Parent-led cognitive behaviour therapy for child anxiety problems: overcoming challenges to increase access to effective treatment

Abstract

Background: Anxiety problems have a particularly early age of onset and are common among children. As we celebrate the anniversary of the BABCP, it is important to recognise the huge contribution that cognitive behavioural therapy (CBT) has made to the treatment of anxiety problems in children. CBT remains the only psychological intervention for child anxiety problems with a robust evidence base, but despite this, very few children with anxiety problems access CBT. Creative solutions are urgently needed to ensure that effective treatments can be delivered at scale. Here we focus on parent-led CBT as this offers a potential solution that is brief and can be delivered by clinicians without highly specialised training. Over the last decade there has been a substantial increase in randomised controlled trials evaluating this approach with consistent evidence of effectiveness. Nonetheless clinicians, and parents, often have concerns about trying the approach and can face challenges in its delivery. Method: We draw on empirical evidence and our clinical experience to address some of these common concerns and challenges, with particular emphasis on the key principles of empowering parents and working with them to provide opportunities for new learning for their children. Conclusions: We conclude by highlighting some important directions for future research and practice, including further evaluation of who does and does not currently benefit from the approach, determining how it should be adapted to optimise outcomes among groups that may not currently get maximum benefits and across cultures, and capitalising on recent technological developments to increase engagement and widen access.

The development of the Helping your Anxious Child programme: a parent-mediated group intervention for parents of autistic children in South Asia

“…The development of the Helping your Anxious Child programme: a parentmediated group intervention for parents of autistic children in South Asia Caitlin Kittridge, 1 Priyanka Rob, 2 Amy Fisher-Rogers, 3 Tarana Anis, 4 Udena Attygalle, 5 Farzana Islam, 6 Aditya Narain Sharma 7 and Jacqui Rodgers 8 Autistic children are at increased risk of experiencing a range of mental health difficulties, including anxiety. A number of intervention programmes are now available in high-income countries to support autistic children.…”

“…1 Anxiety can have a negative impact on a child's social development 2 and academic attainment. 3 A number of parent-led cognitive-behavioural therapy (CBT) programmes for typically developing children experiencing anxiety are available 4 and in recent years programmes have been developed in high-income countries to address anxiety in autistic children (for a recent review see 5 ). Anxiety in autism is particularly complex and may include autism-related features such as anxiety related to sensory differences, restrictive and repetitive behaviours, uncertainty and unusual phobias or idiosyncratic fears.…”

CBT 50 years on: a celebration of empirically grounded and evidence-based psychological therapy

“…Turning to the selection of articles: the current BCP Editor-in-Chief Paul Salkovskis and colleagues (Salkovskis et al ., 2023) have briefly summarised the history of our field with a view to understanding what we can learn from this and how it can be taken forward. Cathy Creswell (Creswell et al ., 2022) considers one of the key challenges we face, which is how to improve access to CBT in children. John Taylor (Taylor and Novaco, 2023) considers the important issue of how to help adults with intellectual disabilities and the challenge of anger management, relating this to therapist experience.…”