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A New Parenting-Based Group Intervention for Young Anxious Children: Results of a Randomized Controlled Trial

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Objective

Despite recent advances, there are still no interventions that have been developed for the specific treatment of young children who have anxiety disorders. This study examined the impact of a new, cognitive–behaviorally based parenting intervention on anxiety symptoms.

Method

Families of 74 anxious children (aged 9 years or less) took part in a randomized controlled trial, which compared the new 10-session, group-format intervention with a wait-list control condition. Outcome measures included blinded diagnostic interview and self-reports from parents and children.

Results

Intention-to-treat analyses indicated that children whose parent(s) received the intervention were significantly less anxious at the end of the study than those in the control condition. Specifically, 57% of those receiving the new intervention were free of their primary disorder, compared with 15% in the control condition. Moreover, 32% of treated children were free of any anxiety diagnosis at the end of the treatment period, compared with 6% of those in the control group. Treatment gains were maintained at 12-month follow-up.

Conclusions

This new parenting-based intervention may represent an advance in the treatment of this previously neglected group. Clinical trial registration information: Anxiety in Young Children: A Randomized Controlled Trial of a New Cognitive-Behaviourally Based Parenting Intervention; http://www.isrctn.org/; ISRCTN12166762.

Section snippets

Method

This study was approved by an NHS Research Ethics Committee.

Treatment of Data

Most CBCL and SCARED scores were significantly non-normal in the treatment condition. There was also evidence of nonnormality in the MASC. Together with the unequal group sizes, this would bias the F ratio in analysis of variance (ANOVA).25 Therefore, data were analyzed using tests based on a robust estimate of location (an M-estimator) and, where possible, 500 bootstrap samples.26 The bootstrap procedure was chosen because, in situations in which the distribution of scores differs across

Discussion

The results indicate that a cognitive-behavior–based parenting intervention for anxiety in young children may be effective in the treatment of this neglected population.

After treatment, those receiving treatment were more than seven times more likely to be free of their primary diagnosis than were the controls. A similar picture emerged for presence of any anxiety diagnosis.

At follow-up, the number of treated children free of their primary diagnosis remained fairly stable, whereas those

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      We identified four individual studies of parenting interventions for anxiety disorders (Bayer et al., 2018; Cartwright-Hatton et al., 2011; Dadds, Spence, Holland, Barrett, & Laurens, 1997; Rapee et al., 2005). A pooled relative risk (RR) of anxiety diagnosis from the four studies (Bayer et al., 2018; Cartwright-Hatton et al., 2011; Dadds et al., 1997; Rapee et al., 2005) was calculated as 0.79 (95%CI: 0.69–0.91) in the first year. The only study reporting outcomes beyond 1 year was the Rapee et al trial (Rapee, Kennedy, Ingram, Edwards, & Sweeney, 2010).

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    The study took place in the Wellcome Trust Clinical Research Facility (Manchester).

    The authors are very grateful to those took part in this study and to the Mental Health Network (North-West).

    Disclosure: Dr. Cartwright-Hatton received support from the MRC Clinician Scientist Fellowship G108/604 during preparation of this manuscript. Drs. McNally, Field, Rust, Laskey, Harrington (deceased), Gallagher, and White, and Ms. Dixon, Ms. Miller, Ms. Pemberton, Ms. Symes, and Ms. Woodham report no biomedical financial interests or potential conflicts of interest.

    Supplemental material cited in this article is available online.

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