Parent- and Teacher-Rated Effectiveness of Cognitive-Behavioral Therapy for Children and Adolescents Under Usual Care Conditions in a University Outpatient Clinic

  • Daniel WalterEmail author
  • Lydia Dachs
  • Johanna Farwick zum Hagen
  • Hildegard Goletz
  • Anja Goertz-Dorten
  • Claudia Kinnen
  • Christiane Rademacher
  • Stephanie Schuermann
  • Paula Viefhaus
  • Tanja Wolff Metternich-Kaizman
  • Manfred Doepfner
Original Article


Compared to randomized controlled trials, studies examining the effectiveness of cognitive behavioral therapy (CBT) in children and adolescents with mental disorders are rare, and a teacher perspective is scarce. The present study investigated the effectiveness of routine CBT in 519 patients aged 6–18 years with mental disorders. Changes in mental health problems were assessed in teacher (Teacher Report Form, TRF) and parent rating (Child Behavior Checklist, CBCL) and were analyzed within the total sample, yielding statistically significant, small to medium effect sizes (teacher rating: d = .74–2.39; parent rating: d = .65–1.18). Changes in a subgroup of patients with elevated symptom scores at treatment start were compared to a historical control group receiving weekly academic tutoring. Net total score effect sizes lay between d = 0.98 and d = 1.29 for teacher rating (parent rating: d = 0.84 to d = 1.01). Nevertheless, a substantial number of patients remained in the clinical range. Symptom changes during family- and patient-based CBT interventions did not differ from treatments including additional school-based interventions, as was also the case for the comparison of treatments with and without additional pharmacotherapy.


Routine treatment Child and adolescent psychotherapy Cognitive-behavioral therapy Outpatient clinic Teacher rating 


Compliance with Ethical Standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical Approval

This study was approved by the ethics committee of the University of Cologne.

Informed Consent

All participants gave informed consent prior to their inclusion in the study.

Supplementary material

10578_2018_860_MOESM1_ESM.docx (34 kb)
Supplementary material 1 (DOCX 33 KB)


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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  • Daniel Walter
    • 1
    • 2
    Email author
  • Lydia Dachs
    • 2
  • Johanna Farwick zum Hagen
    • 2
  • Hildegard Goletz
    • 2
  • Anja Goertz-Dorten
    • 2
  • Claudia Kinnen
    • 2
  • Christiane Rademacher
    • 1
  • Stephanie Schuermann
    • 1
  • Paula Viefhaus
    • 2
  • Tanja Wolff Metternich-Kaizman
    • 1
  • Manfred Doepfner
    • 1
    • 2
  1. 1.Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Medical FacultyUniversity of CologneCologneGermany
  2. 2.School of Child and Adolescent Cognitive Behavior Therapy (AKiP) at the University Hospital CologneCologneGermany

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