A Comparison of Telehealth and In-Person Therapy for Youth Anxiety Disorders

ABSTRACT

Objective

At the onset of the COVID-19 pandemic, telehealth service use increased. However, little research has compared the efficacy of individual cognitive behavioral therapy (CBT) for youth with anxiety administered via (a) telehealth and (b) in-person. The present study used non-inferiority analyses to examine outcomes for youth with anxiety disorders (diagnosed by an Independent Evaluator; IE) treated via telehealth during the COVID-19 pandemic and youth treated via in-person therapy prior to the COVID-19 pandemic.

Method

Participants (n = 92; M_age = 11.5 years; 60.1% female; 75.0% White) were 46 youth who completed telehealth treatment and 46 youth who completed services in-person, matched on age and principal anxiety diagnosis. One-sided t-tests for non-inferiority were first estimated. Next, ANOVAs and regression models were performed, examining treatment differences and candidate moderators (e.g. social anxiety disorder, comorbid attention problems).

Results

Results support non-inferiority across multiple indices of outcomes (i.e. self- and caregiver-reported anxiety symptoms, IE-rated functional impairment, and IE-rated treatment response). Analyses indicate that both treatments were effective in reducing anxiety symptoms and functional impairment. Caregivers reported higher post-treatment levels of anxiety for youth treated via telehealth than youth treated in person. No variables moderated the differences in outcomes between treatment modalities.

Conclusions

Findings support that CBT administered via telehealth is similarly efficacious as CBT administered in-person for youth with anxiety. Implications regarding the availability and accessibility of evidence-based treatment for youth with anxiety are discussed.

Disclosure Statement

Dr. Rabner, Dr. Norris, and Dr. Olino report no competing interests. Dr. Kendall has received support from NIMH and NICHD. He has received royalties from the sales of materials related to the treatment of anxiety disorders in youth (e.g., Guilford Press; Workbook Publishing; Gyldendal Norsk; Gyldendal Akademisk).

Supplementary Data

Supplemental material for this article can be accessed online at https://doi.org/10.1080/15374416.2024.2372770.

Additional information

Funding

This work was supported by the National Institute of Mental Health [F31MH123038].