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...

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Published in:Journal of Adolescent Health Vol. 77; no. 3; pp. 472 - 484
Main Authors: Casella, Caio Borba, Farhat, Luis Carlos, Labbadia, Eunice Monteiro, Zuccolo, Pedro Fonseca, Fatori, Daniel, Argeu, Adriana, Salum, Giovanni Abrahão, Polanczyk, Guilherme V.
Format: research randomized controlled trial Journal Article
Published: Elsevier B.V. Sep2025
Online Access:View this record in EBSCOhost
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      dt: Sep2025
      vid: 77
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      pub: Elsevier B.V.
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        10.1016/j.jadohealth.2025.01.021
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        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
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