Is face-to-face therapy necessary to reduce anxiety in children? – A meta-analysis of online CBT interventions for the youth

• In Event: Poster Session 11
  In Poster Session: PS 11 Topic - Developmental Psychopathology

Abstract

Anxiety disorders are the most prevalent mental health issues in childhood, yet the majority of children do not receive treatment. As one in every five children suffers from an anxiety disorder, increasing the accessibility of evidence-based interventions would be crucial for the psychological well-being of children. Anxiety may have many detrimental effects on youths such as low-self esteem, social and family relationship deficits, difficulties with academic performance, or substance abuse. With recent advances in technology, a growing number of home-based anxiety interventions became accessible. This study is the first meta-analysis to evaluate the effectiveness of cognitive-behavioral home-based anxiety interventions for the youth. Five electronic databases were systematically searched for RCTs that used cognitive-behavioral anxiety intervention for individuals below 18 years. Eighteen studies were found eligible for inclusion in the study.
Aggregated effect sizes using a random-effects model yielded low overall effect for self-ratings (g = 0.242, p < 0.001, 95%CI [.157; .330]), and a medium effect for ratings of clinicians (g = 0.657, p < 0.001, 95%CI [.502; .812]). Effect of treatment was more apparent in clinicians’ ratings than in self-report ratings of children. We found that the effects were homogenous across studies. Neither the characteristics of the intervention (length, place of delivery: home or clinic or school, involvement of a therapist, focus of the treatment: family or individual) nor the characteristics of the patients (average age, female ratio, diagnosis) nor the characteristics of the studies (quality, anxiety questionnaire, blinding of the raters) moderated the effect size.
We conclude that home based cognitive behavioural interventions are effective with or without family involvment. The effect size of home based interventions are comperable to in person therapy. Furthermore, online CBT interventions may provide an accessible, cost effective and scalable anxiety treatment option for children and adolescents.

Authors

• Luca Csirmaz, ELTE Doctoral School of Psychology, MTA-ELTE Lendulet Adaptation Research Group
  Presenting Author

• Krisztian Kasos, MTA-ELTE Lendület Adaptation Research Group, Institute of Psychology, ELTE Eötvös Loránd University
  Non-Presenting Author