To support back-to-school mental health, this week’s e-Weekly highlights a school-based pathway from anxiety screening to CBT. A new Lancet Psychiatry trial by Reardon, Creswell, and colleagues tested a school-based pathway for identifying and treating anxiety in children ages 8–9 across 84 primary schools in England. Parents completed a brief anxiety screen. Families of children who screened positive were offered therapist-supported, parent-led CBT using online modules and brief telephone support.
At 12 months, 61% of children who screened positive in the intervention schools no longer met the screening threshold, compared with 38% receiving usual school support. Parent- and teacher-reported benefits continued for some children for up to two years. However, only 27% of eligible families completed the initial screen, and benefits were less clear on child self-report.
Clinical Takeaway: Back-to-school anxiety may appear as stomachaches, sleep difficulties, morning distress, reassurance seeking, perfectionism, school refusal, or subtle avoidance. Screening is most useful when it leads directly to assessment and evidence-based care.
Parent-led CBT can help caregivers validate distress without reinforcing avoidance, gradually reduce reassurance and family accommodation, and support graded practice—such as rehearsing the morning routine, visiting the school, separating briefly from caregivers, contacting classmates, or remaining in class while anxious.
The goal is not to eliminate anxiety before school begins, but to help children participate while learning that anxiety is manageable.