Journal Article

Treatment of child anxiety disorders via guided parent-delivered cognitive–behavioural therapy: Randomised controlled trial

Creswell, Cathy, Thirlwall, Kerstin, Karalus, Jessica, Voysey, Merryn, Willetts, Lucy, Cooper, Peter J.

2013

Overview

Promising evidence has emerged of clinical gains using guided self-help cognitive-behavioural therapy (CBT) for child anxiety and by involving parents in treatment; however, the efficacy of guided parent-delivered CBT has not been systematically evaluated in UK primary and secondary settings. To evaluate the efficacy of low-intensity guided parent-delivered CBT treatments for children with anxiety disorders. A total of 194 children presenting with a current anxiety disorder, whose primary carer did not meet criteria for a current anxiety disorder, were randomly allocated to full guided parent-delivered CBT (four face-to-face and four telephone sessions) or brief guided parent-delivered CBT (two face-to-face and two telephone sessions), or a wait-list control group (trial registration: ISRCTN92977593). Presence and severity of child primary anxiety disorder (Anxiety Disorders Interview Schedule for DSM-IV, child/parent versions), improvement in child presentation of anxiety (Clinical Global Impression - Improvement scale), and change in child anxiety symptoms (Spence Children's Anxiety Scale, child/parent version and Child Anxiety Impact scale, parent version) were assessed at post-treatment and for those in the two active treatment groups, 6 months post-treatment. Full guided parent-delivered CBT produced superior diagnostic outcomes compared with wait-list at post-treatment, whereas brief guided parent-delivered CBT did not: at post-treatment, 25 (50%) of those in the full guided CBT group had recovered from their primary diagnosis, compared with 16 (25%) of those on the wait-list (relative risk (RR) 1.85, 95% CI 1.14-2.99); and in the brief guided CBT group, 18 participants (39%) had recovered from their primary diagnosis post-treatment (RR = 1.56, 95% CI 0.89-2.74). Level of therapist training and experience was unrelated to child outcome. Full guided parent-delivered CBT is an effective and inexpensive first-line treatment for child anxiety.

• Publisher: Cambridge University Press
• Subject: Anxiety / Anxiety disorders / Anxiety Disorders - psychology / Anxiety Disorders - therapy / Behavior modification / Caregivers / Child / Children / Children & youth / Clinical Competence - statistics & numerical data / Clinical trials / Cognition / Cognition & reasoning / Cognitive ability / Cognitive behavioral therapy / Cognitive Behavioral Therapy - education / Cognitive Behavioral Therapy - methods / Cognitive behaviour therapy / Cognitive-behavioral factors / Diagnosis / Disorders / Efficacy / Fear & phobias / Female / Follow-Up Studies / Humans / Intention to Treat Analysis / Intervention / Kinship care / Male / Medical diagnosis / Medical prognosis / Medical treatment / Mental disorders / Mental health / Outcome Assessment, Health Care - statistics & numerical data / Panic attacks / Parent-child relations / Parents / Parents & parenting / Parents - education / Parents - psychology / Professional-Family Relations / Psychiatric Status Rating Scales / Psychiatry / Registration / Risk factors / Self help / Teenagers / Telephones / Therapists / Therapy / Treatment methods / United Kingdom / Waiting Lists