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

Br J Psychiatry. 2013 Dec;203(6):436-44. doi: 10.1192/bjp.bp.113.126698. Epub 2013 Aug 22.


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.

Aims: To evaluate the efficacy of low-intensity guided parent-delivered CBT treatments for children with anxiety disorders.

Method: 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.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Anxiety Disorders / psychology
  • Anxiety Disorders / therapy*
  • Child
  • Clinical Competence / statistics & numerical data
  • Cognitive Behavioral Therapy / education
  • Cognitive Behavioral Therapy / methods*
  • Female
  • Follow-Up Studies
  • Humans
  • Intention to Treat Analysis
  • Male
  • Outcome Assessment, Health Care / statistics & numerical data*
  • Parents / education*
  • Parents / psychology
  • Professional-Family Relations*
  • Psychiatric Status Rating Scales
  • United Kingdom
  • Waiting Lists

Associated data

  • ISRCTN/ISRCTN92977593