3 - (SYM 1) Icbt in Schools: A Pilot Study Investigating the Feasibility and Acceptability of an Online School-based Treatment Program for Childhood Anxiety

The high prevalence of anxiety in children and adolescents often surpasses the capacity of available clinicians. There is a need to improve how empirically validated anxiety treatments reach children in need. Internet-delivered cognitive behavioural therapy (iCBT) offers a potentially scalable solution. This pilot study examined the feasibility, acceptability, and effectiveness of an iCBT program (Cool Kids Online) delivered through a partnership in which schools identified anxious children and adolescents and outsourced iCBT to a university clinic for an online, minimally therapist supported iCBT program.

Data from 716 Australian children and adolescents (aged 6-17 years) referred by school counsellors under a state government-funded initiative were analysed. Participants completed a baseline assessment before enrolling in a 10-week iCBT program comprising eight online lessons and up to four therapist support calls. Outcomes were measured pre- and post-treatment using the Spence Children’s Anxiety Scale, Short Mood and Feelings Questionnaire, Child Anxiety and Depression Life Interference Scale, and school functioning items.

Pre-post comparisons based on parent-report measures indicated large effect size improvements for anxiety (d = .97), depressive symptoms (d = 0.88), and life interference (d = 0.99). School functioning improved with moderate effects on grades (d = 0.46), test-taking (d = 0.53), class participation (d = 0.46), and peer relationships (d = 0.57). Participants completed an average of six lessons and received three support calls. Parent feedback showed 100% support for continued government funding.

Findings suggest that online, school-based CBT is a feasible, acceptable, and effective treatment for childhood anxiety. Results support large-scale implementation of iCBT by governments in partnership with schools.