Cognitive-behavior therapy for children and adolescents with anxiety disorders: A meta-analysis of secondary outcomes
Open accessAbstract
Anxiety-focused cognitive-behavioral therapy (CBT) effectively reduces anxiety in children and adolescents. An important remaining question is to what extent anxiety-focused CBT also affects broader outcome domains. Additionally, it remains unclear whether parental involvement in treatment may have impact on domains other than anxiety. A meta-analysis (n studies = 42, n participants = 3239) of the effects of CBT and the moderating role of parental involvement was conducted on the following major secondary outcomes: depressive symptoms, externalizing behaviors, general functioning, and social competence. Randomized controlled trials were included when having a waitlist or active control condition, a youth sample (aged<19) with a primary anxiety disorder diagnosis receiving anxiety-focused CBT and reported secondary outcomes. Controlled effect sizes (Cohen’s d ) were calculated employing random effect models. CBT had a large effect on general functioning (-1.25[-1.59;0.90], n studies = 17), a small to moderate effect on depressive symptoms (-0.31[-0.41;-0.22], n studies = 31) and a small effect on externalizing behaviors (-0.23[-0.38;-0.09], n studies = 12) from pre-to post-treatment. Effects remained or even further improved at follow-up. Social competence only improved at follow-up (n studies = 6). Concluding, anxiety-focused CBT has a positive effect on broader outcome domains than just anxiety. Higher parental involvement seemed to have beneficial effects at follow-up, with improvements in general functioning and comorbid symptoms.
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According to previous studies, CBT involving parents was effective for treating child anxiety disorders.
“According to previous studies [30, 31], CBT involving parents was effective for treating child anxiety disorders.”
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- Authors
- Kreuze, L. J., Pijnenborg, G. H. M., de Jonge, Y. B., & Nauta, M. H.
- Affiliations
- University of Groningen (NL)
- Corresponding author
- Kreuze, L.J.
- Venue
- Journal of Anxiety Disorders
- Publisher
- Elsevier BV
- Published
- 2018-12
- Volume
- 60
- Pages
- 43-57
- ISSN
- 0887-6185 (ISSN-L)
- OpenAlex
- W2899500390
- Cited by
- 69
- References
- 62
- Citations by year
- 2026: 5 · 2025: 10 · 2024: 11 · 2023: 17 · 2022: 11 · 2021: 8 · 2020: 5 · 2019: 2
- FWCI
- 0.60
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- Journal of Anxiety Disorders (publishedVersion, other-oa)
- PubMed (publishedVersion)
- University of Groningen research database (University of Groningen / Centre for Information Technology) (publishedVersion, other-oa)
- University of Groningen research database (University of Groningen / Centre for Information Technology) (submittedVersion, other-oa)
- Funders
- faculty of Behavioural and Social sciences from the University of Groningen, the Netherlands
- 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 › Psychological Treatments and Assessments
- Keywords
- cognitive behavioral therapy, anxiety disorders, children and adolescents, parental involvement, depressive symptoms, externalizing problems, general functioning, social competence, comorbid symptoms, secondary outcomes
- MeSH terms
- Adolescent, Anxiety, Anxiety Disorders, Child, Depression, Female, Humans, Male, Parents, Cognitive Behavioral Therapy, Treatment Outcome
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