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Evaluation ViewAttendees 8

Clinical Round Tables

Child / Adolescent - Anxiety

Clinical Round Table 23 - What to Do When More Worries Ring True: Flexibly Applying CBT Strategies to Address Youth Anxiety in 2025

Sunday, November 23, 2025
12:00 PM - 1:30 PM CST
Location: Foster 1, Level 2
Earn 1.5 Credit
Keywords: Anxiety, Worry, CBT
Recommended Readings: Farley, A. M., Merson, R. A., Sanchez, A. L., & Pincus, D. B. (2024). What to do when worries ring true: How CBT clinicians can address realistic worries when treating youth with anxiety. Evidence-Based Practice in Child and Adolescent Mental Health, 10(1), 4–20. https://doi.org/10.1080/23794925.2024.2378431,   Georgiadis, C., Peris, T. S., & Comer, J. S. (2020). Implementing strategic flexibility in the delivery of youth mental health care: A tailoring framework for thoughtful clinical practice. Evidence-Based Practice in Child and Adolescent Mental Health, 5(3), 215–232. https://doi.org/10.1080/23794925.2020.1796550,   Kendall, P. C. & Frank, H. E. (2018). Implementing evidence-based treatment protocols: Flexibility within fidelity. Clinical Psychology, 25(4), e12271. https://doi.org/10.1111/cpsp.12271,   ,  
Youth anxiety is prevalent (Racine et al., 2021) and associated with numerous adverse outcomes (Essau et al, 2014). Cognitive-behavioral therapy (CBT) is a well-established treatment for youth anxiety disorders (Higa-McMillan et al., 2016). In the research on CBT for youth anxiety, clinicians have typically followed treatment manuals with core interventions including psychoeducation, cognitive restructuring, and exposure (e.g., Coping Cat, Cool Kids). These interventions aim to reduce youths’ anxiety-related distress and avoidance by demonstrating that youth are overestimating risk and/or underestimating their ability to cope in various situations.

However, today’s youth are growing up in especially challenging times. They often present to treatment with fears that are more realistic than those provided in manual examples – that is, their fears align with prior experiences and/or reflect true possibilities of negative outcomes. The widely used manuals do not detail how to address such concerns, leaving many CBT clinicians to struggle with how to support their clients (Farley et al., 2024).

At ABCT 2022, in the context of the COVID-19 pandemic, several panelists on this clinical round table discussed the scope and applications of CBT skills when treating anxious youth with realistic worries. During the intervening years, they substantially augmented and refined their recommendations in line with flexibility within fidelity (Kendall & Frank, 2018) and the Strategic Flexibility Model (Georgiadis et al., 2020) and published them in a peer-reviewed article (Farley et al., 2024). ABCT 2025 is timely for presenting these updates given the multitude of stressors that many individuals are currently facing, especially in our evolving political climate.

This clinical round table aims to help CBT clinicians provide more validating and effective care to a greater proportion of their young clients. Panelists will discuss how to 1) assess and conceptualize anxiety and 2) tailor core CBT strategies when treating anxious youth who are affected by stressors in their families, schools, communities, and world. Panelists will also incorporate recommendations on how to support parents/caregivers who express valid concerns about their anxious child’s well-being.

Learning Objectives:

At the end of this session, the learner will be able to:
  1. Describe how a cultural assessment should be used to inform the conceptualization of youth anxiety.
  2. State at least two self-reflection questions to ask oneself when conceptualizing a youth’s anxiety presentation.
  3. Provide validating psychoeducation about anxiety to youth who are experiencing realistic worries.
  4. Pose at least three appropriate questions to anxious youth or their caregivers to help them reframe reality-based anxious/fearful thoughts.
  5. Develop an exposure hierarchy that would sensitively help a young client confront fears related to a real concern.
  6. Increase sensitivity to contextual factors and life experiences when conceptualizing an anxiety presentation and planning treatment.
  7. Improve ability to tailor CBT for youth anxiety to meet individual clients' needs while still adhering to CBT’s core principles and strategies.