Specific Phobias in Youth: A Randomized Controlled Trial Comparing One-Session Treatment to a Parent-Augmented One-Session Treatment

Abstract

Objective Examine the efficacy of a parent-augmented One Session Treatment (A-OST) in treating specific phobias (SP) in youth by comparing this novel treatment to child-focused OST, a well-established treatment. Method A total of 97 youth (ages 6–15, 51.5% female, 84.5% white) who fulfilled diagnostic criteria for SP were randomized to either A-OST or OST. SPs were assessed with semi-structured diagnostic interviews, clinician improvement ratings, and parent and child improvement ratings. In addition, measures of treatment satisfaction and parental self-efficacy were obtained. Blind assessments were completed pretreatment, post-treatment, and 1-month and 6-months following treatment. Analyses were undertaken using mixed models. In addition, gender, age, internalizing/externalizing problems, parent overprotection, and parent anxiety were examined as potential predictors and moderators of treatment outcome. Results Both treatment conditions produced similar outcomes with approximately 50% of youth in both treatments diagnosis free and judged to be much or very much improved at post-treatment and 1-month follow up. At 6-month follow up, however, the treatments diverged with OST resulting in marginally superior outcomes to A-OST, contrary to predictions. Only age of child predicted treatment outcome across the two treatments (older children did better); unexpectedly, none of the variables moderated treatment outcomes. Conclusions Parent augmentation of OST produced no appreciable gains in treatment outcomes. Directions for future research are highlighted.

Comparing outcomes for children with different anxiety disorders following cognitive behavioural therapy

“…An increasing number of randomised controlled trials have emerged that target specific anxiety conditions and provide information about the response of specific anxiety disorders to these targeted CBT protocols (Barrett, Healy-Farrell, & March, 2004;Beidel, Turner, & Morris, 2000;Ollendick et al, 2014;Spence, Donovan, & Brechman-Toussaint, 2000). For example, Spence, Donovan and Brechman-Toussaint (2000) randomized 7-14 year old children with SoAD (n = 50) to either a waitlist condition or cognitive behavioural treatment (with or without parental involvement).…”

Primary Versus Secondary Diagnosis of Generalized Anxiety Disorder in Youth: Is the Distinction an Important One?

“…Indeed, of the 488 youth, 175 (35.9 %) received all three anxiety disorders as coprimary and an additional 209 (42.8 %) received at least two of these anxiety disorders as co-primary. Examples of the former approach include several child-focused anxiety treatment studies [7][8][9][10][11][12], which have included only youth with single disorders such as GAD or SAD. These same decision making rules have been extended to basic psychopathology research where investigators have examined only children with a single primary anxiety diagnosis [13][14][15] and excluded others from study.…”

One session treatment for pediatric blood-injection-injury phobia: A controlled multiple baseline trial

“…Child and Parent Treatment Satisfaction (CTS, PTS; Ollendick et al, 2015). At 1-month follow-up, children and their parents completed a questionnaire assessing their satisfaction with treatment.…”

“…Flatt and King (2010) also included a small number (6 participants) of youth with BII phobias; however, they did not examine differences in treatment outcome across the different types of phobia. Ollendick et al (2015Ollendick et al ( , 2009) specifically excluded youth with BII phobias for various reasons, including poorer treatment response in € Ost et al (2001); unique physiological response (e.g., fainting); and the complexity associated with delivering treatment to these youth (i.e., need for medical professionals).…”

“…OST incorporates in vivo exposure, cognitive challenges, participant modelling, reinforced practice and psychoeducation in a single session maximised to 3 h. Empirical support for OST has been demonstrated in 10 studies, including three large randomised controlled trials (RCT; Ollendick et al, 2015Ollendick et al, , 2009€ Ost, Svensson, Hellstrom, & Lindwall, 2001) and seven smaller clinical trials (Farrell et al, 2013;Flatt & King, 2010;Leutgeb, Sch€ afer, K€ ochel, & Schienle, 2012;Muris, Merckelbach, Holdrinet, & Sijsenaar, 1998;Muris, Merckelbach, Van Haaften, & Mayer, 1997;Waters et al, 2014) for a diverse range of specific phobia subtypes in youth, including animal (e.g., dog, cat, spider), natural environment (e.g., dark, water, heights), situational (e.g., lifts) and other (e.g., vomit, loud noises). In these studies, OST has been found to be superior to a waitlist control (Flatt & King, 2010;Ollendick et al, 2009;€ Ost et al, 2001), psychological placebo (Ollendick et al, 2009) and Eye Movement and Desensitization and Reprocessing (EMDR; Muris et al, 1998Muris et al, , 1997.…”