Guided parent-delivered cognitive behaviour therapy for children with anxiety disorders: Outcomes at 3- to 5-year follow-up.
Brown A., Creswell C., Barker C., Butler S., Cooper P., Hobbs C., Thirlwall K.
OBJECTIVES: Brief guided parent-delivered cognitive behaviour therapy (CBT) has been developed to meet the demand for non-intensive interventions for children with anxiety disorders, and initial trials have shown it to be effective for children with a range of anxiety disorders. This study examined outcomes 3-5 years post-treatment. DESIGN: A long-term follow-up (LTFU) cohort study. METHODS: Families who (1) completed at least 50% of allocated treatment sessions of guided parent-delivered CBT for childhood anxiety as part of a randomized control trial (RCT), (2) provided consent to be recontacted, (3) had not received further mental health interventions, and (4) were contactable were invited to take part. Fifty-seven families (29% of the original sample) completed structured diagnostic interviews on average 50 months after treatment (39-61 months). RESULTS: At LTFU, 79% of the assessed children who had received the treatment no longer met criteria for their primary diagnosis, 63% did not meet criteria for any anxiety disorder, and 61% did not meet criteria for any DSM-IV disorder. Treatment gains were mostly maintained (60%), and some children went on to recover during the follow-up period without additional input from mental health services (19%). Few young people had relapsed since their last assessment (12%). Mean scores on standardized symptom questionnaires were within the normal range. CONCLUSIONS: Children who recovered from anxiety disorders following brief guided parent-delivered CBT typically maintained good outcomes and few relapsed. These findings suggest that this is a viable first-line, low-intensity treatment approach. This study only included a small subsample of those in the original RCT (29%), and more information is required about those who dropped out of treatment and those who required further intervention immediately after treatment. PRACTITIONER POINTS: Treatment gains from brief guided parent-delivered cognitive behaviour therapy for children with anxiety are maintained for most children 3-5 years later. The majority of children who completed at least 50% of the intervention required no further mental health intervention in that time. Some children make continued improvement after completing the intervention. Data are based on a sample of families from southern England where the primary caregiving parent was free of mental health difficulties. Further research is needed to explore the mental health needs of those who do not benefit from this intervention.