Brief Behavioral Therapy For Anxiety And Depression In Youth: Therapist Guide
The Brief Behavioral Therapy for Anxiety and Depression in Youth guide comes in two volumes. This page is for the Therapist Guide. Click here to access the Client Workbook.
The Brief Behavioral Therapy for Anxiety and Depression in Youth guide is a streamlined, transdiagnostic intervention designed to address the most common internalizing disorders in youth: anxiety and depression. This evidence-based program focuses on shared mechanisms underlying these conditions, such as avoidance, withdrawal, and negative affectivity, providing a unified framework that simplifies treatment for both therapists and families. By integrating core behavioral strategies such as graded engagement (which combines elements of exposure therapy and behavioral activation), Brief Behavioral Therapy (BBT) promotes approach behaviors and helps young people regain functional engagement with their lives. Supplementary techniques, including stress management and problem-solving, further enhance its adaptability. BBT is particularly effective in pediatric settings, where it can address mental health needs often signaled by somatic complaints. It has demonstrated significant success in improving outcomes for underserved populations, including racial and ethnic minority youth. Part of the Treatments That Work™ series, this guide offers clear, practical instructions for implementing the intervention, making it an essential resource for clinicians seeking to provide accessible, scalable, and impactful care for children and adolescents with internalizing disorders.
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Introduction & Theoretical Background
Internalizing problems – encompassing feelings of sadness, worry, irritability, and fear – are among the most prevalent psychiatric concerns throughout people’s lives. In youth, nearly one in three children experiences clinically significant anxiety, and one in four undergoes a depressive episode before reaching puberty (Merikangas et al., 2010). Left untreated, these issues can lead to a range of long-term consequences, including chronic depression, poor physical health, academic difficulties, substance abuse, and increased mortality from suicide (Bittner et al., 2007; Fergusson & Woodward, 2002; Pine et al., 1998). Moreover, anxiety and depression often co-occur, with up to 70% of treatment-seeking youth presenting with both disorders, leading to worsened outcomes (Garber & Weersing, 2010).
Despite the high prevalence and significant impact of these issues, internalizing disorders in youth remain underserved in mental health systems and historically underrepresented in clinical research. The child and adolescent anxiety and mood program (ChAAMP) sought to address
Therapist Guidance
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References And Further Reading
- Anderson, P., Toner, P., Bland, M., & McMillan, D. (2016). Effectiveness of transdiagnostic cognitive behaviour therapy for anxiety and depression in adults: A systematic review and meta-analysis. Behavioural and Cognitive Psychotherapy, 44(6), 673–690.
- Bittner, A., Egger, H. L., Erkanli, A., Jane Costello, E., Foley, D. L., & Angold, A. (2007). What do childhood anxiety disorders predict? Journal of Child Psychology and Psychiatry, 48(12), 1174–1183.
- Brent, D. A., Porta, G., Rozenman, M. S., Gonzalez, A., Schwartz, K. T., Lynch, F. L., … Weersing, V. R. (2020). Brief behavioral therapy for pediatric anxiety and depression in primary care: A follow-up. Journal of the American Academy of Child and Adolescent Psychiatry, 59, 856–867.
- Chu, B. C., Crocco, S. T., Esseling, P., Areizaga, M. J., Lindner, A. M., & Skriner, L. C. (2016). Transdiagnostic group behavioral activation and exposure therapy for youth anxiety and depression: Initial randomized controlled trial. Behaviour Research and Therapy,