Web-based parent training for child anxiety

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DESCRIPTION (provided by applicant): Parents who are concerned about their child's emotional development, especially difficulties related to excessive anxiety and stress, are in a valuable position to serve as change-agents for their children, but are typically unaware of when to try to help, or how best to help their children. Additionally, empirical support exists for cognitive-behavioral therapy (CBT) for child anxiety, but child outcomes could be improved and the development and evaluation of approaches to disseminate this and other empirically-supported treatments is critical. Our goal is to design, develop, and eventually provide an affordable web-based parent-training program that will be user-friendly and inform parents about evidence-based strategies that they can employ to effectively help their children manage excessive and distressing anxiety and anxiety-related symptoms/disorders. The WPT will be designed to serve as (a) a stand-alone self-guided program as well as (b) an adjunctive component for parents of youth who receive CBT for anxiety. The interactive WPT program will include components of parent training that have been found to be associated with improved outcomes in the treatment of anxious youth (Barrett, Dadds, & Rapee, 1996; Khanna & Kendall, 2007) and will be based on an empirically supported CBT for child anxiety (Kendall et al., 1994; 2007). The initial aim is to develop and evaluate 3 modules of a 7-session cognitive-behavioral WPT program for parents of youth (ages 7-14) suffering from symptoms of distressing anxiety. In addition, we aim to examine the feasibility and acceptability of WPT with parents of youth (ages 7-14) suffering from symptoms of distressing anxiety as compared to a Bibliotherapy Parent Training (BPT) condition, both as a stand-alone treatment (Study 1) and as an adjunctive treatment to ongoing CBT for child anxiety (Study 2). Findings from the initial studies will inform the application for a Phase II SBIR grant for the development and completion of the full 7-session web-based parent-training program and to conduct a randomized clinical trial (RCT) to evaluate the efficacy of the WPT program as a stand-alone and an adjunctive program. Compared to other parent training formats (i.e., face-to-face sessions, group programs, self-help books), a web- based parent training adds accessibility, affordability, convenience, privacy/confidentiality and, given aspects of the medium, can be engaging, interactive, and easily updated, all while maintaining consistency of care (Greist, 1998; Marks, Cavanagh, Gega, 2007; Ritterband et al., 2006). The web-based platform can also help widen and ease access to care, helping parents overcome barriers to seeking treatment while becoming more educated consumers of mental health services, and subsequently, could facilitate the dissemination of empirically-supported treatments for anxious youth (Ritterband, 2006). As an adjunctive component of CBT for child anxiety, a web-based parent-training program has the potential to enhance child treatment outcomes as well as family functioning and to reduce clinician effort/time (Khanna & Kendall, 2007). A web platform also provides a unique opportunity to quickly and efficiently collect data from a large number of parents which may provide a better understanding of the phenomenology, prevalence, and course of childhood anxiety and about the parents of anxious youth (Khanna, Aschenbrand, & Kendall, 2007). PUBLIC HEALTH RELEVANCE From a public health perspective, there is great potential in self-administered interventions to improve the mental health of children and families who suffer from mental disorders and related emotional problems but who are unable to access services (Scogin, 2003). As Rosen (1987) noted two decades ago, the growing demand for self-administered psychosocial treatments necessitates research on their effectiveness. Additionally, the development and evaluation of approaches such as this that hold the potential to improve child treatment outcomes and facilitate the dissemination of empirically- supported treatments is critical.