The BRAVE Program (Brave Self-Help)
The BRAVE Program is an interactive, online program for the prevention and treatment of childhood and adolescent anxiety. With the support of beyondblue, this program has recently been converted into an online self-help program that is freely available to people living in Australia. There are four available versions, one tailored to children (7 to 12 years), one for teenagers (12 to 17 years), and one for parents of each of these age groups. Young people and their parents can complete the program together or independently. Most participants say that each session takes between 20 to 60 minutes to complete. Participants can complete as little or as much of the program as they wish. BRAVE focuses on developing skills to manage anxiety. These skills encompass recognising physiological signs of anxiety, relaxation strategies, cognitive training including self-talk and restructuring, exposure, problem-solving, and empowerment. The parent sessions aim to help parents to better assist their children in managing their anxiety through psychoeducation and instruction on management techniques. Each session provides reading material and exercises that encourage children and their parents to practice these skills in the real world. There is an 'explore' option for practitioners, or people interested in viewing the program before registering, whereby they can trial each program for 20 minutes. Automated feedback has been built into the self-help program as the site is not monitored by a live professional.
- Service URL:
- Agency Responsible:
- The University of Queensland, Griffith University, and the University of Southern Queensland.
- Intervention Type:
- Psychological – CBT.
- Course Length:
- Long (more than 5 modules). Long (more than 5 modules). 10 sessions for children and teenagers, 6 sessions for parents of children and 5 sessions for parents of teens. Both programs also incorporate 2 additional booster sessions for youth and parents.
- Support Option:
- No support. This is a self-directed program. This program is not monitored by a live professional.
- Primary Category:
- Generalised anxiety disorder. Also targets social anxiety, phobias, separation anxiety disorder
- Secondary Categories:
- Social anxiety and Phobias.
- Target Audiences:
- Child and Adolescent.
- Open: With registration. This program is available to all children and adolescents (aged 7-17 years old), and their parents, living in Australia.
- Contact Details:
- Research Trials:
- Research RCTs:
- Outcome Summary:
The efficacy of a therapist - assisted version of online BRAVE Program has been tested in six randomised controlled trials. This includes 2 RCTs of the online BRAVE Program for Teenagers, 2 RCTs of the online BRAVE Program for Children, 1 RCT of the online BRAVE Program for use by parents of 3-6 year-olds and 1 RCT for children 8 - 12 years old with high functioning autism spectrum disorder (HFASD). No trials have been conducted on the currently available self-help version of online BRAVE program, which although has the same content as the earlier version, is no longer supported by a live therapist. The studies included participants with a variety of anxiety diagnoses, but did not provide results based on specific diagnoses, instead reporting on number of diagnoses, loss of primary diagnosis and severity of anxiety symptoms.
In a study of 52 pre-school aged children there were no significant differences in the proportion of children with their primary anxiety diagnosis or any anxiety diagnosis at post-test. However, children in the online BRAVE intervention showed significantly lower levels of clinical severity, greater reductions in preschool anxiety symptoms and internalising behaviour, as well as improved overall functioning at post-test. The improvements for the online BRAVE intervention were maintained at a 6 month follow-up. Furthermore, the number of children who were free of their anxiety diagnosis increased significantly from 39.1% immediately following treatment, to 70.6% at 3-month follow-up.
In a study of 115 adolescents aged 12-18 years significant reductions in anxiety diagnoses and anxiety symptoms were observed compared to wait-list controls. These improvements were evident at 12 weeks post-baseline and were maintained at 6- and 12-month follow-ups.
In a study of 125 youth aged 8-17 years, significant reduction in anxiety diagnoses was observed in the retained sample but not in the intent-to-treat sample at 12 week post-baseline. Severity of anxiety symptoms decreased significantly compared to the wait-list control at 12 week post-baseline and were maintained at 6-month follow-up. Furthermore, there were no significant differences in terms of loss of anxiety diagnosis or reduction in anxiety symptoms compared to a face-to-face CBT treatment comparison group, suggesting that the BRAVE program was equally efficacious as traditional therapy.
A study of 73 children aged 7-12 years found significant improvements in clinical ratings of severity and global assessments of functioning at post-test. Further, the percentage of children not meeting criteria for their primary anxiety disorders had increased from 30% post-test to 75% at 6 months. Another study of 72 children aged 7 to 14 years with an anxiety disorder found similar results, and no significant difference between the supervised online program and the same intervention delivered in a clinical setting.
One RCT looked at the effectiveness of BRAVE-ONLINE for 42 children aged 8 - 12 with comorbid HFASD and anxiety compared to waitlist controls. 20% and 38% of the intervention group were free of primary anxiety diagnosis at completion and 3 month follow up respectively, which was not significantly greater than the control group. There was, however a significant reduction in symptoms of anxiety as reported by the child and by a parent with effect sizes d > 1.0.
There is good evidence that the online BRAVE Program for children, teenagers and their parents (with therapist support) is effective in anxiety symptom reduction for children and adolescents. The BRAVE program also shows promise for the reduction of anxiety symptoms in preschool aged children and children with HFASD. Further trials of the self-help version of the online BRAVE Program are required to establish its effectiveness in absence of therapist support.
- Recommended rating, reviewer 1:
- Recommended rating, reviewer 2:
Read more about Beacon's Smiley Rating System.
Research paper citations
(1) Donovan, C. L., & March, S. (2014). Online CBT for preschool anxiety disorders: A randomised control trial. Behaviour Research and Therapy, 58, 24-35.
(2) Spence, S. H., Donovan, C. L., March, S., Gamble, A., Anderson, R. E., Prosser, S., & Kenardy, J. (2011). A randomized controlled trial of online versus clinic-based CBT for adolescent anxiety. Journal of Consulting and Clinical Psychology, 79, 629-642.
(3) March, S., Spence, S. H., & Donovan, C. L. (2008). The efficacy of an internet-based cognitive-behavioral therapy intervention for child anxiety disorders. Journal of Pediatric Psychology, 34, 474-487.
(4) 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, 614-621.
(5) Conaughton, R. J., Donovan, C. L., & March, S. (2017). Efficacy of an internet-based CBT program for children with comorbid High Functioning Autism Spectrum Disorder and anxiety: A randomised controlled trial. Journal of Affective Disorders, 218, 260-268.
(6) Spence, S. H., Donovan, C. L., March, S., Kenardy, J. A., & Hearn, C. S. (2017). Generic versus disorder specific cognitive behavior therapy for social anxiety disorder in youth: A randomized controlled trial using internet delivery. Behaviour research and therapy, 90, 41-57.
User ratings and comments are moderated in order to assure the quality of the submissions. It might take a week for your rating to show up.
Login to rate this service.
Other user ratings
No ratings for this service yet.
Last Updated: July 5th 2018