CBT for Anxiety in Children and Adolescents
Evidence-Based Interventions in School Settings
Anxiety can affect students’ academic engagement, attendance, peer relationships, and daily functioning. Cognitive behavioral therapy (CBT) offers an evidence-based approach to understanding anxiety, reducing avoidance, and developing effective coping skills.
This course examines the core principles of CBT for children and adolescents, with an emphasis on developmentally appropriate adaptations and application within school settings. Participants will explore cognitive and behavioral strategies, exposure-based interventions, case formulation, and progress monitoring to support school-based psychological practice.
- 2.0 CE Hours
- Independent Study
- 4 Lessons
- School-Based Practice
What This Course Covers
The course connects established CBT principles with the practical responsibilities of school psychologists and other professionals supporting children and adolescents. Emphasis is placed on selecting and adapting strategies to the student’s developmental needs, school environment, and individual presentation.
Learning Objectives
After completing this course, participants will be able to:
- Describe common cognitive, physiological, and behavioral features of anxiety in children and adolescents, including patterns of avoidance and reassurance seeking.
- Develop an individualized cognitive behavioral case formulation for a student experiencing anxiety in a school setting.
- Explain how cognitive restructuring and graduated exposure are used to reduce avoidance and build coping.
- Identify developmentally appropriate adaptations to CBT that maintain fidelity to core principles in school settings, including caregiver collaboration.
- Apply CBT principles to a school-based case, including selecting methods to monitor student progress.
Course Lessons
Required Reading
Adapting CBT for Youth Anxiety: Flexibility, Within Fidelity, in Different Settings
Kendall and colleagues (2023). Published in Frontiers in Psychiatry.
This open-access, peer-reviewed article examines the delivery and adaptation of cognitive behavioral therapy across settings, including schools and community environments.
Credit-Hour Determination
This independent-study course is designed to provide 2.0 continuing education hours. Course credit is based on estimated learner completion time calculated using the Mergener formula, taking into account instructional reading, assessment questions, and the difficulty of the instructional material.
The credit-hour documentation is available for review below.
CE Program Information & Disclosures
- Instructional level: Intermediate
- Target audience: Psychologists, school psychologists, and other professionals who work with children, adolescents, families, and schools.
- Format and schedule: Asynchronous, self-paced online home study. No live sessions; complete the course at any time during your access period.
- Access period: 1 year from enrollment.
- Cost and refunds: Full refund within 30 days of purchase if the course has not been started. See our refund policy.
- Instructor / content developer: Jaime Flowers, Ph.D., NCSP, LEP, BCBA
- Conflict of interest: Dr. Flowers is the owner of Child & School Psychology CE and receives revenue from course sales. No other relevant financial or nonfinancial relationships are reported.
- Commercial support: This program receives no commercial support.
- Accessibility: Need an accommodation? See our Accessibility & Accommodations page.
- Questions or complaints: See our CE Complaint & Grievance Procedure.
Limitations and Risks
Limitations of the content. Most efficacy evidence for youth anxiety CBT comes from clinic-based trials with specialist therapists, structured protocols, and diagnosed samples; effects delivered in schools by school staff are often smaller and less durable. Systematic reviews note heterogeneous outcome measures, short follow-up periods, and under-representation of culturally and linguistically diverse youth. Session length, the school calendar, and limited parent involvement can also restrict how fully a protocol is delivered.
Risks. CBT for anxiety disorders should be delivered only by practitioners with appropriate training and supervision; using exposure-based procedures without that competence can increase distress or avoidance. Anxiety symptoms can overlap with or mask trauma, depression, medical conditions, neurodevelopmental differences, or safety concerns, so careful assessment and referral to community or medical providers are needed when presentations are complex or severe. Group or classroom delivery also raises confidentiality concerns that require informed consent and clear limits.
References
Primary reading
- Kendall, P. C., Ney, J. S., Maxwell, C. A., Lehrbach, K. R., Jakubovic, R. J., McKnight, D. S., & Friedman, A. L. (2023). Adapting CBT for youth anxiety: Flexibility, within fidelity, in different settings. Frontiers in Psychiatry, 14, Article 1067047. https://doi.org/10.3389/fpsyt.2023.1067047
Supporting references
- James, A. C., Reardon, T., Soler, A., James, G., & Creswell, C. (2020). Cognitive behavioural therapy for anxiety disorders in children and adolescents. Cochrane Database of Systematic Reviews, 2020(11), Article CD013162. https://doi.org/10.1002/14651858.CD013162.pub2
- Walter, H. J., Bukstein, O. G., Abright, A. R., Keable, H., Ramtekkar, U., Ripperger-Suhler, J., & Rockhill, C. (2020). Clinical practice guideline for the assessment and treatment of children and adolescents with anxiety disorders. Journal of the American Academy of Child & Adolescent Psychiatry, 59(10), 1107β1124. https://doi.org/10.1016/j.jaac.2020.05.005
- Werner-Seidler, A., Perry, Y., Calear, A. L., Newby, J. M., & Christensen, H. (2017). School-based depression and anxiety prevention programs for young people: A systematic review and meta-analysis. Clinical Psychology Review, 51, 30β47. https://doi.org/10.1016/j.cpr.2016.10.005