Research shows it truly takes a village to treat childhood anxiety and depression

A new study from Murdoch University has found that treating childhood depression and anxiety is significantly more effective when parents and caregivers are engaged directly in the therapeutic process.

Since the onset of the COVID-19 pandemic, clinically elevated anxiety and depression symptoms in children have surged worldwide, leaving many parents feeling helpless. The study, led by Dr Kim Lee Kho, demonstrates that family-based interventions — particularly the Behaviour Exchange and Systems Therapy – Foundations (BEST-F)model — are instrumental in helping children reduce the internalisation of distress.

Parents play a pivotal role in reducing internalised symptoms

BEST-F, developed collaboratively in Melbourne and Perth by a team including Professor Andrew Lewis, focuses on strengthening the parent–child relationship as the cornerstone of treatment for children aged 3–11.

“Children mirror the emotional cues of their caregivers. When they see parents engaging with a therapist openly and honestly, it gives them permission to do the same,” said Dr Kho.

The study revealed strong evidence that children whose families participated in BEST-F sessions showed a marked reduction in internalised symptoms, such as withdrawal, sadness or suppressed anxiety and improved emotional expression.

Improved communication and family cohesion

According to co-author Dr Renita Almeida, the family’s role in children’s emotional development is critical.

“We know children exist within multiple systems, but the family system is foundational,” Dr Almeida said. “Research confirms that caregiving environments influence the development and transmission of anxiety and depression but also that families hold immense potential for healing and growth.”

Participants in the study described lasting improvements in communication and emotional closeness.

“I felt heard and seen by you [therapist] when we talked about what I’ve experienced in the past. I felt safe, and that changed everything for me and my family could tell the difference too,” said one parent.

A child participant added: “I feel it’s safe talking about it here… now I can tell Mum when I’m upset if something happens at school or with Dad.”

Whole-system therapy shows lasting change

The research found that engaging the whole family system led to long-term, compounding benefits. Follow-up evaluations showed ongoing improvements in family functioning, parent wellbeing and children’s emotional health.

“BEST-F creates ripples,” said Dr Almeida. “The improvements don’t just stop with the child. They radiate outward into parental wellbeing and the broader family dynamic.”

Dr Kho said these findings could reshape future treatment approaches for childhood anxiety and depression.

“With these promising results, we hope to see a larger clinical trial and a pathway to offer BEST-F more widely in community settings,” she said.

About the Research

This study is part of a growing body of work that emphasises relational and systems-based approaches in child mental health interventions.

Read the full study here.