Parental Involvement in Cognitive Behavior Therapy for Children with Anxiety Disorders: 3-Year Follow-Up

Walczak, Monika; Esbjørn, Barbara Hoff; Breinholst, Sonja; Reinholdt-Dunne, Marie Louise

doi:10.1007/s10578-016-0671-2

Cited by 16 publications

(12 citation statements)

References 33 publications

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“…However, receiving professional support alongside computerized therapies might be beneficial, such that blended approaches could be optimal [ 57 ]. In addition, parental involvement in child CBT may lead to better outcomes, although evidence on their role in adolescent CBT is less conclusive [ 58 , 59 ]. Few of the studies we identified described direct parental involvement in the cCBT intervention; for those that did, the extent of parental involvement was minimal and sometimes optional.…”

Section: Discussionmentioning

confidence: 99%

Computerized Cognitive Behavioral Therapy for Treatment of Depression and Anxiety in Adolescents: Systematic Review and Meta-analysis

Wickersham¹,

Barack²,

Cross³

et al. 2022

J Med Internet Res

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Background Depression and anxiety are major public health concerns among adolescents. Computerized cognitive behavioral therapy (cCBT) has emerged as a potential intervention, but its efficacy in adolescents remains unestablished. Objective This review aimed to systematically review and meta-analyze findings on the efficacy of cCBT for the treatment of adolescent depression and anxiety. Methods Embase, PsycINFO, and Ovid MEDLINE were systematically searched for randomized controlled trials in English, which investigated the efficacy of cCBT for reducing self-reported depression or anxiety in adolescents aged 11 to 19 years. Titles, abstracts, and full texts were screened for eligibility by 2 independent researchers (TB and LC). A random-effects meta-analysis was conducted to pool the effects of cCBT on depression and anxiety symptom scores compared with the control groups. Study quality was assessed using the Cochrane Collaboration Risk of Bias tool. Results A total of 16 randomized controlled trials were eligible for inclusion in this review, of which 13 (81%) were included in the meta-analysis. The quality of the studies was mixed, with 5 (31%) studies rated as good overall, 2 (13%) rated as fair, and 9 (56%) rated as poor. Small but statistically significant effects of cCBT were detected, with cCBT conditions showing lower symptom scores at follow-up compared with control conditions for both anxiety (standardized mean difference −0.21, 95% CI −0.33 to −0.09; I2=36.2%) and depression (standardized mean difference −0.23, 95% CI −0.39 to −0.07; I2=59.5%). Secondary analyses suggested that cCBT may be comparable with alternative, active interventions (such as face-to-face therapy or treatment as usual). Conclusions This meta-analysis reinforces the efficacy of cCBT for the treatment of anxiety and depression and is the first to examine this exclusively in adolescents. Future research could aim to identify the active components of these interventions toward optimizing their development and increasing the feasibility and acceptability of cCBT in this age group. Trial Registration PROSPERO CRD42019141941; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=141941

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Section: Discussionmentioning

confidence: 99%

Computerized Cognitive Behavioral Therapy for Treatment of Depression and Anxiety in Adolescents: Systematic Review and Meta-analysis

Wickersham¹,

Barack²,

Cross³

et al. 2022

J Med Internet Res

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“…This suggestion remains only speculative however, and needs to be tested in empirical trials. Indeed, evidence from clinic-delivered CBT has produced conflicting findings with respect to the value of parental involvement in therapy (Walczak et al, 2017; Breinholst et al, 2011). Manassis et al (2014) suggested that this variation in findings may reflect the different ways in which parents can be involved in treatment, and highlighted the need for research to identify specific parental behaviours that enhance treatment outcomes.…”

Section: Discussionmentioning

confidence: 99%

Social support as a predictor of treatment adherence and response in an open-access, self-help, internet-delivered cognitive behavior therapy program for child and adolescent anxiety

Spence

March

Donovan

2019

Internet Interventions

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BackgroundAlthough self-help, internet-based cognitive behaviour therapy (ICBT) can produce significant reductions in anxiety for many young people, a sizable proportion show low program adherence and continue to show anxiety problems after treatment. It is important that we identify factors that predict those most likely to complete program sessions and benefit from self-help ICBT so that we can better match interventions to individual needs, and inform program design and development.ObjectiveThis study examined the role of social support in predicting treatment adherence and outcome among youth enrolled in an open-access, internet-delivered, CBT intervention targeting anxiety.MethodsParticipants were 3684 young people (aged 7 to 17 years) who reported elevated levels of anxiety symptoms when registering for the program. Treatment adherence was assessed as number of treatment sessions completed. Treatment response was evaluated as change in self-reported anxiety symptoms. Youth-reported social support (from friends, family and a special person) at pre-treatment was examined as a hypothesized predictor of adherence and outcome after controlling for baseline anxiety, gender, and age, with age being examined as a moderator.ResultsLinear regression analyses showed that participants with greater social support, from all sources, tended to show greater program adherence, although the proportion of explained variance was small. Age moderated the effect of family support upon adherence, such that greater family support was associated with greater number of sessions completed only for older youth. Greater family and total support were associated with greater reductions in anxiety, irrespective of participant age, but again the percent of variance explained was small. Younger participants were more likely to complete more sessions and to show greater reductions in anxiety. Those with higher pre-treatment anxiety tended to complete fewer sessions but demonstrated greater reductions in anxiety.ConclusionsThe findings highlight the need to consider ways to enhance treatment adherence and outcome of those engaging in self-help ICBT for youth anxiety problems, particularly when social support is low.

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“…Additionally, among youth participants who received CBT+P, the specific parent condition (RLST or RFST) did not significantly predict whether youth met diagnostic criteria for their targeted primary anxiety disorder or any anxiety disorder at follow-up. The absence of differences between treatment conditions in the present study is consistent with findings of some past follow-up studies that involved parents in treatment of youth anxiety disorders (Barrett et al, 2001), but inconsistent with other studies (Cobham et al, 2010;Walczak et al, 2016) that found superior diagnostic outcome at follow-up in parent-involved conditions compared with youth ICBT. While the Cobham study focused on parental anxiety as a parent factor to target during treatment, the Walczak study is most similar to the current study as it targeted specific parenting behaviors and included contingency management and transfer of control strategies in the active parent condition (similar to RFST condition).…”

Section: Primary Anxiety Outcomescontrasting

confidence: 54%

Cognitive Beharioal-Therapy for Child Anxiety: Long-term Follow-up and Predictors of Long-term Outcomes

Busto¹,

Cristina²

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Anxiety and its disorders are highly prevalent in childhood and adolescence, and are associated with impairment in social and academic functioning. Empirical evidence has accumulated demonstrating the efficacy of cognitive-behavioral therapy (CBT) for youth anxiety disorders delivered in individual, group, and parent formats. This dissertation study compared two of these formats, a youth only individual format, and two types of parental involvement formats to answer questions related to the long-term diagnostic outcomes and psychosocial functioning outcomes of youth who receive CBT for anxiety disorders. Specifically, this dissertation sought to compare individual and parent involvement to determine whether targeting parenting behaviors associated with youth anxiety produces significantly lower levels of psychopathology at a follow-up evaluation. The sample consisted of 173 youth and their parents who completed a followup evaluation one to seven years following treatment for youth anxiety disorders. Research questions were examined using regression analyses within a structural equation modeling framework. Results indicate that youth who demonstrated positive treatment gains at post treatment continued to maintain these gains at the long-term follow-up viii period one to seven years following treatment. Treatment condition significantly predicted ratings of youth anxiety symptoms at follow-up according to parent ratings, indicating lower youth anxiety symptom ratings for participants in the parent-involved conditions compared to participants in the youth only condition. Youth in the parentinvolved conditions were also rated higher on social functioning at follow-up on the parent report, as compared to youth in the individual treatment condition. The study findings are discussed in terms of treatment design and clinical implications for the treatment of youth anxiety and its disorders.

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Parental Involvement in Cognitive Behavior Therapy for Children with Anxiety Disorders: 3-Year Follow-Up

Cited by 16 publications

References 33 publications

Computerized Cognitive Behavioral Therapy for Treatment of Depression and Anxiety in Adolescents: Systematic Review and Meta-analysis

Computerized Cognitive Behavioral Therapy for Treatment of Depression and Anxiety in Adolescents: Systematic Review and Meta-analysis

Social support as a predictor of treatment adherence and response in an open-access, self-help, internet-delivered cognitive behavior therapy program for child and adolescent anxiety

Cognitive Beharioal-Therapy for Child Anxiety: Long-term Follow-up and Predictors of Long-term Outcomes

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