contain, as the central active ingredient, exposure to the feared situation (Whiteside et al., 2020).”
BackgroundBilek, E. L., Tomlinson, R. C., Whiteman, A., Johnson, T. D., Benedict, C., Phan, K. L., Monk, C. S., & Fitzgerald, K. D. (2021) · Journal of Clinical Child & Adolescent Psychology · doi:10.1080/15374416.2021.1901230 · Cited by 36
“This report presents interim findings from an ongoing RCT (Premo et al., 2020) in which youth with CADs are randomized to EF-CBT or RMT.”
BackgroundResultInfluentialRacz, J. I., Bialocerkowski, A., Calteaux, I. G., & Farrell, L. J. (2024) · Clinical Child and Family Psychology Review · doi:10.1007/s10567-024-00478-3 · Cited by 40
“Empirically supported treatment is effective for anxiety-related presentations, namely cognitive-behavioural therapy (CBT), of which exposure therapy (ET) is arguably the most important therapeutic component (Carpenter et al., 2018; Muris, 2019; Whiteside et al., 2020).”
BackgroundCervin, M., & Lundgren, T. (2022) · Journal of Child Psychology and Psychiatry · doi:10.1111/jcpp.13485 · Cited by 34
A review of Parent-Child Interaction Therapy (PCIT): Applications for youth anxiety
Phillips, S., & Mychailyszyn, M. (2021) · Children and Youth Services Review · doi:10.1016/j.childyouth.2021.105986 · Cited by 31
Variability in clinician intentions to implement specific cognitive-behavioral therapy components
Wolk, C. B., Becker‐Haimes, E. M., Fishman, J., Affrunti, N. W., Mandell, D. S., & Creed, T. A. (2019) · BMC Psychiatry · doi:10.1186/s12888-019-2394-y · Cited by 29
“For example, while exposure is considered a key component in CBT for anxiety [16], community clinicians rarely use it, relying instead on other less effective CBT strategies, such as relaxation [17, 18].”
BackgroundFrank, H. E., Becker‐Haimes, E. M., Rifkin, L. S., Norris, L. A., Ollendick, T. H., Olino, T. M., Kratz, H. E., Beidas, R. S., & Kendall, P. C. (2020) · Journal of Anxiety Disorders · doi:10.1016/j.janxdis.2020.102308 · Cited by 30
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Bress, J. N., Falk, A. E., Schier, M. M., Jaywant, A., Moroney, E., Dargis, M. A., Bennett, S. M., Scult, M. A., Volpp, K. G. M., Asch, D. A., et al. (2024) · JAMA Network Open · doi:10.1001/jamanetworkopen.2024.28372 · Cited by 33
Optimising Exposure for Children and Adolescents with Anxiety, OCD and PTSD: A Systematic Review
Plaisted, H., Waite, P., Gordon, K., & Creswell, C. (2021) · Clinical Child and Family Psychology Review · doi:10.1007/s10567-020-00335-z · Cited by 25
The Importance of Including Psychophysiological Methods in Psychotherapy
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“Whiteside et al. (2020) found that interventions including relaxation training in the CBT practice are significantly less effective in reducing anxiety than interventions that omitted it and give greater emphasis to cognitive restructuring and exposure.”
Dahlsgaard, K. K., Lewis, M. O., & Spergel, J. M. (2022) · Annals of Allergy Asthma & Immunology · doi:10.1016/j.anai.2022.09.021 · Cited by 24
The Management of Anxiety and Depression in Pediatrics
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Effective—and Tolerable: Acceptance and Side Effects of Intensified Exposure for Anxiety Disorders
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BackgroundResultThe feasibility of verbal and virtual reality exposure for youth with academic performance worry
Whiteside, S. P. H., Brennan, E., Biggs, B. K., Vickers, K. S., Hathaway, J. C., Seifert, S. J., Kramer, K. M., & Hofschulte, D. R. (2020) · Journal of Anxiety Disorders · doi:10.1016/j.janxdis.2020.102298 · Cited by 16
Self-citationLife skills training: Can it increases self esteem and reduces student anxiety?
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Self-citationUnderstanding therapists’ perceived determinants of trauma narrative use
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“One intervention component that is used the least frequently despite having the strongest evidence for its effectiveness is exposure, which involves approaching feared situations in a gradual and supportive manner [6, 7].”
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“…exposure is graded and delivered both in session and out of session, and usually preceded by the introduction of coping strategies (Kendall & Peterman, 2015) despite recent evidence that these might not enhance outcomes, and may in fact impede positive treatment outcomes (Whiteside et al., 2020).”
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“A recent study examining treatment components noted that CBT programs that included a relaxation component was significantly linked with smaller treatment effect sizes when compared with treatment that did not include relaxation (Whiteside et al., 2020).”
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Smárason, O., Skarphéðinsson, G., & Storch, E. A. (2024) · Psychiatric Clinics of North America · doi:10.1016/j.psc.2024.02.002 · Cited by 25
Knowles, K. A., & Tolin, D. (2024) · Child Psychiatry and Human Development · doi:10.1007/s10578-024-01684-4 · Cited by 16
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“This is consistent with findings that the presence of relaxation within protocols is associated with less effective treatment [44, 46, 48].”
ResultSaavedra, L. M., Morgan‐López, A. A., West, S. G., Alegria, M. M., & Silverman, W. K. (2022) · Prevention Science · doi:10.1007/s11121-022-01422-z · Cited by 13
“Over 40 randomized clinical trials provide strong and consistent evidence for the short-term efficacy of exposure-based cognitive behavioral treatment for reducing anxiety and phobic disorders (e.g., Whiteside et al., 2020).”
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Robberegt, S. J., Kooiman, B., Albers, C. J., Nauta, M. H., Bockting, C., & Stikkelbroek, Y. A. J. (2022) · BMJ Open · doi:10.1136/bmjopen-2021-058560 · Cited by 13
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“an average effect size across all studies to ascertain how effective an intervention might be when taking into account the variegated effect sizes across all included studies (Hoogsteder et al., 2022; Lipsey & Wilson, 2001; Whiteside et al., 2020; Woo et al., 2020).”
BackgroundPremo, J. E., Liu, Y., Bilek, E. L., Phan, K. L., Monk, C. S., & Fitzgerald, K. D. (2020) · Journal of Psychiatry and Brain Science · doi:10.20900/jpbs.20200005 · Cited by 12
“Some research has indicated that relaxation training may not be as effective as either cognitive restructuring or exposure therapy for anxious youth, and may not be necessary in CBT [67,84].”
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“In-session exposure tasks have been found to improve anxiety levels, while relaxation techniques have shown less impact (Whiteside et al., 2020).”
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Self-citationRienks, K., Salemink, E., Sigurðardóttir, L. B. L., Meléndez‐Torres, G. J., Staaks, J. P. C., & Leijten, P. H. O. (2025) · Behaviour Research and Therapy · doi:10.1016/j.brat.2025.104692 · Cited by 13
Woodard, G. S., Triplett, N. S., Frank, H. E., Harrison, J. P., Robinson, S., & Dorsey, S. (2021) · Implementation Research and Practice · doi:10.1177/26334895211057883 · Cited by 12
“However, exposure is rarely implemented in community mental health (CMH) settings (Becker-Haimes et al., 2017; Borntrager et al., 2013; Higa-McMillan et al., 2017; Whiteside et al., 2016; Whiteside et al., 2020; Wolitzky-Taylor et al., 2015).”
BackgroundByrne, G., Connon, G., Martin, E. K., McHugh, S., & Power, L. (2021) · British Journal of Clinical Psychology · doi:10.1111/bjc.12309 · Cited by 11
Norris, L. A., Rabner, J. C., Crane, M. E., Cervin, M., Ney, J. S., Benito, K., Kendall, P. C., & Frank, H. E. (2023) · Journal of Anxiety Disorders · doi:10.1016/j.janxdis.2023.102742 · Cited by 10
Cognitive Behavioral Therapy for Anxiety Disorders
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aval, M. H., Mashhadi, A., Suveg, C. M., Bigdeli, I., Yazdi, S. A. A., & Rafi, M. A. (2021) · Behavior Therapy · doi:10.1016/j.beth.2021.09.003 · Cited by 10
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Grajdan, M. M. V., Etel, E., Farrell, L. J., & Donovan, C. L. (2024) · Clinical Child and Family Psychology Review · doi:10.1007/s10567-024-00505-3 · Cited by 12
“…important CBT component in child anxiety treatment and that adding strategies such as relaxation may reduce treatment effects (Ale et al., 2015; Whiteside et al., 2020), research could examine whether including exposure hierarchies in the first parent module and presenting less important…”
Rith‐Najarian, L., Triplett, N. S., Weisz, J. R., & McLaughlin, K. A. (2021) · Development and Psychopathology · doi:10.1017/s0954579420002059 · Cited by 10
“For example, behavioral exposures have shown stronger effectiveness than relaxation skills in the treatment of youth anxiety (Whiteside et al., 2020).”
BackgroundImplementing Cognitive-Behavioral Therapy in Children and Adolescents with Anxiety Disorders
Patriarca, G. C., Pettit, J. W., & Silverman, W. K. (2022) · Clinical Psychology and Special Education · doi:10.17759/cpse.2022110207 · Cited by 9
Emotion‐focused skills training for parents with anxious children. A pilot study
Zahl‐Olsen, R., Severinsen, L., Shahar, B., Stiegler, J. R., & Bertelsen, T. B. (2023) · Journal of Marital and Family Therapy · doi:10.1111/jmft.12643 · Cited by 9
Heinig, I., Weiss, M. H., Hamm, A. O., Hein, G., Hollandt, M., Hoyer, J., Kanske, P., Richter, J., Wïttchen, H., & Pittig, A. (2023) · Journal of Anxiety Disorders · doi:10.1016/j.janxdis.2023.102792 · Cited by 9
Plaisted, H., Waite, P., & Creswell, C. (2021) · Behaviour Research and Therapy · doi:10.1016/j.brat.2021.103997 · Cited by 10
The Cognitive Behavioral Therapy Competence Scale (CCS): initial development and validation
Rodríguez‐Quintana, N., Choi, S. Y., Bilek, E. L., Koschmann, E., Albrecht, J. R., Prisbe, M., & Smith, S. N. (2021) · The Cognitive Behaviour Therapist · doi:10.1017/s1754470x21000362 · Cited by 9
“, 2019), although these components, in addition to cognitive restructuring, are potentially the most effective components for youth experiencing depression or anxiety (e.g. Oud et al., 2019; Whiteside et al., 2020).”
BackgroundWhiteside, S. P. H., Biggs, B. K., Dammann, J. E., Tiede, M. S., Hofschulte, D. R., & Brennan, E. (2020) · Behavior Modification · doi:10.1177/0145445520982966 · Cited by 8
Self-citationBaumel, A. (2025) · Frontiers in Digital Health · doi:10.3389/fdgth.2025.1541676 · Cited by 7
CBT for Youth Anxiety: How Does It Fit Within Community Mental Health?
Kendall, P. C., Maxwell, C. A., Jakubovic, R. J., Ney, J. S., McKnight, D. S., & Baker, S. (2022) · Current Psychiatry Reports · doi:10.1007/s11920-022-01403-7 · Cited by 8
de Jong, R., Lommen, M. J. J., de Jong, P. J., van Hout, W. J. P. J., der Marel, A. C. E. D.-V., & Nauta, M. H. (2024) · Journal of Behavior Therapy and Experimental Psychiatry · doi:10.1016/j.jbtep.2024.101942 · Cited by 7
Becker‐Haimes, E. M., Weiss, M., Schaechter, T., Young, S., & Sanchez, A. L. (2025) · Journal of Mood and Anxiety Disorders · doi:10.1016/j.xjmad.2025.100129 · Cited by 6
“A higher dose of exposure received was also associated with improved treatment response, which aligns with prior trials [2].”
InfluentialOlsson, E., Andrén, P., Claesdotter‐Knutsson, E., Dellgran, K., Castro, O. C., Möttus, A., Mataix‐Cols, D., Gušić, S., Perrin, S. G., Serlachius, E., et al. (2025) · Child Psychiatry & Human Development · doi:10.1007/s10578-025-01908-1 · Cited by 7
Bonnert, M., Nash, S., Andersson, E. M., Bergström, S., Janson, C., & Almqvist, C. (2024) · BMJ Open Respiratory Research · doi:10.1136/bmjresp-2023-002035 · Cited by 10
“15 Although some components may be effective, the training provided for each component may not be sufficient to support cognitive or behavioural changes in participants.”
BackgroundBilek, E. L., Iturra-Mena, A. M., Becker, H. C., Phan, K. L., Monk, C. S., & Fitzgerald, K. D. (2025) · JAACAP Open · doi:10.1016/j.jaacop.2025.04.003 · Cited by 6
“…anxiety disorders, bolstering prior fi ndings that relaxation is not necessary for youth engagement with or even response to CBT for anxiety 5,22,55 and adding important new insights that younger children may especially bene fi t from exposure-based models and that teletherapy is as…”
Dunning, E. E., Khan, A. N., Becker‐Haimes, E. M., & Guzick, A. G. (2025) · Research on Child and Adolescent Psychopathology · doi:10.1007/s10802-025-01317-x · Cited by 7
“This finding was echoed in a meta-analysis of 75 RCT studies (including 5,412 participants) that found protocols with more exposure produced significantly larger effects (standard mean dif - ference: -0.12 to -0.15; Whiteside et al., 2020).”
InfluentialIntroduction and Overview of Day Treatment Programs
Leffler, J. M., & Frazier, E. A. (2022) · Issues in clinical child psychology · doi:10.1007/978-3-031-14567-4_1 · Cited by 6
Meyer, A. E., Choi, S. Y., Tugendrajch, S. K., Rodríguez‐Quintana, N., Smith, S. N., Koschmann, E., Abelson, J. L., & Bilek, E. L. (2024) · Evidence-Based Practice in Child and Adolescent Mental Health · doi:10.1080/23794925.2024.2324770 · Cited by 6
“…true given apparent differences among both the efficacy and frequency of delivery of various CBT components, with behavioral components being the most effective, yet least frequently delivered (Becker-Haimes et al., 2017; Garland et al., 2010; Spates et al., 2006; Whiteside et al., 2020).”
Blossom, J. B., Jungbluth, N. J., Bolden, C. R., Woodruff, M. A., Pringle, W., Read, K. L., Jenness, J. L., Martin, B., & Schoenfelder, E. N. (2024) · Evidence-Based Practice in Child and Adolescent Mental Health · doi:10.1080/23794925.2024.2330397 · Cited by 6
“Treatment components include psychoeducation on anxiety and exposure to feared situations, consistent with growing evidence in support of streamlined expo-sure-based interventions (Whiteside et al., 2020).”
Young, B. N., Mohanty, E., Levine, K., & Klein-Tasman, B. (2023) · Frontiers in Psychology · doi:10.3389/fpsyg.2023.1098449 · Cited by 6
Soo, C. A., Tate, R. L., Catroppa, C., Benson, S. G., McDonald, S., Rapee, R. M., & Anderson, V. A. (2022) · Neuropsychological Rehabilitation · doi:10.1080/09602011.2022.2154811 · Cited by 5
“For example, in the general population, previous researchers have suggested that greater amounts of in-session exposure is related to larger e ff ect sizes between CBT and waitlist control groups (Whiteside et al., 2020).”
BackgroundChessell, C., Halldorsson, B., Walters, S., Farrington, A., Harvey, K., & Creswell, C. (2023) · Behavioural and Cognitive Psychotherapy · doi:10.1017/s1352465823000450 · Cited by 5
“Thus, the lack of improvement for these participants is unsurprising given that exposure to fears/feared situations is key for treatment change (Peris et al ., 2015; Whiteside et al ., 2020).”
BackgroundRueppel, M., Becker, H. C., Iturra-Mena, A. M., Bilek, E. L., Monk, C. S., Phan, K. L., & Fitzgerald, K. D. (2024) · Child Psychiatry & Human Development · doi:10.1007/s10578-023-01658-y · Cited by 5
de Jong, R., Lommen, M. J. J., van Hout, W. J. P. J., Kuijpers, R., Stone, L. L., de Jong, P. J., & Nauta, M. H. (2023) · Journal of Anxiety Disorders · doi:10.1016/j.janxdis.2023.102785 · Cited by 6
Supporting Clinicians in Implementing Exposure Therapy for Anxiety and Related Disorders
Frank, H. E., Woodard, G., & Martinez, R. G. (2025) · Current Psychiatry Reports · doi:10.1007/s11920-025-01612-w · Cited by 3
Gloe, L. M., Biggs, B. K., Geske, J. R., Reneson-Feeder, S. T., Dammann, J. E., Hofschulte, D. R., & Whiteside, S. P. H. (2025) · Behavior Therapy · doi:10.1016/j.beth.2025.07.002 · Cited by 4
Self-citationA comparison of virtual reality and verbal imaginal exposure for childhood anxiety disorders
Biggs, B. K., Whiteside, S. P. H., Knutson, M., Seifert, S. J., Hofschulte, D. R., Geske, J. R., Lass, A. N. S., Vickers, K. S., Gloe, L. M., & Reneson-Feeder, S. T. (2025) · Journal of Anxiety Disorders · doi:10.1016/j.janxdis.2025.102974 · Cited by 4
Self-citationEffectiveness of XR‐Based Exposure Therapy for Phobic Disorders
Lamb, R. L., Perry, J., Sutherland, E. C., Hoston, D., Garris, A., & DeRiggs, A. (2025) · Journal of Counseling & Development · doi:10.1002/jcad.12557 · Cited by 4
Chiappini, E. A., Parrish, C., Reynolds, E. K., & Mcguire, J. F. (2021) · Bulletin of the Menninger Clinic · doi:10.1521/bumc.2021.85.3.231 · Cited by 4
Want to help your patients with food allergy anxiety? Do proximity challenges!
Dahlsgaard, K. K., & Lewis, M. O. (2025) · Annals of Allergy Asthma & Immunology · doi:10.1016/j.anai.2025.02.020 · Cited by 4
Brennan, E., Bailey, K. J., Biggs, B. K., Cunningham, M. L., Dammann, J. E., Reneson-Feeder, S. T., Tiede, M. S., & Whiteside, S. P. H. (2022) · Journal of Child and Family Studies · doi:10.1007/s10826-022-02396-w · Cited by 4
“Additionally, the simplified exposureonly approach of PCET lends itself well to more portable technology-enhanced treatment platforms that align well with modern youth’s interests (e.g., Anxiety Coach app; see Whiteside et al., 2019).”
MethodResultSelf-citationExamining Community Clinicians Use of Imaginal Exposure with Childhood Anxiety Disorders
Whiteside, S. P. H. (2023) · Child Psychiatry & Human Development · doi:10.1007/s10578-023-01556-3 · Cited by 4
“While these strategies may be less effective than exposure, they are prominently included in evidenced based treatment protocol and therapists cannot be faulted for using them [6, 7].”
Self-citationAnderson, N. J., Rozenman, M. S., Pennington, B. F., Willcutt, E. G., & McGrath, L. M. (2022) · Journal of Learning Disabilities · doi:10.1177/00222194221098719 · Cited by 6
Sørensen, N. M., Skaarnes, H., Mathiasen, K., Thastum, M., & Lomholt, J. J. (2025) · JMIR Formative Research · doi:10.2196/66966 · Cited by 3
“It was decided to develop a cognitive behavioral therapy (CBT)–based program as this is the most well-researched approach and has shown good results in previous evaluations using the internet-based format [27-31].”
Koriakina, M. M., Agranovich, O. Е., Ntoumanis, I., Ulanov, M., Blank, I. B., Шестакова, А. Н., & Blagovechtchenski, E. (2025) · Frontiers in Human Neuroscience · doi:10.3389/fnhum.2025.1499521 · Cited by 3
Gloe, L. M., Biggs, B. K., Lipinski, A. W., Pejic, J., Kor, A. K., Knapp, J., Lin, A. J., & Whiteside, S. P. H. (2025) · Evidence-Based Practice in Child and Adolescent Mental Health · doi:10.1080/23794925.2025.2579294 · Cited by 3
Self-citationAdapting and Implementing Evidence-Based Interventions on Inpatient Psychiatric Units
Gurtovenko, K., Waitz, C., & Tebbett-Mock, A. A. (2024) · Issues in clinical child psychology · doi:10.1007/978-3-031-62749-1_12 · Cited by 3
Pilot Study of Self-Distancing Augmentation to Exposure Therapy for Youth Anxiety
Bilek, E. L., Meyer, A. E., Tomlinson, R. C., & Chen, C. R. (2023) · Child Psychiatry & Human Development · doi:10.1007/s10578-023-01540-x · Cited by 3
“Through this process, exposure therapy has gained support as the most effective treatment component in CBT for youth anxiety [8, 9].”
Nonverbal Synchrony and Alliance in Exposure Therapy for Pediatric Anxiety: a Case Report
Oreshina, G. V., & Zhukova, M. (2024) · Journal of Modern Foreign Psychology · doi:10.17759/jmfp.2024130101 · Cited by 3
Wahlund, T., Wallhem, M., Serlachius, E., & Engberg, H. (2021) · The Cognitive Behaviour Therapist · doi:10.1017/s1754470x21000027 · Cited by 3
“Exposure to feared and avoided stimuli, the main treatment component of BIP Worry, is an effective treatment technique for youth with anxiety disorders including GAD and worry (Whiteside et al ., 2019).”
Metadata
- Authors
- Whiteside, S. P. H., Sim, L. A., Morrow, A. S., Farah, W. H., Hilliker, D. R., Murad, M. H., & Wang, Z.
- Affiliations
- Mayo Clinic (US)
- Corresponding author
- Whiteside, Stephen P. H.
- Venue
- Clinical Child and Family Psychology Review
- Published
- 2019-10-18
- Volume
- 23
- Issue
- 1
- Pages
- 102-121
- ISSN
- 1096-4037 (ISSN-L)
- 1573-2827
- PMC
- PMC9005063
- OpenAlex
- W2980786259
- Cited by
- 190
- References
- 127
- Citations by year
- 2026: 28 · 2025: 32 · 2024: 34 · 2023: 23 · 2022: 33 · 2021: 27 · 2020: 11 · 2019: 1
- FWCI
- 2.69
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Clinical Child and Family Psychology Review (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- Agency for Healthcare Research and Quality (HHSA290201500013I)
- Topics
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Social Sciences › Psychology › Clinical Psychology › Child and Adolescent Psychosocial and Emotional Development
- Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
- Keywords
- cognitive behavioral therapy, childhood anxiety disorders, relaxation techniques, treatment components, treatment efficacy, waitlist control, child-reported outcomes, parental involvement
- MeSH terms
- Anxiety Disorders, Child, Humans, Implosive Therapy, Outcome and Process Assessment, Health Care, Relaxation Therapy, Cognitive Behavioral Therapy
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