The Impact of Brief Parental Anxiety Management on Child Anxiety Treatment Outcomes: A Controlled Trial

Abstract

Parental anxiety is a risk to optimal treatment outcomes for childhood anxiety disorders. The current trial examined whether the addition of a brief parental anxiety management (BPAM) program to family cognitive behavioral therapy (CBT) was more efficacious than family CBT-only in treating childhood anxiety disorders. Two hundred nine children (aged 6–13 years, 104 female, 90% Caucasian) with a principal anxiety disorder were randomly allocated to family CBT with a five-session program of BPAM (n = 109) or family CBT-only (n = 100). Family CBT comprised the Cool Kids program, a structured 12-week program that included both mothers and fathers. Overall, results revealed that the addition of BPAM did not significantly improve outcomes for the child or the parent compared to the CBT-only group at posttreatment or 6-month follow-up. Overall, however, children with nonanxious parents were more likely to be diagnosis free for any anxiety disorder compared to children with anxious parents at posttreatment and 6-month follow-up. BPAM did not produce greater reductions in parental anxiety. The results support previous findings that parent anxiety confers poorer treatment outcomes for childhood anxiety disorders. Nevertheless the addition of BPAM anxiety management for parents in its current format did not lead to additional improvements when used as an adjunct to family CBT in the treatment of the child's anxiety disorder. Future benefits may come from more powerful methods of reducing parents’ anxiety.

Treatment of childhood anxiety disorder in the context of maternal anxiety disorder: a randomised controlled trial and economic analysis

“…19 Our study population also had somewhat higher rates of child-and parent-rated anxiety levels than in similar studies. 19 In terms of marital status, the population was representative of the wider population.…”

“…19 Our study population also had somewhat higher rates of child-and parent-rated anxiety levels than in similar studies. 19 In terms of marital status, the population was representative of the wider population. 101 We elected to focus on middle childhood (ages 7-12 years) and intervening with mothers as a methodological expediency as it is likely that the nature of parental influences on child anxiety varies with child age 102,103 and parent gender; 34 however, as a result, the findings cannot be generalised to young children or adolescents or to interventions with fathers or other caregivers.…”

“…19 Their study also specifically focused on children with anxiety disorders who had a parent with an anxiety disorder, and they also failed to find a significant benefit of the addition of parental anxiety management to CCBT. The findings also run contrary to the idea that changing parental responses is necessary for successful treatment of child anxiety disorder in the context of parental anxiety disorder.…”

“…Two studies have systematically targeted parental anxiety in the treatment of child anxiety disorders. In one, 9 child anxiety outcome was better where therapeutic measures to address parental anxiety symptoms were included, and in the other 19 children's outcomes were not improved. In both cases, as the treatment did not significantly alter levels of parental anxiety, it remains unclear what aspect of the treatment effected the clinical improvement in the children.…”

“…Cobham and colleagues 9 found that supplementing child cognitive-behavioural therapy (CCBT) with parent anxiety management was associated with significantly improved diagnostic outcomes for children with anxiety disorders whose parents had elevated trait anxiety; however, this group did not maintain a specific benefit from the parent anxiety management treatment at a 3-year follow-up. 18 More recently, Hudson and colleagues 19 used a similar design but classified groups according to parental anxiety disorder status. In this study, CCBT + parent anxiety management did not confer a significant benefit over CCBT post teatment or at a 6-month follow-up assessment.…”