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Symposium

Child and adolescent mental health

The Kids FACE FEARS pragmatic randomized effectiveness study of therapist-led vs guided online CBT for pediatric anxiety: Overview, main findings, and secondary outcomes

4 - (SYM 39) Comparing Therapist-led versus Guided Online CBT for Treating Pediatric Anxiety: Secondary Outcomes from the KIDS FACE FEARS Trial

Saturday, June 27, 2026
2:56 PM - 3:13 PM PDT
Location: Yerba Buena Salon 12, B3 Level
Keywords: Child Anxiety, Telehealth/m-Health, Randomized Controlled Trial
Abstract Body

This talk presents the first set of secondary outcomes of the Kids FACE FEARS Trial (a large multisite, pragmatic trial comparing the effectiveness of Therapist-Led CBT versus Guided iCBT for pediatric anxiety). The present secondary outcomes analysis focuses on non-anxiety outcomes. Analyses found significant improvements in both conditions from baseline through 12-month follow-up for youth internalizing and externalizing symptoms, attention problems, and sleep quality (all p’s < .001). Time X Condition interaction terms were all nonsignificant (p’s > .05), such that these youth improvements in non-anxiety outcomes were comparable and of similar magnitudes across the two treatment comparators. Analyses also found significant improvements in both conditions from baseline through 12-month follow-up for caregiver anxiety and caregiver stress (both p’s < .001), but not for caregiver depression. These caregiver improvements were roughly comparable across the two treatment comparators (i.e., p > .05 for both Time X Condition interaction terms).



 



These secondary outcomes from the Kids FACE FEARS Trial highlight the extent to which the benefits of Therapist-Led CBT and Guided iCBT for pediatric anxiety extend beyond just anxiety improvements. In this large, multisite pragmatic trial, these treatments were both additionally associated with improved overall youth internalizing and externalizing symptoms, attention problems, and sleep quality, and caregivers whose children received these treatments also reported improved anxiety and stress in themselves. Consistent with findings from trials evaluating traditional office-based CBT for youth anxiety, these findings suggest modernized CBT formats for youth anxiety drawing on technology and reduced therapist intensity can also be associated with positive outcomes that generalize to other, non-anxiety domains. Given problems with the accessibility and acceptability of traditional office-based CBT formats for many youth in need, it is encouraging that these modernized CBT formats with the potential for overcome several care barriers are associated with broadened improvements that extend well beyond just youth anxiety symptoms.