|Benefit-Cost Summary Statistics Per Participant|
|Taxpayers||$3,562||Benefits minus costs||$10,396|
|Participants||$5,769||Benefit to cost ratio||$23.57|
|Others||$1,145||Chance the program will produce|
|Indirect||$381||benefits greater than the costs||95 %|
|Net program cost||($461)|
|Benefits minus cost||$10,396|
|Meta-Analysis of Program Effects|
|Outcomes measured||Treatment age||No. of effect sizes||Treatment N||Adjusted effect sizes(ES) and standard errors(SE) used in the benefit - cost analysis||Unadjusted effect size (random effects model)|
|First time ES is estimated||Second time ES is estimated|
Clinical diagnosis of an anxiety disorder (e.g., general anxiety, panic, social anxiety, obsessive compulsive disorder) or symptoms measured on a validated scale.
Attention-deficit/hyperactivity disorder symptoms
Clinical diagnosis of attention-deficit/hyperactivity disorder (ADHD) or symptoms measured on a validated scale.
Emergency department visits^^
Whether someone visited the emergency department, or the number of times they visited the emergency department.
Externalizing behavior symptoms
Symptoms of externalizing behavior (e.g., aggressive, hostile, or disruptive behavior) measured on a validated scale.
How well individuals (typically those who are developmentally disabled or seriously mentally ill) have adapted to activities of daily living.
Health care costs*^^
Percent change in total medical costs.
Hospital admission, for any reason.
Admission to a psychiatric ward or hospital.
Symptoms of internalizing behavior (e.g., sadness, anxiety, or withdrawal) measured on a validated scale.
Major depressive disorder
Clinical diagnosis of major depression or symptoms measured on a validated scale.
Number or percentage of school days present in a given enrollment period.
Thinking about and/or planning death by suicide.
An attempt to die by suicide resulting in survival.
|10||2||182||0.000||0.115||10||n/a||n/a||n/a||0.000||1.000||Click to expand||Click to collapse|
|Detailed Monetary Benefit Estimates Per Participant|
|Affected outcome:||Resulting benefits:1||Benefits accrue to:|
|Major depressive disorder||Mortality associated with depression||$0||$0||$0||$0||$0|
|Anxiety disorder||Labor market earnings associated with anxiety disorder||$2,339||$5,494||$0||$0||$7,833|
|Externalizing behavior symptoms||Criminal justice system||$59||$0||$140||$29||$228|
|K-12 special education||$158||$0||$0||$79||$238|
|Internalizing symptoms||K-12 grade repetition||$32||$0||$0||$16||$49|
|Health care associated with internalizing symptoms||$973||$275||$1,005||$487||$2,740|
|Program cost||Adjustment for deadweight cost of program||$0||$0||$0||($230)||($230)|
|Detailed Annual Cost Estimates Per Participant|
|Annual cost||Year dollars||Summary|
|Program costs||$1,431||2015||Present value of net program costs (in 2018 dollars)||($461)|
|Comparison costs||$927||2010||Cost range (+ or -)||30 %|
Benefits Minus Costs
Benefits by Perspective
Taxpayer Benefits by Source of Value
|Benefits Minus Costs Over Time (Cumulative Discounted Dollars)|
|The graph above illustrates the estimated cumulative net benefits per-participant for the first fifty years beyond the initial investment in the program. We present these cash flows in discounted dollars. If the dollars are negative (bars below $0 line), the cumulative benefits do not outweigh the cost of the program up to that point in time. The program breaks even when the dollars reach $0. At this point, the total benefits to participants, taxpayers, and others, are equal to the cost of the program. If the dollars are above $0, the benefits of the program exceed the initial investment.|
Albano, A.M., Comer, J.S., Compton, S.N., Piacentini, J., Kendall, P.C., Birmaher, B., . . . Sherrill, J.T. (2018). Secondary outcomes from the child/adolescent anxiety multimodal study: Implications for clinical practice. Evidence-Based Practice in Child and Adolescent Mental Health, 3(1), 30-41.
Arendt, K., Thastum, M., & Hougaard, E. (2016). Efficacy of a Danish version of the Cool Kids program: A randomized wait‐list controlled trial. Acta Psychiatrica Scandinavica, 133(2), 109-121.
Barrett, P.M. (1998). Evaluation of cognitive-behavioral group treatments for childhood anxiety disorders. Journal of Clinical Child Psychology, 27(4), 459-468.
Barrett, P.M., Dadds, M.R., & Rapee, R.M. (1996). Family treatment of childhood anxiety: A controlled trial. Journal of Consulting and Clinical Psychology, 64(2), 333-342.
Bernstein, G.A., Layne, A.E., Egan, E.A., & Tennison, D.M. (2005). School-based interventions for anxious children. Journal of the American Academy of Child & Adolescent Psychiatry, 44(11), 1118-1127.
Chiu, A.W., Langer, D.A., McLeod, B.D., Har, K., Drahota, A., Galla, B.M., . . . Wood, J.J. (2013). Effectiveness of modular CBT for child anxiety in elementary schools. School Psychology Quarterly, 28(2), 141.
Cobham, V.E. (2012). Do anxiety-disordered children need to come into the clinic for efficacious treatment? Journal of Consulting and Clinical Psychology, 80(3), 465.
Conelea, C.A., Selles, R.R., Benito, K.G., Walther, M.M., Machan, J.T., Garcia, A.M., . . . Freeman, J.B. (2017). Secondary outcomes from the pediatric obsessive compulsive disorder treatment study II. Journal of Psychiatric Research, 92, 94-100.
Flannery-Schroeder, E.D., & Kendall, P.C. (2000). Group and individual cognitive-behavioral treatments for youth with anxiety disorders: A randomized clinical trial. Cognitive Therapy and Research, 24(3), 251-278.
Franklin, M.E., Sapyta, J., Freeman, J.B., Khanna, M., Compton, S., Almirall, D., . . . March, J.S. (2011). Cognitive behavior therapy augmentation of pharmacotherapy in pediatric obsessive-compulsive disorder: The Pediatric OCD Treatment Study II (POTS II) randomized controlled trial. JAMA 306(11), 1224-1232.
Gallagher, H.M., Rabian, B.A., & McCloskey, M.S. (2004). A brief group cognitive-behavioral intervention for social phobia in childhood. Journal of Anxiety Disorders, 18(4), 459-479.
Ginsburg, G.S., Becker, K.D., Drazdowski, T.K., & Tein, J.Y. (2012). Treating anxiety disorders in inner city schools: Results from a pilot randomized controlled trial comparing CBT and usual care. Child and Youth Care Forum, 41(1), 1-19.
Ginsburg, G.S., Kendall, P.C., Sakolsky, D., Compton, S.N., Piacentini, J., Albano, A.M., . . . Birmaher, B. (2011). Remission after acute treatment in children and adolescents with anxiety disorders: Findings from the CAMS. Journal of Consulting and Clinical Psychology, 79(6), 806.
Hayward, C., Varady, S., Albano, A.M., Thienemann, M., Henderson, L., & Schatzberg, A.F. (2000). Cognitive-behavioral group therapy for social phobia in female adolescents: Results of a pilot study. Journal of the American Academy of Child and Adolescent Psychiatry, 39(6), 721-726.
Hudson, J.L., Rapee, R.M., Deveney, C., Schniering, C.A., Lyneham, H.J., & Bovopoulos, N. (2009). Cognitive-behavioral treatment versus an active control for children and adolescents with anxiety disorders: A randomized trial. Journal of the American Academy of Child & Adolescent Psychiatry, 48(5), 533-544.
Kendall, P.C., Hudson, J.L., Gosch, E., Flannery-Schroeder, E., & Suveg, C. (2008). Cognitive-behavioral therapy for anxiety disordered youth: A randomized clinical trial evaluating child and family modalities. Journal of Consulting and Clinical Psychology, 76(2), 282-297.
Khanna, M.S., & Kendall, P.C. (2010). Computer-assisted cognitive behavioral therapy for child anxiety: Results of a randomized clinical trial. Journal of Consulting and Clinical Psychology, 78(5), 737-745.
Lau, W.Y., Chan, C.K.Y., Li, J.C.H., & Au, T.K.F. (2010). Effectiveness of group cognitive-behavioral treatment for childhood anxiety in community clinics. Behaviour Research and Therapy, 48(11), 1067-1077.
McNally Keehn, R.H., Lincoln, A.J., Brown, M.Z., & Chavira, D.A. (2013). The Coping Cat program for children with anxiety and autism spectrum disorder: A pilot randomized controlled trial. Journal of Autism and Developmental Disorders, 43(1), 57-67.
Muris, P., Meesters, C., & van Melick, M. (2002). Treatment of childhood anxiety disorders: A preliminary comparison between cognitive-behavioral group therapy and a psychological placebo intervention. Journal of Behavior Therapy and Experimental Psychiatry, 33(3-4), 143-158.
Nauta, M.H., Scholing, A., Emmelkamp, P.M.G., & Minderaa, R.B. (2003). Cognitive-behavioral therapy for children with anxiety disorders in a clinical setting: No additional effect of a cognitive parent training. Journal of the American Academy of Child & Adolescent Psychiatry, 42(11), 1270-1278.
Rapee, R.M., Abbott, M.J., & Lyneham, H.J. (2006). Bibliotherapy for children with anxiety disorders using written materials for parents: A randomized controlled trial. Journal of Consulting and Clinical Psychology, 74(3), 436-444.
Santucci, L.C., & Ehrenreich-May, J. (2013). A randomized controlled trial of the Child Anxiety Multi-Day Program (CAMP) for separation anxiety disorder. Child Psychiatry & Human Development, 44(3), 439-451.
Sevi Tok, E.S., Arkar, H., & Bildik, T. (2016). The effectiveness of cognitive behavioral therapy, medication, or combined treatment for childhood anxiety disorders. Turk Psikiyatri Dergisi, 27(2), 1-8.
Sharma, P., Mehta, M., & Sagar, R. (2017). Efficacy of transdiagnostic cognitive-behavioral group therapy for anxiety disorders and headache in adolescents. Journal of Anxiety Disorders, 46, 78-84.
Shortt, A.L., Barrett, P.M., & Fox, T.L. (2001). Evaluating the FRIENDS program: A cognitive-behavioral group treatment for anxious children and their parents. Journal of Clinical Child Psychology, 30(4), 525-535.
Southam-Gerow, M.A., McLeod, B.D., Weisz, J.R., Chu, B.C., Gordis, E.B., & Connor-Smith, J.K. (2010). Does cognitive behavioral therapy for youth anxiety outperform usual care in community clinics? An initial effectiveness test. Journal of the American Academy of Child & Adolescent Psychiatry, 49(10), 1043-1052.
Spence, S.H., Holmes, J.M., March, S., & Lipp, O.V. (2006). The feasibility and outcome of clinic plus internet delivery of cognitive-behavior therapy for childhood anxiety. Journal of Consulting and Clinical Psychology, 74(3), 614-621.
Storch, E.A., Arnold, E.B., Lewin, A.B., Nadeau, J.M., Jones, A.M., De Nadai, A.S., . . . Murphy, T.K. (2013). The effect of cognitive-behavioral therapy versus treatment as usual for anxiety in children with autism spectrum disorders: A randomized, controlled trial. Journal of the American Academy of Child & Adolescent Psychiatry, 52(2), 132-142.
Storch, E.A., Lewin, A.B., Collier, A.B., Arnold, E., De Nadai, A.S., Dane, B.F., . . . Murphy, T.K. (2015). A randomized controlled trial of cognitive‐behavioral therapy versus treatment as usual for adolescents with autism spectrum disorders and comorbid anxiety. Depression and Anxiety, 32(3), 174-181.
Storch, E.A., Salloum, A., King, M.A., Crawford, E.A., Andel, R., McBride, N.M., & Lewin, A.B. (2015). A randomized controlled trial in community mental health centers of computer‐assisted cognitive behavioral therapy versus treatment as usual for children with anxiety. Depression and Anxiety, 32(11), 843-852.
Suveg, C., Hudson, J.L., Brewer, G., Flannery-Schroeder, E., Gosch, E., & Kendall, P.C. (2009). Cognitive-behavioral therapy for anxiety-disordered youth: Secondary outcomes from a randomized clinical trial evaluating child and family modalities. Journal of Anxiety Disorders, 23(3), 341-349.
Van Steensel, F.J.A., Dirksen, C.D., & Bögels, S.M. (2014). Cost-effectiveness of cognitive-behavioral therapy versus treatment as usual for anxiety disorders in children with autism spectrum disorder. Research in Autism Spectrum Disorders, 8(2), 127-137.
Walkup, J.T., Albano, A.M., Piacentini, J., Birmaher, B., Compton, S.N., Sherrill, J.T., . . . Kendall, P.C. (2008). Cognitive behavioral therapy, sertraline, or a combination in childhood anxiety. The New England Journal of Medicine, 359(26), 2753-2766.
Waters, A.M., Ford, L.A., Wharton, T.A., & Cobham, V.E. (2009). Cognitive-behavioural therapy for young children with anxiety disorders: Comparison of a child + parent condition versus a parent only condition. Behaviour Research and Therapy, 47(8), 654-662.
Wergeland, G.J.H., Fjermestad, K.W., Marin, C.E., Haugland, B.S.M., Bjaastad, J.F., Oeding, K., . . . Heiervang, E.R. (2014). An effectiveness study of individual vs. group cognitive behavioral therapy for anxiety disorders in youth. Behaviour Research and Therapy, 57, 1-12.
Wood, J.J., Ehrenreich-May, J., Alessandri, M., Fujii, C., Renno, P., Laugeson, E., . . . Storch, E.A. (2015). Cognitive behavioral therapy for early adolescents with autism spectrum disorders and clinical anxiety: A randomized, controlled trial. Behavior Therapy, 46(1), 7-19.