Cognitive-Behavioral Therapy for Anxiety in Children Age 7 Years and Younger

Family-based cognitive-behavioral therapy (CBT), where parents learn to implement CBT with children, is the treatment of choice for anxiety disorders in children aged 7 and under, showing similar effect sizes for reduced anxiety symptoms and severity to CBT for older children. Burgeoning research over the past two decades has developed family-based CBT protocols for anxiety disorders, obsessive-compulsive disorder, and posttraumatic stress disorder. In this review, we focus specifically on family-based CBT for child anxiety disorders and symptoms. Fifteen protocols implement this approach for children ages 3 to 7 years, through parent-only sessions, individual parent-child sessions, or group treatment. Most protocols include psycho-education for parents on how to model and selectively reinforce adaptive coping and implementation of graduated exposure to feared situations; some also include psychoeducation and coping skills for children. We describe how these strategies are implemented and propose directions for future research. [ Psychiatr Ann . 2025;55(4):e91–e97.]