The Treatment of Child Anxiety Disorders via Guided CBT Self-Help: A Randomised Controlled Trial
Lead Research Organisation:
University of Reading
Department Name: Sch of Psychology and Clinical Lang Sci
Abstract
Anxiety is the most common form of mental health difficulty in childhood and often leads to future psychological difficulties. One form of treatment shown to be effective is Cognitive Behaviour Therapy (CBT). However, CBT is a specialist treatment which is expensive and not widely available. As such there is a need to provide effective and deliverable forms of CBT. One way of doing this is via a CBT self-help manual. Such manuals have been shown to be effective in helping treat other problems and could increase the availability of CBT to children with anxiety.
The proposed research aims to assess the efficacy of this treatment in reducing childhood anxiety disorders and to determine whether intensity of treatment (8 sessions versus 4 sessions) and the training of the therapists delivering the treatment (clinical psychologists versus graduate psychologists) affect clinical outcomes.
Outcomes will determine whether or not guided CBT self-help delivered to parents of anxious children reduces childhood anxiety disorders. Importantly, outcomes will also reveal whether this form of treatment is effective when intensity is reduced (4 sessions) and whether or not it can be delivered by less skilled therapists (graduate psychologists).
The proposed research aims to assess the efficacy of this treatment in reducing childhood anxiety disorders and to determine whether intensity of treatment (8 sessions versus 4 sessions) and the training of the therapists delivering the treatment (clinical psychologists versus graduate psychologists) affect clinical outcomes.
Outcomes will determine whether or not guided CBT self-help delivered to parents of anxious children reduces childhood anxiety disorders. Importantly, outcomes will also reveal whether this form of treatment is effective when intensity is reduced (4 sessions) and whether or not it can be delivered by less skilled therapists (graduate psychologists).
Technical Summary
Aims:
The proposed study aims to evaluate the efficacy of guided Cognitive Behaviour Therapy (CBT) self- help for childhood anxiety disorders.
Objectives:
The objectives of the study are to establish whether i) guided CBT self-help leads to improvement in child anxiety compared to a wait-list control, ii) full versions of guided CBT self-help and less intense versions of guided CBT self-help are both effective in treating childhood anxiety compared to a wait-list control, iii) guided CBT self-help delivered by clinical psychologists and guided self help delivered by psychology graduates are both effective in treating childhood anxiety compared to a wait-list control.
Design:
A single blind randomised controlled trial in which three groups are compared.
1) A full version of guided CBT self-help (4 face-to-face and 4 telephone sessions).
2) A less intense version of guided CBT self-help (2 face-to-face and 2 telephone sessions)
3) Wait-list control group
Both clinical psychologists and non-clinical psychology graduates will deliver the treatments, allowing for a secondary analysis of expertise effects.
Methodology:
Recruitment and randomisation
Children referred to the East and West Berkshire Child and Adolescent Mental Health Service (CAMHS) will be recruited if the following criteria are fulfilled:
Children: aged 7 to 12 years, primary diagnosis of DSM-IV anxiety disorder, absence of significant physical or intellectual impairment and absence of psychotrophic medication. Not currently receiving any other therapy or treatment for anxiety disorder.
Mother: absence of current DSM-IV anxiety disorder, absence of other severe psychological disturbance (e.g. severe major depressive disorder, psychosis, substance/alcohol dependence) and absence of psychotrophic medication.
Following confirmation of eligibility and informed consent, participants will be randomised (performed centrally at the Centre for Statistics in Medicine, Oxford) to one of the three conditions.
Assessment
The child and mother will be assessed pre-treatment using standardised interview measures and questionnaires. The same measures will be used at follow-up assessments.
Treatment Delivery
Clinical psychologists and non-clinical psychology graduates will deliver the treatment.
Implications:
The proposed research will i) demonstrate whether guided CBT self-help for child anxiety disorder is effective ii) elucidate the intensity required for such a treatment approach to be effective, iii) clarify the necessary level of therapist expertise.
The proposed study aims to evaluate the efficacy of guided Cognitive Behaviour Therapy (CBT) self- help for childhood anxiety disorders.
Objectives:
The objectives of the study are to establish whether i) guided CBT self-help leads to improvement in child anxiety compared to a wait-list control, ii) full versions of guided CBT self-help and less intense versions of guided CBT self-help are both effective in treating childhood anxiety compared to a wait-list control, iii) guided CBT self-help delivered by clinical psychologists and guided self help delivered by psychology graduates are both effective in treating childhood anxiety compared to a wait-list control.
Design:
A single blind randomised controlled trial in which three groups are compared.
1) A full version of guided CBT self-help (4 face-to-face and 4 telephone sessions).
2) A less intense version of guided CBT self-help (2 face-to-face and 2 telephone sessions)
3) Wait-list control group
Both clinical psychologists and non-clinical psychology graduates will deliver the treatments, allowing for a secondary analysis of expertise effects.
Methodology:
Recruitment and randomisation
Children referred to the East and West Berkshire Child and Adolescent Mental Health Service (CAMHS) will be recruited if the following criteria are fulfilled:
Children: aged 7 to 12 years, primary diagnosis of DSM-IV anxiety disorder, absence of significant physical or intellectual impairment and absence of psychotrophic medication. Not currently receiving any other therapy or treatment for anxiety disorder.
Mother: absence of current DSM-IV anxiety disorder, absence of other severe psychological disturbance (e.g. severe major depressive disorder, psychosis, substance/alcohol dependence) and absence of psychotrophic medication.
Following confirmation of eligibility and informed consent, participants will be randomised (performed centrally at the Centre for Statistics in Medicine, Oxford) to one of the three conditions.
Assessment
The child and mother will be assessed pre-treatment using standardised interview measures and questionnaires. The same measures will be used at follow-up assessments.
Treatment Delivery
Clinical psychologists and non-clinical psychology graduates will deliver the treatment.
Implications:
The proposed research will i) demonstrate whether guided CBT self-help for child anxiety disorder is effective ii) elucidate the intensity required for such a treatment approach to be effective, iii) clarify the necessary level of therapist expertise.