ArticleInternet interventions2023
Stepped-care versus therapist-guided, internet-based cognitive behaviour therapy for childhood and adolescent anxiety: A non-inferiority trial.
Article in Internet interventions, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
11 citing papers in PubMed.
- Therapist-guided and self-guided internet-based behavioural activation versus treatment as usual for adolescents with depression: randomised controlled trial with economic evaluation.BMJ mental health · 2026Trial
- Acceptability, Feasibility, and Preliminary Effectiveness of a Mobile App for Teens With or at High Risk for Eating Disorders: A Three-Arm Pilot Randomized Controlled Trial Comparing Self-Help, Guided Self-Help, and Guided Self-Help With a Social Networking Component.The International journal of eating disorders · 2026Trial
- Personalized Transdiagnostic Cognitive Behavior Therapy With Midtreatment Stepped Care to Improve Mental Health Among University Students in Sweden: Feasibility Study for a Randomized Controlled Trial.JMIR formative research · 2026Trial
- Integrating Videoconferencing Therapist Guidance Into Stepped Care Internet-Delivered Cognitive Behavioral Therapy for Child and Adolescent Anxiety: Noninferiority Randomized Controlled Trial.JMIR mental health · 2025Trial
- 10 Years of BRAVE Self-Help Service Delivery for Child and Adolescent Anxiety in Australia: Open Effectiveness-Implementation Trial.Journal of medical Internet research · 2026Article
- Therapists' time allocation in guided digital mental health interventions - A scoping review and case study.Internet interventions · 2026Review
- Latent Profile Analysis Reveals Four Distinct Adolescent Mental Health Patterns for Targeted School Interventions.Child psychiatry and human development · 2026Article
- Who gets included? Equity in digital and decentralised mental health and neurodevelopmental trials: A systematic review.PLOS digital health · 2026Article
- Care Delivery Strategies for Anxiety, Depression, Obsessive Compulsive Disorder, and Tourette Syndrome to Improve Health Outcomes in Children and Youth.Child psychiatry and human development · 2025Review
- Feasibility study of the e-learning version of the "Journey of the Brave:" a universal anxiety-prevention program based on cognitive behavioral therapy.BMC psychiatry · 2024Article
- Editorial for INVENT special issue of the ISRII 2022 meeting.Internet interventions · 2024Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Objective: This preregistered randomized trial examined whether a stepped-care approach to internet-delivered cognitive behaviour therapy (ICBT-SC) is non-inferior to therapist-guided ICBT (ICBT-TG) for child and adolescent anxiety. Method: Participants were 137 Australians, aged 8-17 years (56 male), with a primary anxiety disorder. This randomized, non-inferiority trial compared ICBT-SC to an evidence-based, ICBT-TG program with assessments conducted at baseline, 12 weeks and 9-months after treatment commencement. All ICBT-SC participants completed the first 5 online sessions without therapist guidance. If they responded to treatment in the first 5 sessions (defined as reductions of anxiety symptoms into non-clinical range), they continued without therapist guidance for the final 5 sessions. If they did not respond to treatment in the first 5 sessions, the final five sessions were supplemented with therapist-guidance (through email). All ICBT-TG participants received therapist guidance (email) after each session, for all 10 sessions. Measures included clinical diagnostic interview (severity rating as primary outcome), as well as parent and child reported anxiety and anxiety-related interference (secondary outcomes). Results: ICBT-SC was found to be non-inferior to ICBT-TG on primary and secondary outcomes, according to clinician, parent and young person report at 12-weeks and 9-months. Treatment satisfaction was moderate to high for both conditions. Significant clinical benefits were evident for participants in both treatments. Of participants who remained in the study, 77 % (50.7 % ITT) of ICBT-SC and 77 % (57.1 % ITT) of ICBT-TG were free of their primary anxiety diagnosis by 9-month follow-up, with no differences between conditions. Conclusion: A stepped-care ICBT approach for clinically anxious children and adolescents may offer an acceptable treatment model that can increase access to evidence-based treatment.
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