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Research on CBT to Improve Quality of Life and Self-Esteem in Anxious and Depressed Children

Research on CBT to Improve Quality of Life and Self-Esteem in Anxious and Depressed Children

Treating anxiety and depression in children with a CBT-based program can greatly improve their quality of life and self-esteem. Early emotional support is important.

According to a study published in BMC Psychology, a CBT-based program called EMOTION was tested on children aged 8–12 who had elevated symptoms of anxiety and depression. The program aimed to reduce these emotional symptoms while also improving the children's quality of life and self-esteem.

The results showed that children with higher anxiety and depression had lower quality of life and self-esteem compared to their peers. Girls and older children had the lowest scores in both areas. However, children in the intervention group showed the most improvements in quality of life and self-esteem. More specifically, the biggest improvements were seen in children who had both anxiety and depression, and they showed the most progress compared to the control group.

The study focuses on the problem that anxiety and depression are common in children and often occur together. They can affect important areas of life, like school performance and relationships with friends and family. Even children who don’t have a formal diagnosis of anxiety or depression can still face the same challenges.

Understanding the Research

The study followed a clustered randomized design (cRCT) with 795 children aged 8–12 years who were recruited from 36 schools in Norway. The children were selected based on self-reported symptoms of anxiety and depression and were randomly assigned to either the intervention or control condition.

The children in the intervention group took part in the EMOTION program, which was a 10-week program based on Cognitive Behavioral Therapy (CBT) that reduced anxiety and depression.

  • The first half of the program focused on teaching children new skills to manage their emotions.
  • The second half of the program included activities that helped change negative thinking, try out new behaviors, and improve self-esteem.

Both children and their parents joined separate group sessions. Parents learned the same skills to help their children at home.

The program also helped improve children's self-esteem by encouraging positive comments from their parents and teachers. Trained group leaders, such as school nurses and psychologists, ran the sessions during school hours and got regular help and support.

Here is a summary of the findings from the study:

  • Children who received the EMOTION intervention showed a significant improvement in quality of life and self-esteem compared to those in the control group. It helped them cope with anxiety and depression.
  • Older children in the intervention group showed the largest improvement in quality of life and self-esteem.
  • The program involved group participation and peer support, which contributed to the improvement in quality of life and self-esteem.
  • The behavioral experiments and problem-solving strategies that were part of the intervention helped children cope with challenges and gain confidence.

Practical Strategies for Parents and Caregivers

As you’ve learned from the study, supporting children with anxiety and depression is about more than just recognizing the symptoms — it’s about actively helping them. Here are some strategies:

Involve yourself in your child’s journey

Just like in the EMOTION program, when parents actively engage in the process, it can have a meaningful impact. To do this, consider attending workshops or joining support groups that teach emotional regulation skills. These can give you tools to help your child express and manage their feelings.

Use what you’ve learned in these sessions by practicing together at home. For example, when your child feels upset, try using deep breathing or taking a break together.

Ask about how they are feeling

Parents can use a laid-back approach to encourage kids to open up. Family meals are a great opportunity for conversation — but remember, this doesn’t have to feel like a “formal discussion.”

Walks are another low-pressure opportunity. Walking side by side, rather than face-to-face, can make your child feel less intimidated and more likely to open up.

Check out our feelings worksheets as helpful resources.

Encourage peer support

Peer support can come in many forms, such as informal conversations and group activities. It can be comforting for our children to know that they are not alone in what they’re going through. It reduces the feeling of being “different” especially when dealing with anxiety or depression.

Moreover, peers who have experienced anxiety or depression can share helpful coping tips or just offer support. Hearing how others manage their feelings can inspire new ideas or ways to cope.

Introduce your child to cognitive behavioral therapy concepts

If your child is struggling with anxiety or depression, consider connecting them with a therapist trained in cognitive behavioral therapy. You can also expose your child to CBT concepts with CBT resources for kids, or by helping them identify and challenge some of their common negative thinking patterns.

According to the authors of the study, knowing how these issues affect kids can help us decide what to focus on to help children. Findings from this present study may also help with future research.

Discover more mental health resources for kids and teens! Check out our Anxiety Worksheets, Depression Worksheets, and Coping Skills Worksheets.

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