Anxiety-focused cognitive-behavioral therapy (CBT) effectively reduces anxiety in children and adolescents. An important remaining question is to what extent anxiety-focused CBT also affects broader outcome domains.
Additionally, it remains unclear whether parental involvement in treatment may have impact on domains other than anxiety. A meta-analysis (n<sub>studies</sub> = 42, n<sub>participants</sub> = 3239) of the effects of CBT and the moderating role of parental involvement was conducted on the following major secondary outcomes: depressive symptoms, externalizing behaviors, general functioning, and social competence.
Randomized controlled trials were included when having a waitlist or active control condition, a youth sample (aged<19) with a primary anxiety disorder diagnosis receiving anxiety-focused CBT and reported secondary outcomes. Controlled effect sizes (Cohen's d) were calculated employing random effect models. CBT had a large effect on general functioning (-1.25[-1.59;0.90], n<sub>studies</sub> = 17), a small to moderate effect on depressive symptoms (-0.31[-0.41;-0.22], n<sub>studies</sub> = 31) and a small effect on externalizing behaviors (-0.23[-0.38;-0.09], n<sub>studies</sub> = 12) from pre-to post-treatment.
Effects remained or even further improved at follow-up. Social competence only improved at follow-up (n<sub>studies</sub> = 6). Concluding, anxiety-focused CBT has a positive effect on broader outcome domains than just anxiety. Higher parental involvement seemed to have beneficial effects at follow-up, with improvements in general functioning and comorbid symptoms.
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