1 - (SYM 19) Advancing Equitable and Sustainable CBT for Children: Effectiveness, Follow-up, and Optimization of the Transdiagnostic EMOTION Program

Background: Anxiety and depressive symptoms frequently co-occur in childhood and share overlapping risk factors, maintenance processes, and treatment components. Despite strong evidence for disorder-specific cognitive-behavioral interventions, implementation in routine services remains limited, partly due to the burden of learning and delivering multiple manuals. Transdiagnostic approaches targeting shared mechanisms may increase reach, feasibility, and public health impact. The EMOTION (Coping Kids – Managing Anxiety and Depression) program was developed as a high-intensity, transdiagnostic, indicated preventive intervention for children with elevated symptoms of anxiety and/or depression.

Methods: EMOTION is a group-based CBT program targeting core processes common to anxiety and depression, including emotional awareness, cognitive restructuring, behavioral activation, exposure, and problem solving. The program was evaluated in a large cluster-randomized controlled trial including 706 children aged 8–12 years recruited from 36 Norwegian schools with treatment as usual (TAU) serving as the comparison condition. Outcomes included child- and parent-reported anxiety and depressive symptoms assessed at postintervention and at one-year follow-up. Building on the effectiveness findings, a subsequent optimization study evaluated a version of EMOTION combining face-to-face delivery with digital components aimed at improving engagement and scalability into routine services.

Results: Findings demonstrated significant reductions in both anxiety and depressive symptoms compared to control conditions, supporting the transdiagnostic preventive approach for children with elevated symptoms. Effects were maintained at one-year follow-up, indicating sustained benefits beyond the immediate intervention period. Results from the second study suggest that the hybrid delivery model is feasible and acceptable for both clinicians and families, with preliminary evidence of comparable outcomes and improved implementation indicators, including uptake and adherence in community settings.

Conclusions: Across effectiveness, follow-up, and optimization studies, EMOTION shows promise as a scalable, transdiagnostic preventive intervention for childhood emotional problems. Integrating empirically supported CBT components with flexible, technology-enhanced delivery may facilitate broader implementation and contribute to narrowing the research–practice gap in child mental health services.