Long-term effectiveness of cognitive behavioral therapy for youth with anxiety disorders

J Anxiety Disord. 2018 Jan:53:58-67. doi: 10.1016/j.janxdis.2017.11.003. Epub 2017 Nov 26.


Cognitive behavioral therapy (CBT) has demonstrated favorable long-term outcomes in youth with anxiety disorders in efficacy trials. However, long-term outcomes of CBT delivered in a community setting are uncertain. This study examined the long-term outcomes of individual (ICBT) and group CBT (GCBT) in youth with anxiety disorders treated in community mental health clinics. A total of 139 youth (mean age at assessment 15.5 years, range 11-21 years) with a principal diagnosis of separation anxiety disorder (SAD), social anxiety disorder (SOP), and/or generalized anxiety disorder (GAD) were evaluated, on average, 3.9 years post-treatment (range 2.2-5.9 years). Outcomes included loss of all inclusion anxiety diagnoses, loss of the principal anxiety diagnosis and changes in youth- and parent-rated youth anxiety symptoms. At long-term follow-up, there was loss of all inclusion anxiety diagnoses in 53%, loss of the principal anxiety diagnosis in 63% of participants as well as significant reductions in all anxiety symptom measures. No statistical significant differences in outcome were obtained between ICBT and GCBT. Participants with a principal diagnosis of SOP had lower odds for recovery, compared to those with a principal diagnosis of SAD or GAD. In conclusion, outcomes of CBT for youth anxiety disorders delivered in community mental health clinics were improved at nearly 4 years post-treatment, and recovery rates at long-term follow-up were similar to efficacy trials.

Trial registration: ClinicalTrials.gov NCT00586586.

Keywords: Anxiety disorders; Cognitive behavioral therapy; Community clinic; Long-term follow-up; Youth.

Publication types

  • Controlled Clinical Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Anxiety / psychology
  • Anxiety / therapy
  • Anxiety Disorders / psychology*
  • Anxiety Disorders / therapy*
  • Anxiety, Separation / psychology*
  • Anxiety, Separation / therapy*
  • Child
  • Cognitive Behavioral Therapy*
  • Data Collection
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Phobia, Social / psychology*
  • Phobia, Social / therapy*
  • Psychotherapy, Group*
  • Treatment Outcome
  • Young Adult

Associated data

  • ClinicalTrials.gov/NCT00586586