The DOI matches its Crossref record; 67 of the 68 references it cites were found in a registry or an index.
Computerised therapies for anxiety and depression in children and young people: A systematic review and meta-analysis
Open accessAbstract
One quarter of children and young people (CYP) experience anxiety and/or depression before adulthood, but treatment is sometimes unavailable or inadequate. Self-help interventions may have a role in augmenting treatment and this work aimed to systematically review the evidence for computerised anxiety and depression interventions in CYP aged 5-25 years old. Databases were searched for randomised controlled trials and 27 studies were identified. For young people (12-25 years) with risk of diagnosed anxiety disorders or depression, computerised CBT (cCBT) had positive effects for symptoms of anxiety (SMD -0.77, 95% CI -1.45 to -0.09, k = 6, N = 220) and depression (SMD -0.62, 95% CI -1.13 to -0.11, k = 7, N = 279). In a general population study of young people, there were small positive effects for anxiety (SMD -0.15, 95% CI -0.26 to -0.03; N = 1273) and depression (SMD -0.15, 95% CI -0.26 to -0.03; N = 1280). There was uncertainty around the effectiveness of cCBT in children (5-11 years). Evidence for other computerised interventions was sparse and inconclusive. Computerised CBT has potential for treating and preventing anxiety and depression in clinical and general populations of young people. Further program development and research is required to extend its use and establish its benefit in children.
Overview
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Verification
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
The source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“Furthermore, computerized CBT, such as MoodGym, SPARX, and “Think, Feel, Do” generally have small but positive effects on mental health.96 , 97”
From Rapid Systematic Review: The Impact of Social Isolation and Loneliness on the Mental Health of Children and Adolescents in the Context of COVID-19 (2020) · cites this paper as [96]
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“Importantly, reviews have tended to conclude that effects are better if there is some therapist input97 , 101 and if parents are involved especially for younger children.96 , 97”
From Rapid Systematic Review: The Impact of Social Isolation and Loneliness on the Mental Health of Children and Adolescents in the Context of COVID-19 (2020) · cites this paper as [96]
Experimental — accuracy not yet measuredIn the citing paper
“The efficacy of DHIPSY for some common mental disorders in children and adolescents has been established using meta-analyses [12,16-19].”
From Mechanisms of Change in Digital Health Interventions for Mental Disorders in Youth: Systematic Review (2021) · cites this paper as [17]
In the citing paper
“In the past 5 years, a number of literature reviews have highlighted the increase in research and development activities for eMental healthcare technologies for children and adolescents [18-22].”
From eMental Healthcare Technologies for Anxiety and Depression in Childhood and Adolescence: Systematic Review of Studies Reporting Implementation Outcomes (2018) · cites this paper as [21]
In the citing paper
“Most importantly, DMH tools do not remotely approximate the level of attractiveness and interactivity to which young “digital natives” have grown accustomed [17,32,43].”
From Use of the Principles of Design Thinking to Address Limitations of Digital Mental Health Interventions for Youth: Viewpoint (2019) · cites this paper as [32]
In the citing paper
“However, analyses comparing DMH interventions for both anxiety and depression with active nontherapeutic controls have generally failed to show superiority of DMH interventions [31,32].”
From Use of the Principles of Design Thinking to Address Limitations of Digital Mental Health Interventions for Youth: Viewpoint (2019) · cites this paper as [32]
In the citing paper
“In contrast, Pennant and colleagues [32] showed that face-to-face CBT was more effective than DMH interventions.”
From Use of the Principles of Design Thinking to Address Limitations of Digital Mental Health Interventions for Youth: Viewpoint (2019) · cites this paper as [32]
In the citing paper
“In the understandable and commendable effort to remain “evidence-based,” most DMH interventions for youth are a little-more-than modified and uploaded CBT manuals and workbooks (eg, MoodGym, Cool Kids, Camp Cope-a-lot, and BRAVE; for a review discussing the evidence base of these DMH interventions, see [32,44]).”
From Use of the Principles of Design Thinking to Address Limitations of Digital Mental Health Interventions for Youth: Viewpoint (2019) · cites this paper as [32]
In the citing paper
“Furthermore, problems such as insufficient search processes of the literature, small sample sizes, differences at baseline in study samples, and publication bias play important roles in the quality of these studies [32,39].”
From Use of the Principles of Design Thinking to Address Limitations of Digital Mental Health Interventions for Youth: Viewpoint (2019) · cites this paper as [32]
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Citations
Cites
Quantifying heterogeneity in a meta‐analysis
Higgins, J. P. T., & Thompson, S. G. (2002) · Statistics in Medicine · doi:10.1002/sim.1186 · Cited by 36,763
GRADE guidelines: 3. Rating the quality of evidence
Balshem, H., Helfand, M., Schünemann, H. J., Oxman, A. D., Kunz, R., Brozek, J., Vist, G. E., Falck-Ytter, Y., Meerpohl, J., & Norris, S. (2011) · Journal of Clinical Epidemiology · doi:10.1016/j.jclinepi.2010.07.015 · Cited by 8,285
Merikangas, K. R., He, J.-P., Burstein, M., Swanson, S. A., Avenevoli, S., Cui, L., Benjet, C., Georgiades, K., & Swendsen, J. (2010) · Journal of the American Academy of Child & Adolescent Psychiatry · doi:10.1016/j.jaac.2010.05.017 · Cited by 6,278
Prevalence and development of psychiatric disorders in childhood and adolescence
Costello, E. J., Mustillo, S., Erkanli, A., Keeler, G., & Angold, A. (2003) · Archives of General Psychiatry · doi:10.1001/archpsyc.60.8.837 · Cited by 4,035 · cited 1×
“In adolescence, rates of anxiety disorders remain similar and rates of depression rise to 3% (Costello et al., 2003; Ford et al., 2003; Lewinsohn et al., 1993), with cumulative prevalence of anxiety disorders and depression of around 10% and 25% respectively by 18 years (Lewinsohn et al., 1993;…”
BackgroundGRADE guidelines: a new series of articles in the Journal of Clinical Epidemiology
Guyatt, G. H., Oxman, A. D., Schünemann, H. J., Tugwell, P., & Knottnerus, A. (2011) · Journal of Clinical Epidemiology · doi:10.1016/j.jclinepi.2010.09.011 · Cited by 3,094
Kim-Cohen, J., Caspi, A., Moffitt, T. E., Harrington, H., Milne, B. J., & Poulton, R. (2003) · Archives of General Psychiatry · doi:10.1001/archpsyc.60.7.709 · Cited by 2,025
Pine, D. S., Cohen, P., Gurley, D., Brook, J., & Ma, Y. (1998) · Archives of General Psychiatry · doi:10.1001/archpsyc.55.1.56 · Cited by 1,753
Wang, P. S., Aguilar-Gaxiola, S., Alonso, J., Angermeyer, M. C., Borges, G., Bromet, E. J., Bruffaerts, R., de Girolamo, G., de Graaf, R., Gureje, O., et al. (2007) · The Lancet · doi:10.1016/s0140-6736(07)61414-7 · Cited by 1,655 · cited 2×
“However, there is evidence that many children and young people with anxiety disorders and depression do not receive evidence-based treatment (Kataoka, Zhang, &Wells, 2002; Merikangas, He, Brody, et al., 2010; Stallard, Udwin, Goddard, & Hibbert, 2007; Wang et al., 2007).”
BackgroundUnmet Need for Mental Health Care Among U.S. Children: Variation by Ethnicity and Insurance Status
Kataoka, S. H., Zhang, L., & Wells, K. B. (2002) · American Journal of Psychiatry · doi:10.1176/appi.ajp.159.9.1548 · Cited by 1,566
Lewinsohn, P. M., Hops, H., Roberts, R. E., Seeley, J. R., & Andrews, J. A. (1993) · Journal of Abnormal Psychology · doi:10.1037/0021-843x.102.1.133 · Cited by 1,547
Cited by
Sorted by citations
Loades, M. E., Chatburn, E., Higson-Sweeney, N., Reynolds, S., Shafran, R., Brigden, A., Linney, C., McManus, M. N., Borwick, C., & Crawley, E. (2020) · Journal of the American Academy of Child & Adolescent Psychiatry · doi:10.1016/j.jaac.2020.05.009 · Cited by 2,906
“Furthermore, computerized CBT, such as MoodGym, SPARX, and “Think, Feel, Do” generally have small but positive effects on mental health.(96,97) Although mobile applications for mental health have been found to be generally acceptable to children and adolescents, there is a lack of convincing evidence of effectiveness…”
BackgroundMethodMental Health Smartphone Apps: Review and Evidence-Based Recommendations for Future Developments
Bakker, D., Kazantzis, N., Rickwood, D., & Rickard, N. (2016) · JMIR Mental Health · doi:10.2196/mental.4984 · Cited by 886
“Similar findings for CCBT’s efficacy have emerged from meta-analyses that have focused on anxiety [47], depression [48], and its use with young people [49].”
Hollis, C., Falconer, C. J., Martin, J. L., Whittington, C., Stockton, S., Glazebrook, C., & Davies, E. B. (2017) · Journal of Child Psychology and Psychiatry · doi:10.1111/jcpp.12663 · Cited by 846
“The effects of DHIs on anxiety and depression outcomes were greater in adolescents and young adults than in children (Ebert et al., 2015; Pennant et al., 2015; Podina et al., 2016).”
BackgroundMethodInfluentialSelf-citationCognitive behavioural therapy for anxiety disorders in children and adolescents
James, A. C., James, G., Cowdrey, F. A., Soler, A., & Choke, A. (2015) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd004690.pub4 · Cited by 876
Mental Health Mobile Apps for Preadolescents and Adolescents: A Systematic Review.
Grist, R., Porter, J., & Stallard, P. (2017) · Journal of Medical Internet Research · doi:10.2196/jmir.7332 · Cited by 518
“The Mayo Clinic Anxiety Coach was the only app describing an active “treatment” component (ie, exposure and response prevention) although a further eight provided “coping strategies” and skills practice (eg, meditation, dialectical behavioral therapy [DBT] skills, and CBT techniques).”
BackgroundInfluentialCraske, M. G., Stein, M. B., Eley, T. C., Milad, M. R., Holmes, A., Rapee, R. M., & Wittchen, H.-U. (2017) · Nature Reviews Disease Primers · doi:10.1038/nrdp.2017.24 · Cited by 652
Lehtimaki, S., Martic, J., Wahl, B., Foster, K. T., & Schwalbe, N. (2021) · JMIR Mental Health · doi:10.2196/25847 · Cited by 488
“On the basis of 2 RCTsb included in this review, no difference in anxiety outcomes is found between the intervention and control groups (alternative nontherapeutic videogame).”
BackgroundInfluentialLiverpool, S., Mota, C. P., Sales, C. M. D., Čuš, A., Carletto, S., Hancheva, C., Sousa, S., Cerón, S. C., Moreno-Peral, P., Pietrabissa, G., et al. (2020) · Journal of Medical Internet Research · doi:10.2196/16317 · Cited by 408
“Therefore, considering the increased digital literacy and internet use among youth [16], DHIs may serve as a new way to increase accessibility to MH interventions in this population [17,18].”
Cognitive behavioural therapy for anxiety disorders in children and adolescents
James, A. C., Reardon, T., Soler, A., James, G., & Creswell, C. (2020) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd013162.pub2 · Cited by 344
Self-citationGrist, R., Croker, A., Denne, M., & Stallard, P. (2019) · Clinical Child and Family Psychology Review · doi:10.1007/s10567-018-0271-8 · Cited by 287
Andrews, G., Bell, C., Boyce, P., Gale, C., Lampe, L., Marwat, O., Rapee, R., & Wilkins, G. (2018) · Australian & New Zealand Journal of Psychiatry · doi:10.1177/0004867418799453 · Cited by 243
MacQUEEN, G. M., Frey, B. N., Ismail, Z., Jaworska, N., Steiner, M. S., Lieshout, R. J. V., Kennedy, S. H., Lam, R. W. M., Milev, R. V., Parikh, S. V., et al. (2016) · The Canadian Journal of Psychiatry · doi:10.1177/0706743716659276 · Cited by 266
“, waitlist, no treatment) in alleviating depression symptoms, particularly in adolescents.(18,19) As such, these interventions may be a promising treatment alternative when in-person/face-to-face treatment is not feasible or available.”
BackgroundInternet-Based Cognitive-Behavioral Therapy for Depression: Current Progress and Future Directions
Webb, C. A., Rosso, I. M., & Rauch, S. L. (2017) · Harvard Review of Psychiatry · doi:10.1097/hrp.0000000000000139 · Cited by 217
“Finally, iCBT programs adapted for children and adolescents have been shown to significantly reduce depressive symptoms.(47)”
BackgroundRauschenberg, C., Schick, A., Hirjak, D., Seidler, A., Paetzold, I., Apfelbacher, C., Riedel-Heller, S. G., & Reininghaus, U. (2021) · Journal of Medical Internet Research · doi:10.2196/23365 · Cited by 205
“Importantly, effectiveness has been demonstrated across differing age groups, including adults [24,54,59] and adolescents from the general population [34,52,56,61-63], and effect sizes mostly ranged from small to medium.”
BackgroundBennett, S. D., Cuijpers, P., Ebert, D. D., McKenzie Smith, M., Coughtrey, A. E., Heyman, I., Manzotti, G., & Shafran, R. (2019) · Journal of Child Psychology and Psychiatry · doi:10.1111/jcpp.13010 · Cited by 162
“…and/or depression in youth, of which the majority were self-help or guided self-help, demonstrated medium to large effect sizes (Ebert et al., 2015; Pennant et al., 2015; Rooksby, Elouafkaoui, Humphris, Clarkson, & Freeman, 2015; Stasiak et al., 2016); although findings were inconclusive for…”
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
Self-citationBergin, A. D., Vallejos, E. P., Davies, E. B., Daley, D., Ford, T., Harold, G., Hetrick, S., Kidner, M., Long, Y., Merry, S., et al. (2020) · npj Digital Medicine · doi:10.1038/s41746-020-00339-7 · Cited by 157
Anxiety in youth with asthma: a meta-analysis
Dudeney, J., Sharpe, L., Jaffe, A., Jones, E. B., & Hunt, C. (2017) · Pediatric Pulmonology · doi:10.1002/ppul.23689 · Cited by 169
“For example, appropriate treatment options include cognitive behavior interventions, which have been shown to be effective in reducing anxiety in youth when delivered both inperson(42,43) and remotely through online or smartphonemediums.(44,45) A strength of the meta-analytic procedure is being able to pool results fr…”
BackgroundMusiat, P., Johnson, C., Atkinson, M., Wilksch, S., & Wade, T. (2022) · Psychological Medicine · doi:10.1017/s0033291721004621 · Cited by 166
“…online interventions are increasingly available for a wide range of mental health conditions, such as depression (Andersson & Cuijpers, 2009), anxiety (Andrews, Cuijpers, Craske, McEvoy, & Titov, 2010; Pennant et al., 2015), and eating disorders (Aardoom, Dingemans, Spinhoven, & Van Furth, 2013).”
BackgroundHards, E., Loades, M. E., Higson‐Sweeney, N., Shafran, R., Serafimova, T., Brigden, A., Reynolds, S., Crawley, E., Chatburn, E., Linney, C., et al. (2022) · British Journal of Clinical Psychology · doi:10.1111/bjc.12331 · Cited by 162
Christ, C., Schouten, M. J., Blankers, M., van Schaik, D. J., Beekman, A. T., Wisman, M. A., Stikkelbroek, Y. A., & Dekker, J. J. (2020) · Journal of Medical Internet Research · doi:10.2196/17831 · Cited by 148
“Our results are largely in line with those of previous studies on cCBT in children and young people aged up to 25 years [36], adolescents and young adults aged 12 to 25 years [37] and 10 to 25 years [43], and children and adolescents aged up to 18 years [44].”
BackgroundResultInfluentialPractitioner Review: Anxiety disorders in children and young people – assessment and treatment
Creswell, C., Waite, P., & Hudson, J. (2020) · Journal of Child Psychology and Psychiatry · doi:10.1111/jcpp.13186 · Cited by 140
“a useful approach (Pennant et al., 2015; Spence et al., 2011) although positive benefits are less”
Self-citationScholten, H., & Granic, I. (2019) · Journal of Medical Internet Research · doi:10.2196/11528 · Cited by 138
“Furthermore, problems such as insufficient search processes of the literature, small sample sizes, differences at baseline in study samples, and publication bias play important roles in the quality of these studies [32,39].”
InfluentialVigerland, S., Ljótsson, B., Thulin, U., Öst, L.-G., Andersson, G., & Serlachius, E. (2016) · Behaviour Research and Therapy · doi:10.1016/j.brat.2015.11.006 · Cited by 136
“To date, there are several trials evaluating computerised or internet delivered CBT-interventions for children and adolescents with anxious or depressive symptoms (Pennant et al., 2015; ReyesPortillo et al., 2014; Richardson, Stallard, & Velleman, 2010).”
BackgroundUsing Peer Support to Strengthen Mental Health During the COVID-19 Pandemic: A Review
Suresh, R., Alam, A., & Karkossa, Z. (2021) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2021.714181 · Cited by 162
COVID-19 and telemental health: Benefits, challenges, and future directions.
Madigan, S. L., Racine, N. M., Cooke, J. E., & Korczak, D. J. (2020) · Canadian Psychology/Psychologie canadienne · doi:10.1037/cap0000259 · Cited by 138
Välimäki, M., Anttila, K., Anttila, M., & Lahti, M. (2017) · JMIR mHealth and uHealth · doi:10.2196/mhealth.8624 · Cited by 110
“On the basis of previous reviews, cognitive behavioral therapy (CBT)–based Web-based interventions have been found to impact the appearance of depressive and anxiety symptoms among young people [9-11], whereas online and mobile psychosocial suicide prevention intervention has reduced suicidal ideation, depression, and…”
BackgroundThe impact of COVID-19 on child and adolescent mental health and treatment considerations
Chavira, D. A., Ponting, C., & Ramos, G. (2022) · Behaviour Research and Therapy · doi:10.1016/j.brat.2022.104169 · Cited by 124
Domhardt, M., Steubl, L., & Baumeister, H. (2020) · Zeitschrift für Kinder- und Jugendpsychiatrie und Psychotherapie · doi:10.1024/1422-4917/a000625 · Cited by 101
“Pennant et al. (2015) incorporated any form of computerized therapies which varied between conventional CBT approaches and dynamic gaming-type interventions.”
InfluentialWozney, L., Huguet, A., Bennett, K., Radomski, A. D., Hartling, L., Dyson, M., McGrath, P. J., & Newton, A. S. (2017) · Journal of Medical Internet Research · doi:10.2196/jmir.7573 · Cited by 93
“…CBT and IPT therapies for clinical (adolescents diagnosed with MDD) and general (adolescents with subthreshold symptoms, adolescents considered at high risk for MDD) populations result in improvements in depressive symptoms and moderate to high satisfaction with the therapies [11-13].”
Computerised CBT for depressed adolescents: randomised controlled trial
Smith, P., Scott, R., Eshkevari, E., Jatta, F., Leigh, E., Harris, V., Robinson, A., Abeles, P., Proudfoot, J., Verduyn, C., et al. (2015) · Behaviour Research and Therapy · doi:10.1016/j.brat.2015.07.009 · Cited by 93
“A recent systematic review and meta-analysis (Pennant et al., 2015) concluded that CCBT has potential for treating depression in young people.”
BackgroundGarcía-Escalera, J., Chorot, P., Valiente, R. M., Reales, J. M., & Sandín, B. (2017) · Revista de Psicopatología y Psicología Clínica · doi:10.5944/rppc.vol.21.num.3.2016.17811 · Cited by 94
Topooco, N., Byléhn, S., Nysäter, E. D., Holmlund, J., Lindegaard, J., Johansson, S., Åberg, L., Nordgren, L. B., Zetterqvist, M., & Andersson, G. (2019) · Journal of Medical Internet Research · doi:10.2196/13393 · Cited by 100
“The depression reduction observed in this study is moreover in line with meta-analyses suggesting that computer and Web-based ICBT for youth depression produces effect [11,32], and more broadly, that coached Web-based interventions fare better than self-guided [33].”
BackgroundResultBennett, C. B., Ruggero, C. J., Sever, A. C., & Yanouri, L. (2020) · Journal of Psychotherapy Integration · doi:10.1037/int0000217 · Cited by 87
A Meta-Analysis on the Efficacy of Technology Mediated CBT for Anxious Children and Adolescents
Podina, I. R., Mogoase, C., David, D., Szentagotai, A., & Dobrean, A. (2016) · Journal of Rational-Emotive & Cognitive-Behavior Therapy · doi:10.1007/s10942-015-0228-5 · Cited by 83
Gamifying CBT to deliver emotional health treatment to young people on smartphones
Christie, G. I., Shepherd, M., Merry, S. N., Hopkins, S., Knightly, S., & Stasiak, K. (2019) · Internet Interventions · doi:10.1016/j.invent.2019.100286 · Cited by 81
Hollis, C. P., Hall, C. L., Jones, R., Marston, L., Novere, M. L., Hunter, R. M., Brown, B. J., Sanderson, C., Andrén, P., Bennett, S. D., et al. (2021) · The Lancet Psychiatry · doi:10.1016/s2215-0366(21)00235-2 · Cited by 78
Zagorscak, P., Heinrich, M., Sommer, D., Wagner, B., & Knaevelsrud, C. (2018) · Psychotherapy and Psychosomatics · doi:10.1159/000481515 · Cited by 85
Prevention of depression in childhood and adolescence
Mendelson, T., & Tandon, S. D. (2016) · Child and Adolescent Psychiatric Clinics of North America · doi:10.1016/j.chc.2015.11.005 · Cited by 77
Gonsalves, P. P., Hodgson, E. S., Kumar, A., Aurora, T., Chandak, Y., Sharma, R., Michelson, D., & Patel, V. (2019) · Frontiers in Public Health · doi:10.3389/fpubh.2019.00238 · Cited by 68
Jolstedt, M., Ljótsson, B., Fredlander, S., Tedgård, T., Hallberg, A., Ekeljung, A., Högström, J., Mataix-Cols, D., Serlachius, E., & Vigerland, S. (2018) · Internet Interventions · doi:10.1016/j.invent.2017.11.003 · Cited by 75
Khan, K., Hall, C. L., Davies, E. B., Hollis, C. P., & Glazebrook, C. (2019) · Journal of Medical Internet Research · doi:10.2196/13478 · Cited by 74
Stjerneklar, S., Hougaard, E., McLellan, L. F., & Thastum, M. (2019) · PLOS ONE · doi:10.1371/journal.pone.0222485 · Cited by 71
Gee, B., Reynolds, S. A., Carroll, B., Orchard, F., Clarke, T., Martin, D., Wilson, J., & Pass, L. (2020) · Journal of Child Psychology and Psychiatry · doi:10.1111/jcpp.13209 · Cited by 76
“There are a growing range of evidence-based treatments for depression and anxiety disorders in young people (Pennant et al., 2015; Reynolds, Wilson, Austin, & Hooper, 2012; Tindall et al., 2017; Weersing, Jeffreys, Do, Schwartz, & Bolano, 2017).”
BackgroundNordh, M., Wahlund, T., Jolstedt, M., Sahlin, H., Bjureberg, J., Åhlén, J., Lalouni, M., Salomonsson, S., Vigerland, S., Lavner, M., et al. (2021) · JAMA Psychiatry · doi:10.1001/jamapsychiatry.2021.0469 · Cited by 83
Web-Based and Mobile Suicide Prevention Interventions for Young People: A Systematic Review.
Perry, Y., Werner‐Seidler, A., Calear, A. L., & Christensen, H. M. (2016) · PubMed Central · Cited by 69
Treating child and adolescent anxiety effectively: Overview of systematic reviews
BENNETT, K. J., Manassis, K., Duda, S. J., Bagnell, A. L., Bernstein, G. A., Garland, E., Miller, L. D., Newton, A. S., Thabane, L., & Wilansky, P. (2016) · Clinical Psychology Review · doi:10.1016/j.cpr.2016.09.006 · Cited by 90
“Similarly, Pennant et al (2015) pooled 2 RCTs of ABM and reported no statistically significant difference in anxiety symptoms compared to active controls (SMD = -0.19, 95% CI = -0.69 to 0.32).”
BackgroundInfluentialBusiness as usual? Psychological support at a distance.
Payne, L., Flannery, H., Kambakara Gedara, C., Daniilidi, X., Hitchcock, M., Lambert, D., Taylor, C., & Christie, D. (2020) · Clinical Child Psychology and Psychiatry · doi:10.1177/1359104520937378 · Cited by 65
“The relative minority of studies evaluating non-CBT interventions, such as computerised problem-solving therapy (Hoek et al., 2012) and attention/cognitive bias modification (Hollis et al., 2017; Pennant et al., 2015) are inconclusive due to low quality evidence.”
BackgroundHetrick, S., Cox, G., & Merry, S. (2015) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph120504758 · Cited by 62
“This field is in its infancy currently, but results of trials of computerized CBT indicate potential benefits for treating depression in adolescents [26,70].”
BackgroundBrigden, A., Anderson, E., Linney, C., Morris, R., Parslow, R., Serafimova, T., Smith, L., Briggs, E., Loades, M., & Crawley, E. (2020) · Journal of Medical Internet Research · doi:10.2196/16924 · Cited by 63
“Furthermore, reviews investigating digital interventions for young people with chronic health conditions typically do not include children aged below 10 years [35], or, if they do, only a minority of the interventions included in the reviews include children aged below 13 years [15,36-38], recognizing that there are “…”
BackgroundKuosmanen, T., Fleming, T. M., Newell, J., & Barry, M. M. (2017) · Internet Interventions · doi:10.1016/j.invent.2017.03.004 · Cited by 56
“There is increasing evidence supporting the delivery of computerized mental health programs to promote youth mental health and wellbeing (Clarke et al., 2015; Pennant et al., 2015).”
BackgroundLi, H., Wei, D., Browning, M., Du, X., Zhang, Q., & Qiu, J. (2016) · Psychological Medicine · doi:10.1017/s003329171500238x · Cited by 59
“…inconsistent findings concerning the effects of ABM intervention on depression have been reported (e.g. Hallion & Ruscio, 2011; Mogoaşe et al. 2014; Pennant et al. 2015), a number of studies have found that ABM is an effective tool in reducing depressive symptoms (Baert et al. 2010; Browning et…”
BackgroundMethodDigital Mental Health Interventions for Child and Adolescent Anxiety
Khanna, M. S., & Carper, M. M. (2021) · Cognitive and Behavioral Practice · doi:10.1016/j.cbpra.2021.05.003 · Cited by 64
Wickersham, A., Barack, T., Cross, L., & Downs, J. M. (2022) · Journal of Medical Internet Research · doi:10.2196/29842 · Cited by 69
“Previous systematic reviews and meta-analyses of the efficacy of digitally delivered CBT for anxiety or depression in children and young people have yielded promising results [14,17-23].”
BackgroundFordham, B., Sugavanam, T., Edwards, K., Hemming, K., Howick, J., Copsey, B. J., Lee, H., Kaidesoja, M., Kirtley, S., Hopewell, S., et al. (2021) · Health Technology Assessment · doi:10.3310/hta25090 · Cited by 62
Radomski, A. D., Wozney, L., McGrath, P., Huguet, A., Hartling, L., Dyson, M. P., Bennett, K., & Newton, A. S. (2019) · Journal of Medical Internet Research · doi:10.2196/11128 · Cited by 40
“Recent systematic reviews and meta-analyses have found a range of iCBT programs to be effective at reducing anxiety in children and adolescents [9,10,20,21]; however, poor and highly variable rates of completion can be found across programs (up to 50% of participants not reaching the end of a…”
BackgroundWozney, L., McGrath, P. J., Gehring, N. D., Bennett, K., Huguet, A., Hartling, L., Dyson, M. P., Soleimani, A., & Newton, A. S. (2018) · JMIR Mental Health · doi:10.2196/mental.9655 · Cited by 50
“In the past 5 years, a number of literature reviews have highlighted the increase in research and development activities for eMental healthcare technologies for children and adolescents [18-22].”
BackgroundDomhardt, M., Messner, E.-M., Eder, A.-S., Engler, S., Sander, L. B., Baumeister, H., & Terhorst, Y. (2021) · Child and Adolescent Psychiatry and Mental Health · doi:10.1186/s13034-021-00401-6 · Cited by 43
“Furthermore, the efficacy of internet-based interventions for depression in youth is documented by four meta-analyses [23, 24, 27, 28], with effect sizes in the range from 0.”
BackgroundWolpert, M., Dalzell, K., Ullman, R., Garland, L., Cortina, M. A., Hayes, D., Patalay, P., & Law, D. (2018) · The Lancet Psychiatry · doi:10.1016/s2215-0366(18)30465-6 · Cited by 49
Mechler, J., Lindqvist, K., Carlbring, P., Topooco, N., Falkenström, F., Lilliengren, P., Andersson, G., Johansson, R., Midgley, N., Edbrooke-Childs, J. H., et al. (2022) · The Lancet Digital Health · doi:10.1016/s2589-7500(22)00095-4 · Cited by 61
“4,5 8 Grist and colleagues 9 reported that CBT-based interventions were more effective than treatments based on other approaches, and that therapist-guided interventions showed larger effects than self-guided programmes for children and adolescents.”
BackgroundAnxiety disorders in children and adolescents
Hill, C., Waite, P., & Creswell, C. (2016) · Paediatrics and Child Health · doi:10.1016/j.paed.2016.08.007 · Cited by 48
Self-citationHill, C., Martin, J. L., Thomson, S., Scott-Ram, N., Penfold, H. A., & Creswell, C. (2017) · The British Journal of Psychiatry · doi:10.1192/bjp.bp.115.180372 · Cited by 48
“Notably in the most recent reviews of digital interventions for anxiety and depression (13, 18) there were no examples of clinical or health-economic outcomes associated with e-therapies that have been developed within the NHS.”
BackgroundSelf-citationJohn, A., Lee, S. C., Solomon, S., Crepaz-Keay, D., McDaid, S., Morton, A., Davidson, G., Van Bortel, T., & Kousoulis, A. A. (2021) · BMJ Open · doi:10.1136/bmjopen-2020-048123 · Cited by 45
Evidence-based practice in cognitive–behavioural therapy
Stallard, P. N. (2021) · Archives of Disease in Childhood · doi:10.1136/archdischild-2020-321249 · Cited by 47
Conley, C. S., Raposa, E. B., Bartolotta, K., Broner, S. E., Hareli, M., Forbes, N., Christensen, K. M., & Assink, M. (2022) · JMIR Mental Health · doi:10.2196/34254 · Cited by 53
“In contrast, Pennant et al [54] found greater effects of computerized therapies for youth with subclinical symptoms versus a clinical diagnosis of anxiety; however, this effect was not found for depression.”
BackgroundResultInfluentialDomhardt, M., Engler, S., Nowak, H., Lutsch, A., Baumel, A., & Baumeister, H. (2021) · Journal of Medical Internet Research · doi:10.2196/29742 · Cited by 41
Spence, S. H., March, S., & Donovan, C. L. (2019) · Internet Interventions · doi:10.1016/j.invent.2019.100268 · Cited by 47
“Research into the impact of internet-delivered cognitive behavior therapy (ICBT) for youth anxiety with brief therapist assistance has indicated positive outcomes for the majority of participants (Ebert et al., 2015; Pennant et al., 2015; Stasiak et al., 2016).”
BackgroundHill, C., Creswell, C., Vigerland, S., Nauta, M. H., March, S., Donovan, C., Wolters, L., Spence, S. H., Martin, J. L., Wozney, L., et al. (2018) · Internet Interventions · doi:10.1016/j.invent.2018.02.002 · Cited by 44
Self-citationFerrari, M., Sabetti, J., McIlwaine, S. V., Fazeli, S., Sadati, S. M. H., Shah, J. L., Archie, S., Boydell, K., Lal, S., Henderson, J. L., et al. (2022) · Frontiers in Digital Health · doi:10.3389/fdgth.2022.814248 · Cited by 56
Online Support and Intervention for Child Anxiety (OSI): Development and Usability Testing
Hill, C., Reardon, T., Taylor, L., & Creswell, C. (2022) · JMIR Formative Research · doi:10.2196/29846 · Cited by 43
“Internet-based cognitive behavioral therapy (iCBT) for child anxiety is effective and acceptable within research settings [5,6]; however, user engagement, uptake, and adherence remain as challenges within routine clinical practice [7-9].”
BackgroundSelf-citationOnline Indicated Preventive Mental Health Interventions for Youth: A Scoping Review
van Doorn, M., Nijhuis, L. A., Egeler, M. D., Daams, J. G., Popma, A., van Amelsvoort, T., McEnery, C., Gleeson, J. F., Öry, F. G., Avis, K. A., et al. (2021) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2021.580843 · Cited by 43
“(46) included 27 studies in their systematic review and meta-analysis researching both indicated and universal preventive computerized therapies for anxiety and depression in children and young people (12–25 years).”
BackgroundEilert, N., Wogan, R., Leen, A., & Richards, D. (2022) · JMIR Pediatrics and Parenting · doi:10.2196/33551 · Cited by 43
“For example, Pennant et al [65] found medium between-group effects for CBT-based digital treatment of symptoms and small effect sizes for prevention across general populations.”
BackgroundLitvin, S., Saunders, R., Jefferies, P., Seely, H., Pössel, P., & Lüttke, S. (2023) · JMIR Mental Health · doi:10.2196/47285 · Cited by 43
“Digital health interventions (DHIs) have repeatedly been shown to be effective in improving mental well-being and relieving the symptoms of depression [1-4] and anxiety [1-3,5,6] in young people.”
BackgroundInfluentialLudlow, K., Russell, J. K., Ryan, B., Brown, R. L., Joynt, T., Uhlmann, L. R., Smith, G. E., Donovan, C., Hides, L., Spence, S. H., et al. (2023) · DIGITAL HEALTH · doi:10.1177/20552076231216410 · Cited by 42
“20,21 Digital interventions include web-based programs, mobile technologies, and virtual reality, which may be delivered as standalone treatments or as adjuncts to in-person treatments.”
BackgroundChatterton, M. L., Rapee, R. M., Catchpool, M., Lyneham, H. J., Wuthrich, V. M., Hudson, J. L., Kangas, M., & Mihalopoulos, C. (2019) · Australian & New Zealand Journal of Psychiatry · doi:10.1177/0004867418823272 · Cited by 42
Pilot study of a well-being app to support New Zealand young people during the COVID-19 pandemic
Serlachius, A., Boggiss, A., Lim, D., Schache, K., Wallace-Boyd, K., Brenton-Peters, J., Buttenshaw, E., Chadd, S., Cavadino, A., Cao, N., et al. (2021) · Internet Interventions · doi:10.1016/j.invent.2021.100464 · Cited by 35
“However, reviews of RCTs evaluating online or eHealth interventions, in particular those based on CBT, have shown moderate to large effect sizes for improving depression and anxiety in young adults (Pennant et al., 2015; Grist and Cavanagh, 2013).”
Stjerneklar, S., Hougaard, E., Nielsen, A. D., Gaardsvig, M. M., & Thastum, M. (2018) · Internet Interventions · doi:10.1016/j.invent.2018.01.001 · Cited by 36
“(N=404–3389) of children and adolescents with anxiety and/or depressive symptoms (Ebert et al., 2015; Pennant et al., 2015; Podina et al., 2016; Ye et al., 2014) now support the effectiveness of ICBT with anxious adolescents showing moderate-to-large effects on anxiety symptoms compared to no treatment (g=0.”
BackgroundIntellectual disability and computers in therapy: Views of service users and clinical psychologists
Vereenooghe, L., Gega, L., & Langdon, P. E. (2017) · Cyberpsychology: Journal of Psychosocial Research on Cyberspace · doi:10.5817/cp2017-1-11 · Cited by 37
Stjerneklar, S., Hougaard, E., & Thastum, M. (2019) · Internet Interventions · doi:10.1016/j.invent.2019.01.003 · Cited by 38
Nagamitsu, S., Kanie, A., Sakashita, K., Sakuta, R., Okada, A., Matsuura, K., Ito, M., Katayanagi, A., Katayama, T., Otani, R., et al. (2022) · JMIR mhealth and uhealth · doi:10.2196/34154 · Cited by 38
Self-management, self-care, and self-help in adolescents with emotional problems: a scoping review
Town, R., Hayes, D., March, A., Fonagy, P., & Stapley, E. (2023) · European Child & Adolescent Psychiatry · doi:10.1007/s00787-022-02134-z · Cited by 52
“[132] Global Systematic review and metaanalysis N/A self-help”
BackgroundSelf-citationCliffe, B., Croker, A., Denne, M., & Stallard, P. N. (2019) · Child and Adolescent Mental Health · doi:10.1111/camh.12362 · Cited by 39
“Technologically supported interventions have evolved rapidly and range from interventions such as computerised CBT (cCBT) (Pennant et al., 2015) and smartphone applications (apps) (Grist, Cliffe, Denne, Croker, & Stallard, 2018), through to the use of telecommunications such as text messaging,…”
BackgroundHavinga, P. J., Maciejewski, D. F., Hartman, C. A., Hillegers, M. H. J., Schoevers, R. A., & Penninx, B. W. J. H. (2021) · British Journal of Clinical Psychology · doi:10.1111/bjc.12277 · Cited by 37
McCashin, D., Coyle, D., & O’Reilly, G. (2019) · Journal of Medical Internet Research · doi:10.2196/13540 · Cited by 38
“The first theme—the helpfulness of tech-assisted CBT for young people—corroborated the dominant trend evident in the quantitative literature, that is, young people who completed tech-assisted CBT interventions were significantly more likely to report positive outcomes versus control groups [5].”
InfluentialStasiak, K., Merry, S., Frampton, C. M., & Moor, S. (2016) · Psychotherapy Research · doi:10.1080/10503307.2016.1244617 · Cited by 37
“Studies of cCBT for children and adolescents with depression and anxiety report effect sizes from small (0.11) to large (1.49) (Calear &Christensen, 2010; Richardson, Stallard, & Velleman, 2010), with stronger evidence for programs for anxious adolescents (Pennant et al., 2015).”
BackgroundInfluentialNavarro, P., Sheffield, J. K., Edirippulige, S., & Bambling, M. (2019) · JMIR Mental Health · doi:10.2196/15564 · Cited by 46
“Although promising evidence for the effectiveness of TBOC interventions is starting to emerge [35-39], greater variance has been observed in the impact of these interventions for YSUs [33,40-42] than adults [43-48].”
BackgroundBabiano-Espinosa, L., Wolters, L., Weidle, B., de Beek, V. O., Pedersen, S. A., Compton, S., & Skokauskas, N. (2019) · Systematic Reviews · doi:10.1186/s13643-019-1166-6 · Cited by 33
Liverpool, S., Donagh, C. M., Feather, J., Uzondu, C., Howarth, M. L., Bannerman, F., Kaehne, A., Foster, C., & Mateus, C. (2025) · European Child & Adolescent Psychiatry · doi:10.1007/s00787-025-02722-9 · Cited by 43
“%) focused on anxiety and or depression only [30, 59, 69, 73, 76, 78, 79, 81, 83–86, 88, 92, 95, 97, 101, 104–107].”
InfluentialXu, F., Cui, W., Xing, T., & Parkinson, M. (2019) · Frontiers in Psychology · doi:10.3389/fpsyg.2019.00819 · Cited by 35
Cervin, M., & Lundgren, T. (2022) · Journal of Child Psychology and Psychiatry · doi:10.1111/jcpp.13485 · Cited by 34
de Voogd, E. L., Wiers, R. W. H. J., de Jong, P. J., Zwitser, R. J., & Salemink, E. (2018) · PLoS ONE · doi:10.1371/journal.pone.0194274 · Cited by 34
Charkhandeh, M., Talib, M. A., & Hunt, C. J. (2016) · Psychiatry Research · doi:10.1016/j.psychres.2016.03.044 · Cited by 34
“The effectiveness of CBT on depression has been studied on adults and young people across a wide age range (Pennant et al., 2015), but at the start of this project there had not been such an extensive study that focused on adolescents aged 12–17 years.”
BackgroundLockwood, J., Williams, L., Martin, J. L., Rathee, M., & Hill, C. (2022) · JMIR Mental Health · doi:10.2196/29008 · Cited by 34
“Relatively few apps for anxiety in childhood implemented in real-world (nontrial) settings have been empirically evaluated [25,26,35].”
BackgroundResultInfluentialMcGovern, R., Balogun-Katung, A., Artis, B., Bareham, B. K., Spencer, L. P., Alderson, H., Brown, E., Brown, J., Lingam, R., McArdle, P., et al. (2024) · Journal of Prevention · doi:10.1007/s10935-024-00785-z · Cited by 48
“Whilst there are an increasing number of evidence-based interventions to treat mental health problems in children and young people (Pennant et al., 2015; Reynolds et al., 2012; Tindall et al., 2017), this treatment is not accessible to all young people (Department of Health, 2015; Radez et al.,…”
BackgroundYoung Adults’ Experience of Loneliness in London’s Most Deprived Areas
Fardghassemi, S., & Joffé, H. (2021) · Frontiers in Psychology · doi:10.3389/fpsyg.2021.660791 · Cited by 35
Babowitch, J. D., & Antshel, K. M. (2016) · Journal of Affective Disorders · doi:10.1016/j.jad.2016.04.018 · Cited by 30
Babbage, C. M., Jackson, G. M., Davies, E. B., & Nixon, E. (2022) · JMIR Mental Health · doi:10.2196/25716 · Cited by 36
“Reference lists of relevant systematic reviews (Multimedia Appendix 3 [16,21,31,32,34,35,37,39,43-45]) were hand searched by CMB and imported into EndNote (Clarivate) with other references.”
BackgroundAndersson, R., Åhlén, J., Mataix‐Cols, D., Lenhard, F., Henje, E., Månsson, C., Sahlin, H., Beckman, M., Serlachius, E., & Vigerland, S. (2022) · BMJ Open · doi:10.1136/bmjopen-2022-066357 · Cited by 34
“41 42 If ICBT could be entirely unguided, without sacrificing efficacy and safety, it could drastically increase availability to treatment.”
BackgroundDay, J. J., Freiberg, K., Hayes, A. J., & Homel, R. J. (2019) · Clinical Child and Family Psychology Review · doi:10.1007/s10567-019-00282-4 · Cited by 33
Radomski, A. D., Bagnell, A., Curtis, S., Hartling, L., & Newton, A. S. (2020) · JMIR Mental Health · doi:10.2196/15795 · Cited by 30
“There is a trend in the literature that some type of program support can increase program use or effectiveness of iCBT for children and adolescents [10]; however, inconsistent evidence is published [16,28,86,87], and what type of support, such as when it should be provided and by whom, that improves outcomes is unclea…”
Metadata
- Authors
- Pennant, M. E., Loucas, C. E., Whittington, C., Creswell, C., Fonagy, P., Fuggle, P., Kelvin, R., Naqvi, S., Stockton, S., & Kendall, T.
- Affiliations
- Royal College of Psychiatrists (GB)
- University College London (GB)
- University of Reading (GB)
- Anna Freud Centre (GB)
- University of Cambridge (GB)
- Corresponding author
- Pennant, Mary E.
- Venue
- Behaviour Research and Therapy
- Publisher
- Elsevier BV
- Published
- 2015-04
- Volume
- 67
- Pages
- 1-18
- ISSN
- 0005-7967 (ISSN-L)
- OpenAlex
- W1985615249
- Cited by
- 269
- References
- 68
- Citations by year
- 2026: 16 · 2025: 19 · 2024: 22 · 2023: 18 · 2022: 29 · 2021: 35 · 2020: 30 · 2019: 34 · 2018: 19 · 2017: 24 · 2016: 16 · 2015: 7
- FWCI
- 3.03
- Type
- journal article
- Language
- en
- Open access
- green
- discovery.ucl.ac.uk
- Locations
- Behaviour Research and Therapy (publishedVersion)
- PubMed (publishedVersion)
- UCL Discovery (University College London) (submittedVersion)
- Funders
- Department of Health and Social Care
- National Institute for Health and Care Excellence
- Topics
- Social Sciences › Psychology › Applied Psychology › Digital Mental Health Interventions
- 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
- Keywords
- computerized cognitive behavioral therapy, childhood anxiety, adolescent depression, children and young people, self-help intervention, anxiety symptoms, depressive symptoms, prevention of mental disorders
- MeSH terms
- Adolescent, Adult, Anxiety Disorders, Child, Child, Preschool, Computers, Depressive Disorder, Female, Humans, Male, Cognitive Behavioral Therapy, Randomized Controlled Trials as Topic, Treatment Outcome, Internet, Young Adult, Mobile Applications
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
