Treating child anxiety using family-based internet delivered cognitive behavior therapy with brief therapist guidance: A randomized controlled trial

IF 4.8 2区医学 Q1 PSYCHIATRY Journal of Anxiety Disorders Pub Date : 2023-12-05 DOI:10.1016/j.janxdis.2023.102802

Lauren F. McLellan , Samantha Woon , Jennifer L. Hudson , Heidi J. Lyneham , Eyal Karin , Ronald M. Rapee

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Abstract

Online treatment delivery has the potential to increase access to evidence-based mental health care for children with anxiety disorders. Using a randomized controlled trial design, we evaluated the efficacy of Cool Kids Online, a family-based and therapist supported internet-delivered cognitive behavioral treatment (CBT) designed to target anxiety disorders in children. Ninety-five children aged 7–12 years with a DSM-5 anxiety disorder were randomly allocated to Cool Kids Online or a waitlist control. Children were assessed at baseline, week 11, and 6-months following treatment. Children in waitlist received treatment after week 11 and also completed assessments immediately and six months after treatment, allowing treatment maintenance to be evaluated for all children. Compared to waitlist, Cool Kids Online led to significantly greater remission of anxiety disorders (primary and all anxiety diagnoses) and greater reduction of caregiver-reported anxiety symptoms and interference at week 11. Child-reported anxiety symptoms and interference and child- and caregiver-reported depressive or externalizing symptoms did not differ significantly between conditions. Medium to large within-treatment effects were observed for all children from pre to post treatment with post treatment effects maintained until follow-up. Overall, the findings provide support for the efficacy of the program in treating anxiety. Cool Kids Online compared to waitlist for the remission of anxiety disorders in clinically anxious children; anzctr.org.au; ACTRN12615000947505.

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在简短的治疗师指导下，使用基于家庭的互联网提供认知行为疗法治疗儿童焦虑症:一项随机对照试验

在线治疗有可能增加焦虑症儿童获得循证精神卫生保健的机会。采用随机对照试验设计，我们评估了酷孩子在线的疗效，酷孩子在线是一种基于家庭和治疗师支持的网络认知行为治疗(CBT)，旨在针对儿童焦虑症。95名患有DSM-5焦虑症的7-12岁儿童被随机分配到酷孩子在线组或候补组。在治疗后的基线、第11周和6个月对儿童进行评估。等待名单中的儿童在第11周后接受治疗，并在治疗后立即和6个月完成评估，从而对所有儿童的治疗维持情况进行评估。与等候名单相比，在第11周，酷孩子在线导致了更大程度的焦虑症缓解(主要和所有焦虑诊断)，更大程度上减少了照顾者报告的焦虑症状和干扰。儿童报告的焦虑症状和干扰以及儿童和照顾者报告的抑郁或外化症状在不同情况下没有显著差异。从治疗前到治疗后，所有儿童均观察到中等到较大的治疗内效果，治疗后效果一直保持到随访。总的来说，这些发现为该项目治疗焦虑的有效性提供了支持。酷孩子在线与临床焦虑儿童焦虑障碍缓解候补名单的比较anzctr.org.au;ACTRNXXX。

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来源期刊

Journal of Anxiety Disorders Multiple-

CiteScore

16.60

自引率

2.90%

发文量

期刊介绍： The Journal of Anxiety Disorders is an interdisciplinary journal that publishes research papers on all aspects of anxiety disorders for individuals of all age groups, including children, adolescents, adults, and the elderly. Manuscripts that focus on disorders previously classified as anxiety disorders such as obsessive-compulsive disorder and posttraumatic stress disorder, as well as the new category of illness anxiety disorder, are also within the scope of the journal. The research areas of focus include traditional, behavioral, cognitive, and biological assessment; diagnosis and classification; psychosocial and psychopharmacological treatment; genetics; epidemiology; and prevention. The journal welcomes theoretical and review articles that significantly contribute to current knowledge in the field. It is abstracted and indexed in various databases such as Elsevier, BIOBASE, PubMed/Medline, PsycINFO, BIOSIS Citation Index, BRS Data, Current Contents - Social & Behavioral Sciences, Pascal Francis, Scopus, and Google Scholar.