Cited by 136Digital Mental Health InterventionsAnxiety, Depression, Psychometrics, Treatment, Cognitive ProcessesChild and Adolescent Psychosocial and Emotional Development

Internet-delivered cognitive behavioural therapy for children with anxiety disorders: A randomised controlled trial

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Vigerland, Sarah, Ljótsson, Brjánn, Thulin, Ulrika, Öst, Lars-Göran, Andersson, Gerhard, Serlachius, Eva·2016·Behaviour Research and Therapy

Abstract

BACKGROUND: Cognitive behaviour therapy (CBT) has been shown to be an effective treatment for anxiety disorders in children, but few affected seek or receive treatment. Internet-delivered CBT (ICBT) could be a way to increase the availability of empirically supported treatments. AIMS: A randomised controlled trial was conducted to evaluate ICBT for children with anxiety disorders. METHOD: Families (N = 93) with a child aged 8-12 years with a principal diagnosis of generalised anxiety disorder, panic disorder, separation anxiety, social phobia or specific phobia were recruited through media advertisement. Participants were randomised to 10 weeks of ICBT with therapist support, or to a waitlist control condition. The primary outcome measure was the Clinician Severity Rating (CSR) and secondary measures included child- and parent-reported anxiety. Assessments were made at pre-treatment, post-treatment and at three-month follow-up. RESULTS: At post-treatment, there were significant reductions on CSR in the treatment group, with a large between-group effect size (Cohen's d = 1.66). Twenty per cent of children in the treatment group no longer met criteria for their principal diagnosis at post-treatment and at follow-up this number had increased to 50%. Parent-reported child anxiety was significantly lower in the treatment group than in the waitlist group at post-treatment, with a small between-group effect size (Cohen's d = 0.45). There were no significant differences between the groups regarding child-ratings of anxiety at post-treatment. Improvements were maintained at three-month follow-up, although this should be interpreted cautiously due to missing data. CONCLUSIONS: Within the limitations of this study, results suggest that ICBT with therapist support for children with anxiety disorders can reduce clinician- and parent-rated anxiety symptoms. TRIAL REGISTRATION: Clinicaltrials.gov: NCT01533402.

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  • Internet-delivered CBT has shown treatment effects comparable to those of face-to-face CBT for pediatric anxiety disorders.

    “Similarly, Internet-delivered CBT has shown treatment effects comparable to those of face-to-face CBT for pediatric anxiety disorders [27].”

    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 [27]

    The Introduction (page unavailable) reports outcomes comparable to face-to-face treatment for adults, not children. The Abstract reports that internet-delivered CBT reduced anxiety symptoms in children, but the trial compared it with a waitlist, not face-to-face CBT. The pediatric comparison in the claim is therefore unsupported. (LLM, conf=0.88)

    Experimental — accuracy not yet measured
  • According to a previous study using three kinds of rating scales (doctor-rated, parent-rated and child-rated) to measure anxiety in the same children, the doctor-rated scale produced the least similar results among the three kinds of rating scales, while the parent-rated scale showed smaller differences than the doctor-rated scale, and the self-rated scale showed no differences.

    “According to a previous study using three kinds of rating scales (doctor-rated, parent-rated and child-rated) to measure anxiety in the same children, the doctor-rated scale produced the least similar results among the three kinds of rating scales, while the parent-rated scale showed smaller differences than the doctor-rated scale, and the self-rated scale showed no differences [34].”

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Authors
Vigerland, S., Ljótsson, B., Thulin, U., Öst, L.-G., Andersson, G., & Serlachius, E.
Affiliations
  • Karolinska Institutet (SE)
  • Stockholm University (SE)
  • Linköping University (SE)
Corresponding author
Vigerland, Sarah
Venue
Behaviour Research and Therapy
Publisher
Elsevier BV
Published
2016-01
Volume
76
Pages
47-56
ISSN
0005-7967 (ISSN-L)
OpenAlex
W2175826023
Cited by
136
References
63
Citations by year
2026: 11 · 2025: 17 · 2024: 8 · 2023: 10 · 2022: 11 · 2021: 17 · 2020: 14 · 2019: 16 · 2018: 13 · 2017: 11 · 2016: 8
FWCI
17.26
Type
journal article
Language
en
Open access
Locations
  • Behaviour Research and Therapy (publishedVersion, cc-by-nc-nd)
  • PubMed (publishedVersion)
  • KTH Publication Database DiVA (KTH Royal Institute of Technology) (submittedVersion, other-oa)
Funders
  • Stockholm County Council (HNS 9576)
  • Stockholm County Council and the Karolinska Institutet (ALF 20110278, 20120070)
  • Claes Groschinsky foundation (SF11 147)
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
internet-based cognitive behavioral therapy, childhood anxiety disorders, generalized anxiety disorder, panic disorder, separation anxiety disorder, social anxiety disorder, specific phobia, therapist support, parent-reported anxiety
MeSH terms
Anxiety, Anxiety Disorders, Child, Female, Humans, Male, Psychiatric Status Rating Scales, Therapy, Computer-Assisted, Cognitive Behavioral Therapy, Panic Disorder, Treatment Outcome, Internet

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