--- _id: '6938' abstract: - lang: eng text: " Background - \r\n Cognitive behavioral therapy (CBT) is one of the most widely established treatments for mental disorders in children and adolescents and is empirically supported across a wide range of disorders, including evidence from routine care. However, evidence on long-term maintenance of effects in routine outpatient care is still limited, particularly across diagnostic groups. This study examines the long-term, cross-diagnostic effectiveness of CBT in children and adolescents treated under routine outpatient care conditions.\r\n
\r\n Methods - \r\n Analyses are based on pre-existing routine outcome monitoring data from 1225 patients (mean age = 14.00 years, SD = 3.24) receiving CBT, collected between 2017 and 2025. Symptoms were assessed using the parent- and patient-reported Strengths and Difficulties Questionnaire (SDQ) at pre-treatment, post-treatment and at 6-, 12- and 24-month follow-ups. Additional self-rated treatment-success ratings were collected at follow-up (covering expectations fulfilled, perceived helpfulness, problem recurrence and perceived change). Effectiveness was described using group means as well as clinical significance. Pre- to post- and pre- to follow-up changes were analysed using paired Wilcoxon signed-rank tests. Associations between follow-up SDQ scores and self-rated treatment success were examined using partial Spearman correlations controlling for baseline SDQ.\r\n
\r\n Results - \r\n \r\n Across both parent- and patient-reported SDQ assessments, total difficulties and problem subscales showed significant improvements from pre- to post-treatment and from pre-treatment to all follow-up time points. Effect sizes were consistently moderate-to-large\r\n \ (\r\n r_rb = 0.59–0.77), with sustained effects up to 24 months. Higher follow-up SDQ difficulties were associated with lower self-rated treatment success across multiple follow-up ratings, with strongest associations observed for problem recurrence and change compared to before treatment. Sensitivity analyses restricted to participants in the clinical range at baseline (SDQ ≥ 17) yielded consistent results.\r\n \r\n
\r\n Conclusions - \r\n Routine outpatient CBT for children and adolescents was associated with meaningful symptom improvements that persisted up to two years after treatment. Clinically significant change analyses indicated that while many patients showed reliable improvement, a substantial proportion remained classified as unchanged according to conservative criteria. Subjective follow-up ratings were consistent with standardized symptom outcomes, supporting the perceived durability of treatment success under routine care conditions in a diagnostically heterogeneous sample.\r\n " article_number: '663' article_type: original author: - first_name: Matthis Michael full_name: Hüwelmeier, Matthis Michael last_name: Hüwelmeier - first_name: Lena full_name: Staniczek, Lena last_name: Staniczek - first_name: Silvia full_name: Schneider, Silvia last_name: Schneider - first_name: Xiao Chi full_name: Zhang, Xiao Chi last_name: Zhang - first_name: André full_name: Wannemüller, André last_name: Wannemüller - first_name: Gerrit full_name: Hirschfeld, Gerrit id: '234690' last_name: Hirschfeld orcid: 0000-0003-2143-4564 orcid_put_code_url: https://api.orcid.org/v2.0/0000-0003-2143-4564/work/216243758 - first_name: Karen full_name: Krause, Karen last_name: Krause - first_name: Sören full_name: Friedrich, Sören last_name: Friedrich - first_name: Ruth full_name: von Brachel, Ruth last_name: von Brachel citation: alphadin: 'Hüwelmeier, Matthis Michael ; Staniczek, Lena ; Schneider, Silvia ; Zhang, Xiao Chi ; Wannemüller, André ; Hirschfeld, Gerrit ; Krause, Karen ; Friedrich, Sören ; u. a.: Long-term effectiveness of cognitive behavioral therapy (CBT) for children and adolescents in routine care. In: BMC Psychology Bd. 14, Springer Science and Business Media LLC (2026), Nr. 1' ama: Hüwelmeier MM, Staniczek L, Schneider S, et al. Long-term effectiveness of cognitive behavioral therapy (CBT) for children and adolescents in routine care. BMC Psychology. 2026;14(1). doi:10.1186/s40359-026-04667-3 apa: Hüwelmeier, M. M., Staniczek, L., Schneider, S., Zhang, X. C., Wannemüller, A., Hirschfeld, G., … von Brachel, R. (2026). Long-term effectiveness of cognitive behavioral therapy (CBT) for children and adolescents in routine care. BMC Psychology, 14(1). https://doi.org/10.1186/s40359-026-04667-3 bibtex: '@article{Hüwelmeier_Staniczek_Schneider_Zhang_Wannemüller_Hirschfeld_Krause_Friedrich_von Brachel_2026, title={Long-term effectiveness of cognitive behavioral therapy (CBT) for children and adolescents in routine care}, volume={14}, DOI={10.1186/s40359-026-04667-3}, number={1663}, journal={BMC Psychology}, publisher={Springer Science and Business Media LLC}, author={Hüwelmeier, Matthis Michael and Staniczek, Lena and Schneider, Silvia and Zhang, Xiao Chi and Wannemüller, André and Hirschfeld, Gerrit and Krause, Karen and Friedrich, Sören and von Brachel, Ruth}, year={2026} }' chicago: Hüwelmeier, Matthis Michael, Lena Staniczek, Silvia Schneider, Xiao Chi Zhang, André Wannemüller, Gerrit Hirschfeld, Karen Krause, Sören Friedrich, and Ruth von Brachel. “Long-Term Effectiveness of Cognitive Behavioral Therapy (CBT) for Children and Adolescents in Routine Care.” BMC Psychology 14, no. 1 (2026). https://doi.org/10.1186/s40359-026-04667-3. ieee: M. M. Hüwelmeier et al., “Long-term effectiveness of cognitive behavioral therapy (CBT) for children and adolescents in routine care,” BMC Psychology, vol. 14, no. 1, 2026. mla: Hüwelmeier, Matthis Michael, et al. “Long-Term Effectiveness of Cognitive Behavioral Therapy (CBT) for Children and Adolescents in Routine Care.” BMC Psychology, vol. 14, no. 1, 663, Springer Science and Business Media LLC, 2026, doi:10.1186/s40359-026-04667-3. short: M.M. Hüwelmeier, L. Staniczek, S. Schneider, X.C. Zhang, A. Wannemüller, G. Hirschfeld, K. Krause, S. Friedrich, R. von Brachel, BMC Psychology 14 (2026). date_created: 2026-05-30T20:46:26Z date_updated: 2026-05-30T20:46:38Z department: - _id: 4b2dc5c9-bee3-11eb-b75f-ecc80f94fb21 doi: 10.1186/s40359-026-04667-3 intvolume: ' 14' issue: '1' language: - iso: eng main_file_link: - open_access: '1' oa: '1' publication: BMC Psychology publication_identifier: eissn: - 2050-7283 publication_status: published publisher: Springer Science and Business Media LLC quality_controlled: '1' status: public title: Long-term effectiveness of cognitive behavioral therapy (CBT) for children and adolescents in routine care tmp: image: /images/cc_by.png legal_code_url: https://creativecommons.org/licenses/by/4.0/legalcode name: Creative Commons Attribution 4.0 International Public License (CC-BY 4.0) short: CC BY (4.0) type: journal_article user_id: '234690' volume: 14 year: '2026' ...