Research on the Long-Term Effectiveness of CBT for Youth with Anxiety Disorders

A 2024 paper published in Psychotherapy and Psychosomatics, following 210 children with an average age of about 12 from the “Kids Beating Anxiety (KibA)” clinical trial, found that 61.38% of participants experienced remission of their anxiety disorders post-treatment. This increased slightly to 63.64% after over 2 years.

Both children and their caregivers reported lasting improvements in anxiety severity, daily functioning, and quality of life. These changes remained stable over time, with no decline, and some even improved further. Notably, the results were as strong, if not stronger, than those seen in previous studies.

The findings from the KibA trial support the claim that CBT is one of the most effective, evidence-based treatments for anxiety. CBT, which stands for Cognitive Behavioral Therapy, helps individuals identify and challenge negative or irrational thought patterns that contribute to their anxiety or depression symptoms.

Understanding the Research

Krause and colleagues conducted a non-controlled, observational trial that assessed the effectiveness of Cognitive Behavioral Therapy (CBT) for children with anxiety disorders (AD).

The study used a multi-informant, multi-dimensional approach to collect data from children, caregivers, and blinded diagnosticians. It included standardized tools, such as the Kinder-DIPS-OA clinical diagnostic interview, the Spence Children's Anxiety Scale (SCAS), and the Strengths and Difficulties Questionnaire (SDQ).

Children received either family-based CBT for separation anxiety or child-focused CBT for other anxiety disorders. Assessments were done at baseline, immediately after treatment, at a 6-month follow-up, and at a long-term follow-up that took place between 2.67 to 7.26 years after treatment.

Based on the results, both types of CBT were effective for children diagnosed with anxiety. Here are the key findings:

• Most of the children (70.48%) did not take any medication during therapy. This suggested that the CBT interventions alone were sufficient for many participants.
• About 30.95% of families received additional booster sessions after the regular treatment, which provided ongoing support.
• After treatment termination, 73.79% of the children were free of their primary anxiety diagnosis. This increased to 79.76% at the 6-month follow-up and slightly decreased to 77.27% at the long-term follow-up (mean age 16.57 years).
• Children's anxiety levels significantly decreased, as reported by both the children and their caregivers. This improvement lasted over time, especially in the children's own reports. Moreover, they reported being highly satisfied with the therapy.

Practical Strategies for Parents and Caregivers

How can you support a child through their anxiety treatment and make the most out of CBT? Here are tips that may help:

• Give your child opportunities to practice what they’ve learned in therapy. CBT techniques become more effective if they are applied in everyday situations. For example, if they learned about cognitive distortions, encourage them to notice and challenge these when they start feeling anxious. Encourage them to replace negative statements with positive. If they say, “This is impossible,” let them try a statement like, “I can cope with this. I am stronger than I think!”
• Let them feel comfortable telling you about their thoughts and feelings. Kids who feel secure in their parents are more likely to open up about the things they are worried about. The more they share, the better you can guide them. Show them that you’re listening actively without interrupting or immediately offering solutions. Even if you don’t fully understand their feelings, you can say things like, “I can see that you’re feeling worried, and that’s okay.”
• Stay patient and keep supporting them. Anxiety can be unpredictable, and although your child is making progress, it’s normal to experience ups and downs. Let them know that it's okay to have difficult days.

The authors mentioned that the results are especially remarkable because the children in the study were at an age where new anxiety or other mental health issues would typically be expected to increase over time.

For more resources to support kids and teens, check out our CBT Worksheets and Anxiety Management Worksheets.