Hope predicts long-term well-being following cognitive behavioral therapy for anxiety and related disorders

Prior research indicates that cognitive behavioral therapy (CBT) results in moderate-to-large increases in hope and well-being, though long-term treatment outcomes are less clear. This study examined whether gains in these outcomes were maintained up to 36 months after CBT and whether hope - an established change mechanism during treatment - was associated with sustained well-being during long-term follow-up when controlling for post-treatment anxiety and depression.

A subset of 69 participants [M_age = 30.29 (SD = 9.94) yrs, 62.32% female, 89.86% White, 89.85% Non-Hispanic/Latinx] with anxiety disorders from a randomized equivalence trial of transdiagnostic and single-diagnosis CBT protocols were re-consented into a long-term follow-up study and completed assessments every 6 months across 3 years.

Standardized mean gain scores and multilevel modeling (MLM) revealed no significant differences in well-being or hope between post-treatment and follow-up timepoints in either condition. MLM indicated that higher hope at the within-person (standardized γ₁₀ = 0.26, p < .001) and between-person levels (standardized γ₀₁ = 0.42, p < .001) were associated with greater well-being across long-term follow-up, whereas post-treatment anxiety and depression were not significant predictors.

Findings suggest sustained increases in hope may help preserve gains in well-being up to 3 years after CBT.