Does Videoconferencing-Based Cognitive Behavioral Therapy for Anxious Youth Work? A Systematic Review of the Literature

Opinion statement While videoconferencing has become a common tool for remote communication in health-related services such as psychotherapy, scientific evidence for its outcomes is scarce in the population of youth with problematic anxiety. This paper reviews the primary and secondary outcomes of cognitive behavioral therapies (CBT) delivered via videoconferencing for youth with subclinical or clinical anxiety. Quantitative and qualitative studies focusing on youth (aged 7 to 20), anxiety, CBT, and videoconferencing were systematically searched on Embase, PubMed, PsycINFO, and ERIC databases. Eight studies met the inclusion criteria, of which seven were extracted for quantitative data. Out of the seven studies, only one study was quasi-experimental with an in-person CBT comparison group, while another study was a small-scaled randomized controlled trial with a waitlist control group. The pooled sample size was 213 children and adolescents. Significant changes in primary (i.e., anxiety symptoms and severity) and secondary outcome measures (e.g., global functioning and life interference) at post-treatment of videoconferencing-based CBT were reported, but lacking a control group in a majority of the studies reduces the finding’s validity. Satisfaction, treatment completion rate, and therapist’s fidelity were rarely reported but found to be high in some studies. None of the studies reported negative effects specific to videoconferencing-based CBT. The current evidence for this topic is somewhat limited in terms of quantity and quality. Replication studies in low- and middle-income countries are also lacking. More well-designed trials are needed to provide more conclusive evidence for the videoconferencing modality, which may help scale up psychological interventions for a highly prevalent problem such as youth anxiety in remote or low-income areas.