Examining Efficacy of Long-Term CBT in Youth With Anxiety Disorders

A sad girl hiding her face
A sad girl hiding her face
Outcomes of long-term CBT in community settings were previously uncertain.

According to the results of a study published in the Journal of Anxiety Disorders, cognitive behavioral therapy (CBT) delivered in community clinics resulted in positive long-term outcomes among youth with anxiety disorders. Improvements were reported nearly 4 years after treatment.

To assess long-term outcomes of CBT for anxiety disorders, 139 children and adolescents (mean age at assessment, 15.5 years; 54.47% female) who were treated with CBT in randomized controlled trials were evaluated after a mean of 3.9 years.

The principal diagnoses at treatment were separation anxiety disorder, social anxiety disorder, and/or generalized anxiety disorder. At follow-up, participants were assessed for all inclusion anxiety diagnoses, loss of the principal anxiety diagnosis, and changes in youth- and parent-rated anxiety symptoms.

At long-term follow-up, 53% of participants did not meet criteria for any inclusion anxiety diagnosis, and 63% no longer met criteria for their principal anxiety diagnosis. Compared with posttreatment assessment, the long-term outcomes were significantly improved for both measures (P <.05).

Among participants who did not lose their principal anxiety diagnosis at posttreatment evaluation (n=83), 53% lost their diagnosis at long-term follow-up. Among participants who did not lose all inclusion anxiety diagnoses at posttreatment assessment (n=102), 45% lost those diagnoses at long-term follow-up. The changes between posttreatment assessment and long-term follow-up were not significantly associated with additional interim treatment.

The clinical severity of the principal, secondary, and tertiary diagnoses were all significantly reduced at long-term follow-up compared with at posttreatment.

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Outcomes were not significantly different between group or individual CBT. Compared with patients with separation anxiety disorder or generalized anxiety disorder, those with social anxiety disorder were less likely to have improved outcomes at long-term follow-up.

The study authors concluded that the results demonstrated, “long term effectiveness of CBT for youth.”


Kodal A, Fjermestad K, Bjelland I, et al. Long-term effectiveness of cognitive behavioral therapy for youth with anxiety disorders. J Anxiety Disord. 2017;53:58-67.