Parent-delivered CBT may reduce intervention cost, but questions arise about effectiveness.

Commentary on: Creswell C, Violato M, Fairbanks H, et al . Clinical outcomes and cost-effectiveness of brief guided parent-delivered cognitive behavioural therapy and solution-focused brief therapy for treatment of childhood anxiety disorders: a randomised controlled trial. Lancet Psychiatry 2017;4:529–539. Psychological treatment of anxiety-related problems in youth has a rich history, dating back to Sigmund Freud’s work.1 After decades of clinical literature and scores of treatment outcome studies, a growing consensus formed among experts that cognitive–behavioural methods were especially effective, particularly the behavioural component involving graded exposure to feared stimuli. Delivery of this treatment approach by professional therapists can involve substantial cost, so the effort by Creswell and colleagues to investigate the use of parents to deliver the treatment has practical significance, and the study’s comparison between brief guided parent-delivered cognitive–behavioural therapy (GPD-CBT) and solution-focused brief therapy (SFBT) could add to the practical …