title: Treatment of child anxiety disorders via guided parent-delivered cognitive-behavioural therapy: randomised controlled trial.
abstract: BACKGROUND
  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.
  
  
  OBJECTIVE
  To evaluate the efficacy of low-intensity guided parent-delivered CBT treatments for children with anxiety disorders.
  
  
  METHODS
  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.
  
  
  RESULTS
  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.
  
  
  CONCLUSIONS
  Full guided parent-delivered CBT is an effective and inexpensive first-line treatment for child anxiety.
authors: Kerstin Thirlwall, DClinPsy, Winnicott Research Unit, School of Psychology and Clinical Language Sciences, University of Reading, UK; Peter J. Cooper, DPhil, Winnicott Research Unit, School of Psychology and Clinical Language Sciences, University of Reading, UK, and Stellenbosch University, Matieland, South Africa; Jessica Karalus, MSc, Winnicott Research Unit, School of Psychology and Clinical Language Sciences, University of Reading, UK; Merryn Voysey, MBiostat, Centre for Statistics in Medicine, University of Oxford, UK; Lucy Willetts, MSc, PhD, Cathy Creswell, DClinPsy, PhD, Winnicott Research Unit, School of Psychology and Clinical Language Sciences, University of Reading, UK.
authors: Kerstin
authors: K
authors: Thirlwall
authors: Peter J
authors: PJ
authors: Cooper
authors: Jessica
authors: J
authors: Karalus
authors: Merryn
authors: M
authors: Voysey
authors: Lucy
authors: L
authors: Willetts
authors: Cathy
authors: C
authors: Creswell
mesh_terms: D001008:Anxiety Disorders / Q000523:psychology / Q000628:therapy*; D002648:Child; D002983:Clinical Competence / Q000706:statistics & numerical data; D015928:Cognitive Behavioral Therapy / Q000193:education / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D057194:Intention to Treat Analysis; D008297:Male; D017063:Outcome Assessment, Health Care / Q000706:statistics & numerical data*; D010290:Parents / Q000193:education* / Q000523:psychology; D011368:Professional-Family Relations; D011569:Psychiatric Status Rating Scales; D006113:United Kingdom; D014850:Waiting Lists