title: Internet-delivered cognitive behavioural therapy for children with anxiety disorders: A randomised controlled trial.
abstract: BACKGROUND
  Cognitive behaviour therapy (CBT) has been shown to be an effective treatment for anxiety disorders in children, but few affected seek or receive treatment. Internet-delivered CBT (ICBT) could be a way to increase the availability of empirically supported treatments.
  
  
  OBJECTIVE
  A randomised controlled trial was conducted to evaluate ICBT for children with anxiety disorders.
  
  
  METHODS
  Families (N = 93) with a child aged 8-12 years with a principal diagnosis of generalised anxiety disorder, panic disorder, separation anxiety, social phobia or specific phobia were recruited through media advertisement. Participants were randomised to 10 weeks of ICBT with therapist support, or to a waitlist control condition. The primary outcome measure was the Clinician Severity Rating (CSR) and secondary measures included child- and parent-reported anxiety. Assessments were made at pre-treatment, post-treatment and at three-month follow-up.
  
  
  RESULTS
  At post-treatment, there were significant reductions on CSR in the treatment group, with a large between-group effect size (Cohen's d = 1.66). Twenty per cent of children in the treatment group no longer met criteria for their principal diagnosis at post-treatment and at follow-up this number had increased to 50%. Parent-reported child anxiety was significantly lower in the treatment group than in the waitlist group at post-treatment, with a small between-group effect size (Cohen's d = 0.45). There were no significant differences between the groups regarding child-ratings of anxiety at post-treatment. Improvements were maintained at three-month follow-up, although this should be interpreted cautiously due to missing data.
  
  
  CONCLUSIONS
  Within the limitations of this study, results suggest that ICBT with therapist support for children with anxiety disorders can reduce clinician- and parent-rated anxiety symptoms.
  
  
  BACKGROUND
  Clinicaltrials.gov: NCT01533402.
authors.affiliation: Department of Clinical Neuroscience, Centre for Psychiatric Research and Education, Karolinska Institutet, Gävlegatan 22, 113 30 Stockholm, Sweden. Electronic address: sarah.vigerland@ki.se.
authors.forename: Sarah
authors.initials: S
authors.lastname: Vigerland
authors.affiliation: Department of Clinical Neuroscience, Division of Psychology, Karolinska Institutet, Nobels väg 9, 171 77 Stockholm, Sweden. Electronic address: brjann.ljotsson@ki.se.
authors.forename: Brjánn
authors.initials: B
authors.lastname: Ljótsson
authors.affiliation: Department of Clinical Neuroscience, Centre for Psychiatric Research and Education, Karolinska Institutet, Gävlegatan 22, 113 30 Stockholm, Sweden. Electronic address: ulrika.thulin@ki.se.
authors.forename: Ulrika
authors.initials: U
authors.lastname: Thulin
authors.affiliation: Department of Clinical Neuroscience, Division of Psychology, Karolinska Institutet, Nobels väg 9, 171 77 Stockholm, Sweden; Department of Psychology, Stockholm University, 106 91 Stockholm, Sweden. Electronic address: ost@psychology.su.se.
authors.forename: Lars-Göran
authors.initials: LG
authors.lastname: Öst
authors.affiliation: Department of Clinical Neuroscience, Division of Psychology, Karolinska Institutet, Nobels väg 9, 171 77 Stockholm, Sweden; Department of Behavioral Sciences and Learning, Linköping University, 581 83 Linköping, Sweden. Electronic address: gerhard.andersson@liu.se.
authors.forename: Gerhard
authors.initials: G
authors.lastname: Andersson
authors.affiliation: Department of Clinical Neuroscience, Centre for Psychiatric Research and Education, Karolinska Institutet, Gävlegatan 22, 113 30 Stockholm, Sweden. Electronic address: eva.serlachius@ki.se.
authors.forename: Eva
authors.initials: E
authors.lastname: Serlachius
mesh_terms: D001007:Anxiety / Q000628:therapy; D001008:Anxiety Disorders / Q000628:therapy*; D002648:Child; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D005260:Female; D006801:Humans; D020407:Internet; D008297:Male; D016584:Panic Disorder / Q000628:therapy; D011569:Psychiatric Status Rating Scales; D013813:Therapy, Computer-Assisted / Q000379:methods*; D016896:Treatment Outcome
keywords: Anxiety disorders; CBT; Children; Internet-delivered treatment