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Symposia

Child / Adolescent - Anxiety

Using Research Findings to Extend Treatment’s Effectiveness and Reach: Examples from Pediatric Anxiety & OCD

2 - (SYM 33) The Kids FACE FEARS Pragmatic Randomized Effectiveness Study of Therapist-led versus Guided Online Treatment for Pediatric Anxiety: Overview and Preliminary Outcomes

Saturday, November 22, 2025
10:27 AM - 10:48 AM CST
Location: Strand 9, Level 2
Keywords: Anxiety, OCD (Obsessive Compulsive Disorder), CBT
Recommended Readings: Franklin, M. E., Engelmann, J. M., Bulkes, N. Z., Horvath, G., Piacsek, K., Osterlund, E., Freeman, J. B., Schwartz, R., Himle, M., & Riemann, B. C. (2024). Intensive CBT telehealth for pediatric OCD during the COVID-19 pandemic: Comparison with a matched sample treated in person. Journal of the American Academy of Child & Adolescent Psychiatry Open, 2(1), 26-35.,   Freitag, G. F., Salem, H., Conroy, K., Busto, C., Adrian, M., Borba, C. P. C., . . . Comer, J. S. (2023). The patient-reported outcomes measurement information system (PROMIS) pediatric and parent-proxy short forms for anxiety: Psychometric properties in the kids FACE FEARS sample. Journal of Anxiety Disorders, 94, 1-9. doi:https://doi.org/10.1016/j.janxdis.2023.102677,   Kemp, J., Barker, D., Benito, K., Herren, J., & Freeman, J. (2021). Moderators of psychosocial treatment for pediatric obsessive-compulsive disorder: Summary and recommendations for future directions. Journal of Clinical Child and Adolescent Psychology, 50(4), 478-485. doi:https://doi.org/10.1080/15374416.2020.1790378,   Schwartz, R. A. (2018). Treating incompleteness in obsessive-compulsive disorder: A meta-analytic review. Journal of Obsessive-Compulsive and Related Disorders, 19, 50-60. doi:https://doi.org/10.1016/j.jocrd.2018.08.001,  
Abstract Body

CBT is a “gold standard” psychological treatment for pediatric anxiety, but care barriers limit CBT accessibility, with minoritized youth particularly underserved. Modern CBT formats draw on varying levels of therapist involvement and differential technologies to overcome barriers, but much is unknown about their comparative effectiveness in typical care settings. The Kids Formats of Anxiety Care Effectiveness study For Extending the Acceptability and Reach of Services (Kids FACE FEARS) trial (N=305) is a recently completed multisite, pragmatic randomized trial comparing Therapist-Led CBT (telehealth, office-based, or hybrid) versus Guided Online CBT (with minimal therapist support) for treating youth anxiety. Treatment was offered in English and Spanish to youth ages 7-18 years. Families were enrolled in 4 US regions from high-volume, urban health sites affiliated with major medical centers. Families were randomized and provided treatment for up to 20 weeks. Treatment was integrated into the natural flow of usual care and implemented by routine care providers (i.e., non-research therapists). Major assessments were conducted at baseline, midtreatment, post, and 1-year follow-up. Sample demographics make Kids FACE FEARS one of the larger, more diverse, and more representative trials of CBT for pediatric anxiety (61% female; M age=11.9 years; >70% youth of color, 39% with foreign-born caregivers; 23% experiencing resource insecurity). We will describe this landmark study’s rationale, stakeholder partnerships, sample, design and methodology, and—for the first time at a conference—we will present the main outcomes (currently under embargo). These include comparative effectiveness findings on anxiety severity, responder rates, perceived treatment effectiveness, and treatment satisfaction. Findings will be discussed in terms of their ability to improve treatment efficiency, inform patient-centered decision-making, and help tailor treatment selections for anxious youth.