“Brave Online” for anxiety

Brave Online is an online CBT program for 3-7-year-olds, 8-12-year-olds and 13-17-year-olds to help children cope with anxiety.

Families can register here: https://brave4you.psy.uq.edu.au/

Created by Professor Sue Spence.

Evidence: Level 1B (randomised control trial)

Cost: Free

Platform: Website

Optimised for mobile: No

Program duration: 10 x 60 minute sessions

From their website: “BRAVE was developed for children and teenagers who experience Separation Anxiety Disorder, Social Phobia, Specific Phobia and Generalised Anxiety Disorder. This online cognitive behavioural therapy (CBT) program helps young people to learn new ways to manage their anxiety and fears. Young people complete one session per week over 10 weeks. It can help with social worries, anxiety about separating from loved ones, fears of specific objects or situations (e.g. dogs, needles, storms, darkness), worries about friendships, school performance or other everyday worries.”

Three standout studies have been performed on Brave Online.

Study 1 – Primary school-aged children

  • Pubmed link – click here
  • N = 73
  • Study type: RCT
  • Sample population: 7-12 year olds with anxiety disorder
  • Comparison: wait-list
  • Recruitment: Referred through parents, teachers, counsellors through school-based advertising
  • Measures:
    • Diagnosis measured by ADIS-C and ADIS-P.
    • Functioning measures by Children’s global assessment scale.
    • Anxiety symptoms measured by Spence anxiety scale, and CBCL for internalising symptoms.
    • Depression symptoms: Centre for Epidemiological Studies for Depression Scale
  • Effect size: Significant effects post-treatment (compared to wait-list) for the online program for all measures (except depression symptoms). The effect was largest for all of these measures 6 months post-treatment (not compared to the waitlist), which was when they stopped following these children up.

Study 2 – Adolescents

  • Pubmed link – click here
  • N = 115
  • Study type: RCT
  • Sample population: 12-18 year olds with anxiety disorder (half of subjects’ parents had a university degree)
  • Comparison: wait-list, clinic-based psychologist appointments administering the BRAVE program
  • Recruitment: Referred by parents, teachers, counsellors, GPs through school-based (and other) advertising.
  • Measures:
    • Diagnosis measured by DSM-IV by phone interview (ADIS C/P).
    • Functioning measures by Children’s global assessment scale.
    • Anxiety symptoms measured by Spence anxiety scale, and CBCL for internalising symptoms.
  • Effect size: Significant effects post treatment (compared to wait-list) for the online program for primary anxiety disorder, equivalent to face-to-face delivery. The number free of primary anxiety diagnosis was largest 12 months post treatment for both clinic based an online therapy (not compared to waitlist) – 68.2% were free of primary anxiety diagnosis at 12 months post treatment (this was when the study stopped following these children up).

Study 3 – Preschoolers

  • Pubmed link – click here
  • N = 52
  • Study type: RCT
  • Sample population: Parents of 3-6 year olds with clinical anxiety disorder
  • Comparison: wait-list
  • Recruitment: Referred by GPs, early childhood educators through media, newsletters and school based (and other) advertising via an online consent form and website.
  • Measures:
    • Diagnosis measured by DSM-IV by phone interview (ADIS P).
    • Functioning measures by Children’s global assessment scale.
    • Anxiety symptoms measured by Preschool anxiety scale, and CBCL for internalising symptoms.
  • Effect size: Significant effects post-treatment (compared to wait-list) for the online program for all of the above measures, with the largest effect, measured 6 months post-treatment (this was when the study stopped following up these families).

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