Efficacy and acceptability of parent-only group cognitive behavioral intervention for treatment of anxiety disorder in children and adolescents: a meta-analysis of randomized controlled trials

Abstract

Background Anxiety disorder is the most prevalent mental disorder among children and adolescents, causing significant psychosocial problems and physical health conditions. Cognitive behavioral therapy (CBT) is an effective treatment for anxiety disorder in children and adolescents. And parent-only CBT is an alternative treatment for childhood anxiety disorder, which includes psychologists and parents rather than children in the treatment. As a new type of CBT, parent-only CBT has some advantages. However, it remains unclear whether parent-only CBT interventions are effective for treating children and adolescents with anxiety disorder. Methods In this study, we evaluated the efficacy (the mean change scores of the anxiety rating scale from baseline to post-treatment, standardized mean difference SMD) and acceptability (the proportion of patients in the treatment group who withdrew from treatment early for any reason, risk ratios RRs) of parent-only cognitive behavioral therapy (CBT) for children and adolescents with anxiety disorder. We searched electronic databases, including PubMed, Cochrane Library, Embase, Web of Science, ProQuest, and PsycINFO from inception to June 2019. We included randomized controlled trials (RCTs) comparing parent-only CBT either with waitlist (WL), or CBT with parents in children and adolescents with anxiety disorder. Results Finally, six RCTs with 407 participants were included in the meta-analyses. In terms of efficacy, pooled analyses indicated that parent-only CBT was significantly more effective than WL for reducing anxiety symptoms with SMD of − 0.72 (95% CI − 1.41 to − 0.03, p = 0.04), and more remission rate with RR of 4.33 (37.96% vs. 6.85, 95% CI 1.82 to 10.27, p = 0.0009) at post-treatment. And our analyses showed no evidence that parent-only CBT had significantly greater efficacy than CBT with parents with SMD of 0.21 (95% CI − 0.09 to 0.50, p = 0.17). Acceptability in the parent-only CBT group was not significantly different to the WL group with RR of 0.92 (95% CI 0.52 to 1.62, p = 0.77), and was significantly worse than in the CBT with parents group with RR of 1.93 (95% CI 1.05 to 3.57, p = 0.03). Conclusions Current evidence indicates that parent-only CBT can be an alternative and acceptable intervention for treating children and adolescents with anxiety disorder.

Use of latent profile analysis and k-means clustering to identify student anxiety profiles

“…People with anxiety disorders usually have recurring intrusive thoughts or concerns and may have physical symptoms such as sweating, trembling, dizziness or a rapid heartbeat. Anxiety disorders are often the first presentation of psychopathology in youth and are considered the most common psychiatric disorders in children and adolescents [ 1 – 4 ]. Globally, anxiety is the ninth leading cause of illness and disability among adolescents aged 15–19 years and sixth among those aged 10–14 years [ 5 ].…”

Study protocol for a Randomized Controlled Trial of Supportive Parents – Coping Kids (SPARCK) - a Transdiagnostic and Personalized Parent Training Intervention to Prevent Childhood Mental Health Problems

“…Finally, recent research proposes parents as change agents in addressing child internalizing symptoms through alternative approaches beyond those designed for externalizing issues (45)(46)(47)(48). Parent-led cognitive behavioral therapy (CBT), in which parents are empowered to implement strategies in their child's daily life, has been found to be effective (45,49). Furthermore, a new research area underscores the substantial role of parental accommodation in perpetuating anxiety symptoms (50,51).…”

Psychological interventions for children with emotional and behavioral difficulties aged 5–12 years: An evidence review

“…A further review found that very small benefits for anxiety symptoms were maintained until 12 months in Parent-only CBT was effective in reducing anxiety, comparable to programs involving both children and parents. Parent-directed CBT may be more suitable for younger children, but dropout rates tend to be higher in parent-only programs (Yin et al 2021). Other reviews have shown that parental involvement is not necessarily beneficial in the treatment of anxiety (Cordier et al 2021;Peris et al 2021;Wergeland et al 2021).…”