Background <p>Mental health issues in children, particularly anxiety, are a major global concern, with the prevalence of these disorders in Czechia mirroring global trends. While parent-led cognitive-behavioral therapy (CBT) has shown promise in addressing anxiety with benefits like reduced therapist involvement, cost-effectiveness, and long-term sustainability, such programs are scarce in Czechia.</p> Methods <p>This study aimed to adapt a Parent-led CBT program from the University of Oxford for the Czech context using complementary frameworks and guides for the process of adaptation to ensure its feasibility, acceptability, and sustainability. Using mixed-methods methodology, we adapted and piloted a parent-led CBT intervention for children with anxiety in Czechia. Adaptations were guided by ADAPT, ToC, CFIR, and TIDieR frameworks to ensure relevant local adaptations. A formative phase included three workshops and 50 semi-structured interviews with key stakeholders to identify barriers, facilitators, and implementation context and needs. Feasibility piloting involved 12 parents, with quantitative outcomes collected via standardized measures and qualitative feedback from interviews and a focus group discussion (FGD) thematically analyzed to inform further implementation adaptations.</p> Results <p>The adapted intervention is described having been piloted with Czech parents, yielding promising results: significant reductions in child anxiety, high attendance rates, and positive feedback.&#xa0;This study demonstrated the feasibility and acceptability of the adapted parent-led CBT program for children with anxieties in Czechia.</p> Conclusions <p>Guided by ToC and CFIR, adaptations balanced the evidence-based original intervention with culturally and contextually important adaptations to increase future implementation success. Further research should assess effectiveness and implementation fidelity to inform sustainable uptake and integration in the Czech mental health system.</p>