Evidence-Based Treatments for Anxiety in Children

  • Laura Nabors
Part of the Springer Series on Child and Family Studies book series (SSCFS)


This chapter presents information from evidence-based treatments. Critical insights from seminal reviews of treatments in the field are also presented, along with information about techniques that therapists can use in treatment. Techniques include distraction, relaxation, desensitization, and graded exposure. Being a detective and applying several techniques may help some children. Involving parents so that they can practice techniques with the child can be helpful as well. Excerpts from clinical examples are presented to show application of different anxiety management strategies. Using a modular approach, where the clinician moves from successful treatment techniques that may help lessen symptom severity, may be a parsimonious and effective way to apply the evidence base in clinical practice settings.


Coping Cat Evidence-based Multimodal treatment study Parent involvement Graded exposure Relaxation Modular approach Distraction Worry detective 


  1. Caron, C., & Rutter, M. (1991). Comorbidity in child psychopathology: Concepts, issues, and research strategies. Journal of Child Psychology & Psychiatry & Allied Disciplines, 32(7), 1063–1080. Scholar
  2. Chorpita, B. F., Daleiden, E. L., Park, A. L., Ward, A. M., Levy, M. C., Cromley, T., … Krull, J. L. (2017). Child STEPs in California: A cluster randomized effectiveness trial comparing modular treatment with community implemented treatment for youth with anxiety, depression, conduct problems, or traumatic stress. Journal of Consulting and Clinical Psychology, 85(1), 13–25. Scholar
  3. Crawford, A. M., & Manassis, K. (2001). Familial predictors of treatment outcome in childhood anxiety disorders. Journal of the American Academy of Child and Adolescent Psychiatry, 40, 1182–1189. Scholar
  4. Higa-McMillan, C. K., Francis, S. E., Rith-Najarian, L., & Chorpita, B. F. (2016). Evidence-base update: 50 years of research on treatment for child and adolescent anxiety. Journal of Clinical Child and Adolescent Psychology, 45(2), 91–113. Scholar
  5. Hirschfeld-Becker, D. R., Dina, R., Masek, B., Henin, A., Blakely, L. R., Pollock-Wurman, R. A., … Biederman, J. (2010). Cognitive-behavioral therapy for 4- to 7-year-old children with anxiety disorders: A randomized clinical trial. Journal of Consulting and Clinical Psychology, 78(4), 498–510. Scholar
  6. Hoffman, S. G., & Otto, M. W. (2017). Cognitive behavioral therapy for social anxiety disorder: Evidence-based and disorder specific treatment techniques (2nd ed.). New York: Routledge.CrossRefGoogle Scholar
  7. Keeton, C. P., Ginsburg, G. S., Drake, K. L., Sakolsky, D., Kendall, P. C., Birmaher, B., … Walkup, J. T. (2013). Benefits of child-focused anxiety treatments for parents and family functioning. Depression and Anxiety, 30(9), 865–872. Scholar
  8. Kendall, P. C. (2012). Anxiety disorders in youth. In P. C. Kendall (Ed.), Child and adolescent therapy: Cognitive-behavioral procedures (4th ed., pp. 143–189). New York: Guilford Press.Google Scholar
  9. Kendall, P. C., Gosch, E., Furr, J. M., & Sood, E. (2008). Flexibility within fidelity. Journal of the American Academy of Child and Adolescent Psychiatry, 47, 987–993. Scholar
  10. Kendall, P. C., & Hedtke, K. A. (2006a). Cognitive behavioral therapy for anxious children: Therapist manual 3. Ardmore, PA: Workbook Publishing.Google Scholar
  11. Kendall, P. C., & Hedtke, K. A. (2006b). Coping cat workbook 2. Ardmore, PA: Workbook Publishing.Google Scholar
  12. Kendall, P. C., Makover, H., Swan, A., Carper, M. M., Mercado, R., Kagan, E., & Crawford, E. (2016). What steps to take? How to approach concerning anxiety in youth. Clinical Psychology: Science and Practice, 23(3), 211–229. Scholar
  13. Kiff, C. J., Ernestus, S., Gonzalez, A., Kendall, P. C., Albano, A. M., Compton, S. N., … Piacentini, J. (2018). The interplay of familial and individual risk in predicting clinical improvements in pediatric anxiety disorders. Journal of Clinical Child & Adolescent Psychology, 47(S1), S542–S554. Scholar
  14. Lee, P., Zehgeer, A., Ginsburg, G., McCracken, J., Keeton, C., Kendall, P. C., … Compton, S. (2019). Child and adolescent adherence with cognitive behavioral therapy for anxiety: Predictors and associations with outcomes. Journal of Clinical Child & Adolescent Psychology, 48(S1), S215–S226. Scholar
  15. Manassis, K., Lee, T. C., Bennett, K., Zhao, X. Y., Mendlowitz, S., Duda, S., … Wood, J. J. (2014). Types of parental involvement in CBT with anxious youth: A preliminary meta-analysis. Journal of Consulting and Clinical Psychology, 82(6), 1163–1172. Scholar
  16. Nabors, L., Odar Stough, C., Combs, A., & Elkins, J. (2019). Implementing the coping positively with my worries manual: A pilot study. Journal of Child and Family Studies, 28(10), 2708–2717. Scholar
  17. Ollendick, T. H., & King, N. J. (1998). Empirically supported treatments for children with phobic and anxiety disorders: Current status. Journal of Clinical Child Psychology, 27(2), 156–167. Scholar
  18. Ӧst, L.-G., & Ollendick, T. H. (2017). Brief, intensive and concentrated cognitive behavioral treatments for anxiety disorders in children: A systematic review and meta-analysis. Behaviour Research and Therapy, 97, 134–145. Scholar
  19. Park, A. L., Chorpita, B. F., Regan, J., & Weisz, J. R. (2014). Integrity of evidence-based practice: Are providers modifying practice content or practice sequencing? Administration and Policy in Mental Health and Mental Health Services Research, 42(2), 186–196. Scholar
  20. Peterman, J. S., Carper, M. M., & Kendall, P. C. (2019). Testing the habituation-based model of exposures for child and adolescent anxiety. Journal of Child & Adolescent Psychology, 48(S1), S34–S44. Scholar
  21. Piacentini, J., Bennett, S., Compton, S. N., Kendall, P. C., Birmaher, B., Albano, A. M., … Walkup, J. (2014). 24- and 36-week outcomes for the child/adolescent anxiety multimodal study (CAMS). Journal of the American Academy of Child & Adolescent Psychiatry, 53(3), 297–310. Scholar
  22. Primeau, M., Gershon, A., Talbot, L., Cotto, I., Lotspeich, L., Hardan, A., … O’Hara, R. (2016). Individuals with autism spectrum disorders have equal success rate but require longer periods of systematic desensitization than control patients to complete ambulatory polysomnography. Journal of Clinical Sleep Medicine, 12(3), 357–362. Scholar
  23. Santucci, L., & Ehrenreich-May, J. (2013). A randomized controlled trail of the child anxiety multi-day program (CAMP) for separation anxiety disorder. Child Psychiatry and Human Development, 44, 439–451. Scholar
  24. Santucci, L. C., Thomassin, K., Petrovic, L., & Weisz, J. R. (2015). Building evidence-based interventions for the youth, providers, and contexts of real-world mental health care. Child Development Perspectives, 9(2), 67–73. Scholar
  25. Schoenwald, S. K., Kelleher, K., & Weisz, J. (2008). Building bridges to evidence-based practice: The MacArthur Foundation child system and treatment enhancement projects (Child STEPs). Administration and Policy in Mental Health and Mental Health Services Research, 35(1–2), 66–72. Scholar
  26. Silverman, W. K., Kurtines, W. M., Jaccard, J., & Pina, A. A. (2009). Directionality of change in youth anxiety treatment involving parents: An initial examination. Journal of Consulting and Clinical Psychology, 77, 474–485. Scholar
  27. Silverman, W. K., Pina, A. A., & Viswesvaran, C. (2008). Evidence-based psychosocial treatments for phobic and anxiety disorders in children and adolescents. Clinical Child and Adolescent Psychology, 37(1), 105–130. Scholar
  28. Silverman, W. K., & Treffers, P. D. (Eds.). (2001). Anxiety disorders in children and adolescents: Research, assessment and intervention (pp. 313–334). New York, NY: Cambridge University Press.Google Scholar
  29. Spence, S. H., & Rapee, R. M. (2015). The etiology of social anxiety disorder: An evidence-based model. Behaviour Research and Therapy, 86, 50–67. Scholar
  30. Walkup, J., Albano, A. M., Piacentini, J., Birmaher, B., Compton, S. N., Sherrill, J. T., … March, J. S. (2008). Cognitive behavioral therapy, sertraline, and their combination for children and adolescents with anxiety disorders: Acute phase efficacy and safety. New England Journal of Medicine, 359, 2753–2766. Scholar
  31. Weisz, J. R., Chorpita, B. F., Palinkas, L. A., Schoenwald, S. K., Miranda, J., Bearman, S. K., … the Research Network on Youth Mental Health. (2012). Testing standard and modular designs for psychotherapy treating depression, anxiety, and conduct problems in youth: A randomized effectiveness trial. Archives of General Psychiatry, 69, 274–282. Scholar
  32. Weisz, J. R., Sandler, I. N., Durlak, J. A., & Anton, B. S. (2006). A proposal to unite two different worlds of children’s mental health. American Psychologist, 61, 644–645. Scholar
  33. Whiteside, S. P. H., Deacon, B. J., Benito, K., & Stewart, E. (2016). Factors associated with practitioners’ use of exposure therapy for childhood anxiety disorders. Journal of Anxiety Disorders, 40, 29–36. Scholar

Copyright information

© Springer Nature Switzerland AG 2020

Authors and Affiliations

  • Laura Nabors
    • 1
  1. 1.School of Human ServicesUniversity of CincinnatiCincinnatiUSA

Personalised recommendations