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Effectiveness of cognitive behavioral therapy (CBT) for child and adolescent anxiety disorders across different CBT modalities and comparisons: a systematic review and meta-analysis
Open accessAbstract
Aim: Pediatric Anxiety Disorders (AD) are common. Cognitive behavioral therapy (CBT) is one of two first-line treatments of youth AD and it has previously been shown to be superior to wait-list but not placebo therapy. This study consists of a systematic review and meta-analysis of the literature to assess the efficacy of CBT modalities in comparison to control contingencies for pediatric anxiety disorders.Methods: Studies were included if they were randomized controlled trials, and if CBT was manualized or modular, alone or in combination with medication. CBT was required to include behavioral treatment, exposure treatment, or cognitive elements. Eligible studies included participants aged 18 years or younger.Results: Eighty-one studies were included, with 3386 CBT participants and 2527 control participants. The overall results indicated that CBT is an effective treatment for childhood AD. The results showed that individual-based CBT is superior to wait-list and attention control. Group-based CBT is superior to wait-list control and treatment as usual. Remote-based CBT was superior to attention control and wait-list control. Family-based CBT was superior to treatment as usual, wait-list control, and attention control. Selective serotonin reuptake inhibitors were no more effective than individual-based CBT. Combination treatment was, however, more effective than individual-based CBT.Conclusion: To the best of our knowledge, no meta-analysis has thus far disentangled the effects of CBT modalities across various comparisons. This meta-analysis hence provides an important update to the literature on the efficacy of CBT for treating anxiety disorders in young people.
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“In terms of youth, a meta-analysis of 81 RCTs tested various modalities of CBT (individual, group, family-based, and remote) against waitlist, attention, TAU, and medication controls in children and adolescents (Mage = 10.9 [1.6]) with mixed anxiety disorders [118].”
From Psychotherapeutic treatments for generalized anxiety disorder: cognitive and behavioral therapies, enhancement strategies, and emerging efforts (2022) · cites this paper as [118]
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“Overall, CBT in various modalities was superior to waitlist, showed mixed beneficial effects compared to attention controls, and did not outperform TAU.”
From Psychotherapeutic treatments for generalized anxiety disorder: cognitive and behavioral therapies, enhancement strategies, and emerging efforts (2022) · cites this paper as [118]
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“Individual CBT was not significantly different from SSRIs, but the combined treatment was superior to either treatment alone at post-test.”
From Psychotherapeutic treatments for generalized anxiety disorder: cognitive and behavioral therapies, enhancement strategies, and emerging efforts (2022) · cites this paper as [118]
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Metadata
- Authors
- Sigurvinsdóttir, A. L., Jensínudóttir, K. B., Baldvinsdóttir, K. D., Smárason, O., & Skarphedinsson, G.
- Affiliations
- Akureyri Hospital (IS)
- University of Iceland (IS)
- National University Hospital of Iceland (IS)
- Faculty of Psychology, University of Iceland, Reykjavik, Iceland;
- Corresponding author
- Sigurvinsdóttir, Anna Lilja
- Venue
- Nordic Journal of Psychiatry
- Publisher
- Informa UK Limited
- Published
- 2019-11-18
- Volume
- 74
- Issue
- 3
- Pages
- 168-180
- ISSN
- 0029-1455 (ISSN-L)
- 0803-9488
- 1502-4725
- OpenAlex
- W2945326664
- Cited by
- 130
- References
- 112
- Citations by year
- 2026: 20 · 2025: 21 · 2024: 27 · 2023: 21 · 2022: 21 · 2021: 15 · 2020: 5
- FWCI
- 1.51
- Type
- journal article
- Language
- en
- Open access
- green
- hdl.handle.net
- Locations
- Nordic Journal of Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Skemman (submittedVersion)
- Hirsla (Landspítali University Hospital) (submittedVersion)
- 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, childhood anxiety disorders, child and adolescent anxiety, selective serotonin reuptake inhibitors, combination therapy, treatment efficacy, waitlist control, attentional control
- MeSH terms
- Adolescent, Anxiety Disorders, Child, Child Behavior Disorders, Combined Modality Therapy, Humans, Psychotherapy, Group, Cognitive Behavioral Therapy, Randomized Controlled Trials as Topic, Treatment Outcome, Selective Serotonin Reuptake Inhibitors
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