Family Intervention for Child and Adolescent Anxiety: A Meta-Analytic Review of Therapy Targets, Techniques, and Outcomes
Abstract
Parent- and family-level correlates of youth anxiety are well-documented, and they highlight potential targets for family-focused intervention. Although family-based approaches for treating youth anxiety generally are considered efficacious for achieving symptom reduction, they vary in format and approach and it remains unclear whether they offer an advantage over individual child treatment. To better understand the current state of the evidence, we used meta-analytic methods to examine the therapeutic approaches described in existing family interventions for child and adolescent anxiety, whether they mapped to the major mechanisms proposed in the literature, and the timeline along which relevant parent/family variables were measured. We examined how these mechanism-focused family interventions performed in RCTs relative to individual child CBT and whether they shifted symptoms and relevant parenting behaviors. A total of 11 randomized controlled trials (RCTs) compared individual cognitive behavior therapy (CBT) to CBT+ a family component (CBT + FAM) and included a youth anxiety measure at pre- and post-treatment; only half of these (n=6) also included a parent/family functioning measure at both pre- and post-treatment (across both primary and secondary outcome papers). Only a single study included anxiety measures at a mid-treatment time point, and none included parent measures at a mid-treatment time point. Findings are discussed in terms of design considerations and advancing the field of family intervention for youth anxiety.
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The finding that parent-involvement CBTs outperformed individual CBT is novel and important given inconsistent prior data on whether parent involvement enhances child anxiety CBT outcome.
“These are novel and important findings given the lack of consistent data showing that parent involvement in their child’s CBT enhances anxiety outcome (e.g., Kendall et al., 2008; Nauta et al., 2003; Peris et al., 2021; Silverman et al., 2009).”
From Boundaries on Parent Involvement in Their Child’s Anxiety Cognitive-Behavioral-Treatment Outcome: Parent Reinforcement and Relationship Behaviors Moderate Outcome (2024) · cites this paper as Peris et al., 2021
Integration of parent involvement and training into child-focused CBT protocols for anxious youth has not been found to enhance the short-term effectiveness of such interventions.
“However, the integration of parent involvement and training into child-focused CBT protocols for anxious youth has not been found to enhance the short-term effectiveness of such interventions [9,10].”
From A Qualitative Study of Participant Feedback on an Acceptance and Commitment Therapy Group-Based Intervention for Parents of Youth with Anxiety Disorders. (2026) · cites this paper as [10]
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Conceptualizing Emotion Regulation and Coregulation as Family-Level Phenomena
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Dysregulation, Catastrophic Reactions, and the Anxiety Disorders
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“These are novel and important findings given the lack of consistent data showing that parent involvement in their child’s CBT enhances anxiety outcome (e.g., Kendall et al., 2008; Nauta et al., 2003; Peris et al., 2021; Silverman et al., 2009).”
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Cognitive Behavioral Therapy for Anxiety and Depression in Children and Adolescents
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Parental beliefs about anxiety as a mediator of parental Overcontrol and adolescent anxiety
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- Authors
- Peris, T. S., Thamrin, H., & Rozenman, M. S.
- Affiliations
- University of California, Los Angeles (US)
- Arizona State University (US)
- University of Denver (US)
- Corresponding author
- Peris, Tara S.
- Venue
- Journal of Affective Disorders
- Publisher
- Elsevier BV
- Published
- 2021-05
- Volume
- 286
- Pages
- 282-295
- ISSN
- 0165-0327 (ISSN-L)
- OpenAlex
- W3135427460
- Cited by
- 57
- References
- 109
- Citations by year
- 2026: 9 · 2025: 9 · 2024: 16 · 2023: 9 · 2022: 9 · 2021: 5
- FWCI
- 6.65
- Type
- journal article
- Language
- en
- Update notices
- erratum (2021-08-01)
- Open access
- closed
- Licence
- Locations
- Journal of Affective Disorders (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Child and Adolescent Psychosocial and Emotional Development
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Social Sciences › Psychology › Clinical Psychology › Psychological Treatments and Assessments
- Keywords
- family intervention, childhood anxiety, adolescent anxiety, cognitive behavioral therapy, family-focused therapy, parental behavior, family functioning, therapeutic mechanisms
- MeSH terms
- Adolescent, Anxiety, Anxiety Disorders, Child, Humans, Parents, Cognitive Behavioral Therapy, Parenting
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