Feasibility and effects of an integrative cognitive behavioural and mindfulness intervention (I-CBTM) and a feedback-informed treatment (FIT) approach for adolescent anxiety

Cognitive behavioural therapy (CBT) is recognised as a first-line psychotherapeutic treatment for adolescent anxiety. However, many adolescents continue to suffer from the condition even after completing CBT. The current research attempted to enhance the existing treatment through two approaches: (1) the incorporation of mindfulness techniques into the CBT, to offer coping strategy choices, and (2) the inclusion of a feedback-informed treatment (FIT) approach, to enhance adolescent engagement in treatment. In this research, an individual, integrative CBT-mindfulness intervention (I-CBTM) with/without a FIT approach was developed for 12- to 19-year-olds with anxiety, and subsequently implemented and evaluated in natural settings. A pilot-testing and a subsequent larger-scale main trial were conducted to investigate the feasibility of the intervention program alongside the feedback effect. Data were mainly collected from therapists and adolescent participants at pre-, mid- and post-treatment and 3, 6 and 12 months post-treatment; session-by-session symptom tracking was also included. The overall findings showed that the I-CBTM with/without the FIT was acceptable and effective for the adolescents, largely producing early treatment progress and statistically significant, reliable and durable outcomes. The feedback effect was not statistically significant, though a meta-analysis, which was conducted as part of this research, found a small effect size for FIT approaches (Tam & Ronan, 2017). Whilst still in its infancy, the present integrative intervention model for adolescent anxiety offers innovative opportunities for development in practice and research. Future rigorous, in-depth, large-scale trials are required to further refine this model, ultimately offering an effective, appealing and accessible intervention for this population.