The follow-up of a randomized controlled trial shows that the internet-based Master Your Worries intervention programme for treating children’s anxiety has a long-term effect on the participants. Anxiety symptoms continued to reduce after two years and the impact of the therapy was clearly greater at that point than at six months. The results are internationally significant as this is the first randomised controlled trial to prove the long-term efficacy of internet-based cognitive behavioural therapy for children, even two years after the intervention.
A new follow-up study examined the efficacy of the Master Your Worries programme developed by the Research Centre for Child Psychiatry at the University of Turku in Finland, which involved 465 Finnish children aged 10–13 years showing symptoms of anxiety. The children were screened at the annual health check-ups at school. No similar study, conducted as a population-based screening programme, on the identification of anxiety in children and remote care has been published previously.
In the study, the children experiencing anxiety symptoms were randomized either to the Master Your Worries programme or to the control group that received digital materials on anxiety, well-being, and healthy lifestyle. Symptoms of anxiety decreased in children in both groups during the follow-up period. However, the symptoms of children who took part in the Master Your Worries programme decreased significantly more, while their functional ability also improved to a greater extent. Furthermore, the study found that the positive effects of the therapy were greatest among children with more severe symptoms.
“The difference was evident in both the children’s own assessments and their parents’ assessments at the one-year and two-year follow-ups. It was particularly interesting to note that the effects of the therapy continued to strengthen between six and twelve months, even though the actual treatment period had already ended,” says Doctoral Researcher Katri Kaajalaakso from the University of Turku.
According to the researchers, the results point to what is known as a delayed treatment effect.
“The ways of thinking and behaving learnt through cognitive behavioural therapy can gradually become part of the child’s and the whole family’s everyday life. Therefore, the positive effects of the treatment may continue to strengthen long after the actual therapy has ended,” says principal investigator, Professor Andre Sourander.
Early and accessible forms of treatment are needed for anxiety in children and adolescents
It is estimated that 6–18 percent of school-age children and adolescents suffer from an anxiety disorder, and anxiety among young people in particular has increased globally over the last decade. At the same time, there is a shortage of professionals in children’s mental health services, which means that the vast majority of children are not receiving proven effective treatment.
Master Your Worries is a ten-week online intervention programme developed entirely in Finland, in which both the child and the parent actively participate in the therapy. The child works through the online content with the support of their parent, while the parents have their own set of online resources, and the family receives weekly telephone guidance throughout the programme. The study found that the programme also supported parents’ well-being and provided them with tools to help their child in everyday life.
The results of the study support the view that children’s anxiety symptoms should be identified as early as possible, for example, through school health services or primary health care. According to the researchers, the Master Your Worries programme could, in the future, complement existing services and offer an effective treatment option, particularly for children who have been diagnosed with an anxiety disorder or who exhibit significant anxiety symptoms.
“Master Your Worries is one of the most effective digital programmes for treating anxiety on an international level. Guided, digital-based treatment offers the opportunity to reach children and families at an early stage, regardless of where they live. As anxiety in childhood is common and is linked to, among other things, problems at school, physical symptoms, later depression and self-harming behaviour, there is a great need for effective and easily accessible forms of treatment,” Professor Sourander emphasises.