Brief Internet-Delivered Cognitive-Behavioral Intervention for Children and Adolescents With Emotional Symptoms in Brazil: A Randomized Clinical Trial.
Emotional symptoms impose a significant burden on children and adolescents, particularly in low- and middle-income countries, where treatment options are limited. Addressing this gap, we developed and assessed a brief cognitive-behavioral internet-delivered intervention targeting anxiety and depress...
| Published in: | Journal of Adolescent Health Vol. 77; no. 3; pp. 472 - 484 |
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| Main Authors: | , , , , , , , |
| Format: | research randomized controlled trial Journal Article |
| Published: |
Elsevier B.V.
Sep2025
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| Online Access: | View this record in EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=187702316&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 187702316 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 1054139X ILK jtl: Journal of Adolescent Health issn: 1054139X maglogo: N pubinfo: dt: Sep2025 vid: 77 iid: 3 pid: 467 pub: Elsevier B.V. place: New York, New York artinfo: ui: 187702316 187702316 187702316 10.1016/j.jadohealth.2025.01.021 187702316 ppf: 472 ppct: 12 formats: tig: atl: Brief Internet-Delivered Cognitive-Behavioral Intervention for Children and Adolescents With Emotional Symptoms in Brazil: A Randomized Clinical Trial. aug: au: Casella, Caio Borba Farhat, Luis Carlos Labbadia, Eunice Monteiro Zuccolo, Pedro Fonseca Fatori, Daniel Argeu, Adriana Salum, Giovanni Abrahão Polanczyk, Guilherme V. affil: Division of Child and Adolescent Psychiatry, Department of Psychiatry, Faculdade de Medicina FMUSP, Universidade de São Paulo, São Paulo, São Paulo, Brazil sug: subj: Anxiety Therapy Depression Therapy Cognitive Therapy Methods Cognitive Therapy Methods Internet-Based Intervention Methods Treatment Outcomes Human Child Adolescence Brazil Randomized Controlled Trials Random Assignment Videoconferencing Psychoeducation Caregivers Emotions Confidence Intervals Parents Descriptive Statistics Scales Child: 6-12 years Adolescent: 13-18 years ab: Emotional symptoms impose a significant burden on children and adolescents, particularly in low- and middle-income countries, where treatment options are limited. Addressing this gap, we developed and assessed a brief cognitive-behavioral internet-delivered intervention targeting anxiety and depression symptoms in Brazilian youth. We conducted a single-blind, two-arm, parallel-group, randomized controlled trial in youth aged 8–17 with a total T-score ≥70 on the 25-item version of the Revised Children's Anxiety and Depression Scale, parent (RCADS-P) and child report (RCADS-C). Participants were randomly assigned (1:1) to cognitive-behavioral intervention (5 weekly sessions conducted by videoconference focused on skills training) or psychoeducation. Sessions were conducted with youth and their caregivers jointly. Participants were assessed at baseline, at post-treatment and at the 30-day follow-up. The primary outcome was the change from baseline to post-treatment on RCADS-P and RCADS-C scores. This trial is registered with ClinicalTrials.gov , NCT05139433. Between October 15, 2021, and February 27, 2023, 280 participants were randomized, with 231 completing post-treatment and 214 completing follow-up assessments. In comparison to participants in the psychoeducation group, participants in the intervention group showed greater reductions in emotional symptoms according to youths (mean difference = 4.3, p =.013, standardized mean difference (SMD) = 0.25 [95% confidence interval (CI) 0.05–0.44]) and parents (mean difference = 3.6, p =.023, SMD =.21 [95% CI 0.03–0.40]), as well as in anxiety scores according to youths (mean difference = 4.4, p =.0043, SMD = 0.28 [95% CI 0.09–0.47]) and parents (mean difference = 3.2, p =.030, SMD = 0.21 [95% CI 0.02–0.40]). There were no significant differences in depression scores at post-treatment according to youth (mean difference = 2.9, p =.063, SMD = 0.19 [95% CI −0.01 to 0.39]) or parents (mean difference = 2.2, p =.15, SMD = 0.15 [95% CI −0.05 to 0.33]), but effects emerged at the 30-day follow-up. No serious adverse events were reported. The cognitive-behavioral intervention was effective in reducing emotional symptoms in children and adolescents in Brazil. This intervention holds promise for enhancing access to mental health care within a stepped-care model in public health contexts. pubtype: Academic Journal doctype: research randomized controlled trial Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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