School-based screening successfully identifies and treats childhood anxiety disorders
A groundbreaking study from Finland’s University of Turku has demonstrated that anxiety disorders in children can be effectively screened through school health services, with digital interventions showing promising results in reducing symptoms. The research, published in the Journal of the American Academy of Child & Adolescent Psychiatry on 4 February 2025, is the first randomised controlled trial globally to examine internet-based cognitive behavioural therapy using population-based screening in school-age children.
Innovative two-stage screening process
Researchers led by Professor Andre Sourander employed a systematic approach to identify children with anxiety disorders through routine school health check-ups. The study screened over 11,000 children aged 10-13 using a two-stage model.
“We found that 80 percent of all children screened at stage two received an anxiety disorder diagnosis. This is a significant result as it shows that children’s anxiety disorder can be screened at a population level,” explains Professor Sourander. “Early identification of anxiety disorders is particularly challenging as some anxiety is normal, and early manifestations of the disorder often go unnoticed by those around the child.”
Concerningly, the research revealed that less than 5% of participants had received medication for anxiety, while under 13% had accessed specialised healthcare in the previous six months, highlighting the prevalence of untreated anxiety conditions among school-age children.
Digital intervention shows significant benefits
The study evaluated the effectiveness of the “Master Your Worries” programme—a 10-week intervention developed at the University of Turku that combines digital materials, exercises and weekly telephone support. From the screened population, 465 children participated in the randomised controlled trial, with some receiving the full intervention while others were provided digital psychoeducational materials as a control measure.
Results showed that children who completed the Master Your Worries programme experienced reduced symptoms across multiple anxiety types, including generalised anxiety, social anxiety and separation anxiety.
“A noteworthy result is that the greatest benefit of the intervention was obtained by children who met the diagnostic criteria for anxiety disorder. A targeted intervention is therefore most effective for children who suffer from severe anxiety,” notes Professor Sourander.
Even minimal intervention shows promise
Interestingly, even the control group, which received only psychoeducational materials, demonstrated significant improvements in anxiety symptoms, daily functioning and quality of life at the six-month follow-up. Parents of these children also reported improvements in their own wellbeing.
Professor Sourander emphasises the implications: “Identifying children’s anxiety symptoms as part of school health care and providing low-threshold psychoeducation can bring great benefits to children with anxiety and their families. The findings are important in planning low-threshold early interventions and in service planning for children with anxiety.”
Addressing a growing mental health challenge
With anxiety disorders affecting an estimated 6-18% of school-age children and adolescents—and previous research from the same centre indicating increasing prevalence, particularly among teenagers—these findings represent a significant advancement in early intervention strategies.
“Anxiety has increased globally among adolescents over the past decade. Early identification and treatment of anxiety is one of the biggest challenges mental health services face today,” says Professor Sourander. “Untreated anxiety in childhood predicts depression, substance abuse, suicidal thoughts, and other psychiatric problems in adulthood. This is why it is important to identify and provide evidence-based treatment for childhood anxiety.”
Reference:
Sourander, A., et al. (2025). Internet-Based Cognitive–Behavioral Therapy Intervention Master Your Worries With Telephone Coaching for Anxious Finnish Children Aged 10-13 Years: A Population-Based Randomized Controlled Trial. Journal of the American Academy of Child & Adolescent Psychiatry. https://doi.org/10.1016/j.jaac.2024.11.024
