Guided parent‐delivered cognitive behaviour therapy for children with anxiety disorders: Outcomes at 3‐ to 5‐year follow‐up

Abstract

Objectives. Brief guided parent-delivered cognitive behaviour therapy (CBT) has been developed to meet the demand for non-intensive interventions for children with anxiety disorders, and initial trials have shown it to be effective for children with a range of anxiety disorders. This study examined outcomes 3-5 years post-treatment.Design. A long-term follow-up (LTFU) cohort study.Methods. Families who (1) completed at least 50% of allocated treatment sessions of guided parent-delivered CBT for childhood anxiety as part of a randomized control trial (RCT), (2) provided consent to be recontacted, (3) had not received further mental health interventions, and (4) were contactable were invited to take part. Fifty-seven families (29% of the original sample) completed structured diagnostic interviews on average 50 months after treatment (39-61 months).Results. At LTFU, 79% of the assessed children who had received the treatment no longer met criteria for their primary diagnosis, 63% did not meet criteria for any anxiety disorder, and 61% did not meet criteria for any DSM-IV disorder. Treatment gains were mostly maintained (60%), and some children went on to recover during the follow-up period without additional input from mental health services (19%). Few young people had relapsed since their last assessment (12%). Mean scores on standardized symptom questionnaires were within the normal range.Conclusions. Children who recovered from anxiety disorders following brief guided parent-delivered CBT typically maintained good outcomes and few relapsed. These findings suggest that this is a viable first-line, low-intensity treatment approach. This study only included a small subsample of those in the original RCT (29%), and more information is required about those who dropped out of treatment and those who required further intervention immediately after treatment.

A mixed-methods investigation of parent-child posttrauma discussion and the effects of encouraging engagement

“…This information, along with observations relating to why parents may or may not feel comfortable talking to their child about the trauma, are of potential importance when designing low-dose, parent-led interventions, which would most likely include the encouragement of conversations between parent and child. A first-line, cost-effective parent-delivered CBT has already been developed for children with anxiety , with the majority (60%) of treatment gains maintained at a three to five year follow-up (Brown et al, 2017). In the PTSD field, parent-focused interventions also show significant promise for children exposed to acute trauma (Berkowitz et al, 2011).…”

“…Evidence is accumulating with respect to the potential benefits of engaging parents in psychological interventions for children, with parent-focused interventions being increasingly utilised in the child mental health field (e.g. Brown et al, 2017;Cobham, Filus, & Sanders, 2017;Creswell et al, 2017). There has been growing interest in low-dose, parentfocused prevention/intervention programs in the context of child PTSS (Berkowitz, Stover, & Marans, 2011;Marsac, Kassam-Adams, Hildenbrand, Kohser, & Winston, 2010).…”

Brief, Non-Pharmacological, Interventions for Pediatric Anxiety: Meta-Analysis and Evidence Base Status

“…ADIS-C/P CSR diagnostic recovery rates at 6-month FU were comparable for both treatment conditions (76% for full guided, 71% for brief guided). Improvements for the intervention conditions were maintained at 3-to 5-year FU (Brown et al, 2017). Waters et al (2013) [32] N = 37.…”

Parents’ Perspectives on Guided Parent-Delivered Cognitive Behavioral Therapy for Childhood Anxiety Disorders: A Qualitative Study

“…This allowed a focus on experiences and outcomes associated with GPD-CBT specifically. Of the 65 families that took part in follow-up assessments (see Brown et al, 2017), 39 parents consented to participate, all of whom participated in in-depth interviews.…”

“…The approach has also been found to be cost-effective compared to an alternative brief psychological therapy for child anxiety disorders (Creswell et al, 2017). Furthermore, long-term follow-up studies have shown that few children who recover following GPD-CBT with relapse in subsequent years (Brown et al, 2017). Thus, GPD-CBT could fit within a stepped care model where low-intensity treatments are routinely offered for mild–moderate presentations while more intensive treatments are reserved for those presenting with severe anxiety disorders and those who do not respond to low-intensity interventions (Bower & Gilbody, 2005).…”