Web-based parent training for child anxiety

描述（由申请人提供）：父母关心孩子的情感发展，特别是与过度焦虑和压力相关的困难，他们处于一个有价值的位置，可以作为孩子的变革推动者，但通常不知道何时尝试帮助，或者如何最好地帮助他们的孩子。此外，对儿童焦虑的认知行为疗法（CBT）也有经验支持，但儿童的结果可能会得到改善，传播这种疗法和其他经验支持的治疗方法的发展和评估是至关重要的。我们的目标是设计、开发并最终提供一个可负担得起的基于网络的家长培训项目，该项目将是用户友好的，并告知家长他们可以采用的循证策略，以有效地帮助他们的孩子管理过度的、令人痛苦的焦虑和焦虑相关的症状/障碍。WPT将被设计为(a)一个独立的自我指导计划，以及(b)为接受CBT治疗焦虑的青少年的父母提供辅助组件。交互式WPT项目将包括父母培训的组成部分，这些内容已被发现与改善治疗焦虑青少年的结果有关（Barrett, Dadds, & Rapee, 1996; Khanna & Kendall, 2007），并将基于经验支持的儿童焦虑CBT （Kendall等人，1994;2007）。最初的目的是为患有焦虑症状的青少年（7-14岁）的父母开发和评估一个7期认知行为WPT计划的3个模块。此外，我们的目的是研究WPT作为儿童焦虑的独立治疗（研究1）和持续CBT治疗（研究2）的辅助治疗，在患有焦虑症状的青少年（7-14岁）父母(阅读疗法父母训练（BPT）条件下的可行性和可接受性。初步研究的结果将为第二阶段SBIR拨款的申请提供信息，用于开发和完成完整的7期基于网络的父母培训项目，并进行随机临床试验（RCT），以评估WPT项目作为独立项目和辅助项目的有效性。与其他家长培训形式（即面对面会议，小组课程，自助书籍）相比，基于网络的家长培训增加了可访问性，可负担性，便利性，隐私/机密性，并且在媒体的某些方面，可以引人入胜，互动性和易于更新，同时保持护理的一致性（Greist, 1998; Marks, Cavanagh, Gega, 2007； Ritterband等人，2006）。基于网络的平台还可以帮助扩大和简化获得护理的机会，帮助父母克服寻求治疗的障碍，同时成为心理健康服务的受过更多教育的消费者，随后，可以促进对焦虑青年的经验支持治疗的传播（Ritterband， 2006年）。作为儿童焦虑的CBT辅助成分，基于网络的家长培训项目有可能提高儿童治疗效果和家庭功能，并减少临床医生的努力/时间（Khanna & Kendall, 2007）。网络平台也提供了一个独特的机会，可以快速有效地从大量父母那里收集数据，这些数据可以更好地了解儿童焦虑的现象、流行程度和过程，以及焦虑青少年的父母（Khanna, Aschenbrand, & Kendall, 2007）。从公共卫生的角度来看，自我管理的干预措施在改善患有精神障碍和相关情绪问题但无法获得服务的儿童和家庭的心理健康方面具有巨大潜力（Scogin， 2003年）。正如Rosen（1987）在20年前指出的那样，对自我管理的社会心理治疗的需求日益增长，需要对其有效性进行研究。此外，开发和评估诸如此类有可能改善儿童治疗结果并促进经验支持的治疗方法的传播的方法至关重要。

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.