Piloting a one-day parent-only intervention in the treatment of youth with anxiety disorders: child and family-level outcomes

OBJECTIVE

Parent-only cognitive-behavioural therapy (CBT) interventions have promise for youth with anxiety disorders. Fear-Less Triple P (FLTP) is one such intervention that has been found comparable to child-focused CBT. Although traditionally administered in six sessions, a one-day workshop format of FLTP was developed to improve accessibility. The current study compared the effectiveness of the six-session and one-day workshop formats.

METHOD

Seventy-three youth (mean age, 8.4 years; 74% male) were randomized to traditional FLTP (6-week group) or the one-day workshop format. Anxiety diagnostic status, self- and parent-reported anxiety symptoms scores, independent evaluator-rated improvement, treatment satisfaction, and measures of family functioning were included to assess treatment outcome. Data were collected prior to treatment, and 1-week, 6-months, and 12-months following treatment.

RESULTS

Both conditions resulted in significant improvement in child anxiety symptom scores per parent report (on both questionnaire and diagnostic interview measures). Furthermore, significant decreases in sibling anxiety were observed in both treatment conditions. There were no statistically significant differences between conditions on any outcome measure.

CONCLUSIONS

Results of this study add to the growing evidence that brief, low-intensity, parent-only interventions can effectively target child psychopathology. These brief interventions are ideal for families for whom the resources and time required to commit to a standard multi-week intervention are prohibitive.

REGISTRATION OF CLINICAL TRIALS

This trial was registered with the Australian and New Zealand Clinical Trials Registry (ACTRN 12615001284550).

Bibliotherapy for Specific Phobias of Dogs in Young Children: A Pilot Study

Bibliotherapy, particularly when supplemented with therapist contact, has emerged as an effective treatment for anxiety symptoms in children. However, its effectiveness in treating specific phobias in young children has been explored in only one study which targeted nighttime fears. The current study tested a novel bibliotherapy for fears of dogs in four to seven-year-old children. The therapy was conducted over four weeks and was supplemented with brief, weekly videoconference calls with a therapist. A non-concurrent multiple baseline design was used to evaluate the effectiveness of this treatment in a sample of seven children between four and seven years of age. Significant reductions in specific phobia diagnostic severity, parent and child fear ratings, and child avoidance during a behavioral approach task were all observed. Additionally, treatment adherence, retention, and satisfaction were all high. Future research is needed to replicate the findings in larger, more heterogeneous samples and to explore possible predictive variables; however, this study provides initial support for bibliotherapy as a non-intensive, first-line intervention for specific phobias in young children.

Changes in Anxiety Control Beliefs Following a Brief CBT Treatment and Their Association With Anxiety Symptom Reduction

Anxiety control beliefs (i.e., beliefs regarding one's ability to cope with external, fear-inducing threats and internal reactions to those perceived threats) have been found to negatively predict anxiety symptoms in children and adults and to be modifiable by cognitive-behavioral therapy for anxiety disorders. The current study examines whether changes in anxiety control beliefs were seen following a brief, intensive treatment for specific phobias, and whether those changes were associated with improvements in the targeted phobia and comorbid anxiety disorder symptoms. Participants were 135 children and adolescents (M age = 9.01 years, 49% male) who received one-session treatment (OST) with or without parental involvement for their primary specific phobia. Results indicated that self-reported anxiety control beliefs significantly increased following treatment and that these increases significantly predicted reductions in specific phobia severity and symptoms of comorbid anxiety disorders 6 months and 1 year following treatment. Findings illustrate that involvement in a single 3-hour OST was associated with changes in anxiety control beliefs and demonstrate the potential importance of targeting control beliefs in pediatric anxiety treatment.

Teaching emotion regulation to children with autism spectrum disorder: Outcomes of the Stress and Anger Management Program (STAMP)

Young children with autism spectrum disorder (ASD) struggle with emotion regulation (ER), which is developmentally preceded by lability/negative affect (L/N), and their parents face unique challenges to parenting and providing assistance. The Stress and Anger Management Program (STAMP) is a cognitive-behavioral treatment designed to address ER deficits in young children with ASD through child skill-building and parent training. The current study evaluated child L/N, ER, and parental confidence outcomes in 4- to 7-year-old children with ASD (N = 23; 19 boys) and their parents randomly assigned to a treatment (n = 12) or a waitlist control group (n = 11). Child L/N decreased, regulation was not significantly changed, and parental confidence regarding the child's ability to manage anger and anxiety increased from pre- to posttreatment in the treatment group, but not in the waitlist group. Implications for future interventions that address ER in children with ASD and their parents are discussed.