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Internet-Based Cognitive Behavioral Therapy and Telephone Coaching for Anxiety in Children
Andre Sourander1,2,3, Katri Kaajalaakso1,2, Tarja Korpilahti-Leino1,2
1Research Centre for Child Psychiatry, University of Turku, Turku, Finland.
JAMA Network Open
|August 14, 2026
Summary
Internet-based cognitive-behavioral therapy (iCBT) significantly reduced anxiety in children over 24 months. The effectiveness of this online intervention for childhood anxiety showed a delayed increase, offering valuable insights for future research and clinical practice.
Area of Science:
- Child and Adolescent Psychiatry
- Digital Health Interventions
- Anxiety Disorders in Youth
Background:
- Limited long-term data exist on internet-based cognitive-behavioral therapy (iCBT) for childhood anxiety.
- Anxiety disorders are a significant concern in school-aged children, necessitating effective and accessible treatment options.
Purpose of the Study:
- To evaluate the long-term effectiveness of iCBT in children with anxiety.
- To compare iCBT outcomes against a psychoeducation control group over 12 and 24 months.
Main Methods:
- A 2-year follow-up of a randomized clinical trial (Master Your Worries) involving Finnish school children aged 10-13 with elevated anxiety.
- Participants received either guided iCBT (10 modules with coaching) or digital psychoeducation.
- Anxiety was measured using the Screen for Child Anxiety Related Disorders (SCARED-C/P) and other scales.
Main Results:
- iCBT demonstrated statistically significant differences in reducing anxiety scores (SCARED-C/P) at both 12 and 24 months compared to the control group.
- The effect size of iCBT increased from 6 to 12 months and was maintained through 24 months.
- Specific anxiety subgroups, such as social anxiety, also showed significant improvement with iCBT.
Conclusions:
- Guided iCBT shows sustained effectiveness in treating childhood anxiety up to 24 months.
- The findings suggest a delayed increase in iCBT effectiveness for childhood anxiety.
- This study has significant implications for the future of digital mental health interventions for children.
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