Parent-Augmented Cognitive Behavioral Therapy to Treat Children With Specific Phobias
Condition: Anxiety Disorders; Specific Phobia
MeSH terms: Anxiety Disorders; Phobic Disorders
Study type: Interventional

Summary: 
      This study will compare the effectiveness of two types of cognitive behavioral therapy,
      one-session exposure treatment and family-enhanced one-session exposure treatment, in
      treating children with specific phobias.
    

Detailed description: 
      A specific phobia is a fear of a particular object or situation. For many children, phobias
      result in considerable academic difficulties, social and personal distress, and interference
      in day-to-day activities. Physical symptoms typically accompany the intense anxiety caused by
      a specific phobia and may include blushing, profuse sweating, trembling, nausea, and
      difficulty talking. Phobias can persist a lifetime and may lead to other adult anxiety, mood,
      and substance use disorders. One-session exposure treatment (OST), a form of cognitive
      behavior therapy, has been considered a rapid and effective treatment for adults with a
      variety of specific phobias. Upward of 75 to 80% of adults treated with OST were considered
      diagnoses free following treatment. OST has proven useful in treating some children with
      specific phobias but not all. It is possible that parental factors may affect whether a child
      continues to experience a phobia and how well a child responds to treatment. For example,
      parents who are overly protective or have a phobia themselves may prevent their child from
      overcoming a specific phobia. Family-enhanced OST (augmented OST) involves the parents of
      affected children and provides the parents with strategies to assist their children in
      overcoming phobias. This study will compare the effectiveness of OST and augmented OST in
      treating children with specific phobias. This study will also evaluate how parental factors
      influence the expression and maintenance of phobias in children.

      Participants in this study will be randomly assigned to receive OST or augmented OST.
      Participants receiving OST will attend one extended treatment session, lasting up to 3 hours
      in duration. During this session, the child will be taught a number of cognitive and
      behavioral skills to deal effectively with the feared situation or object. The child will
      also be exposed to the feared situation or object in a highly structured, safe, and
      controlled manner. This treatment will only be delivered to the child and will not involve a
      parent or guardian. Participants receiving augmented OST will attend the same type of
      extended treatment session, but, in addition, their parent or guardian will attend a 3-hour
      session. During this session, parents will first be educated on specific phobias, including
      why phobias occur and how they are maintained over time. Next, parents will observe their
      child being treated from behind a one-way mirror for about 1 hour. During this time, a
      therapist will explain what the child's therapist is doing and discuss ways for parents to
      implement the treatment at home. Parents will then be asked to join their child and the
      therapist for the last hour of the child's session to assist the therapist with treatment.

      Outcomes will be assessed for all participants immediately after treatment and at 1-, 6-, and
      12-month follow-up evaluations during which the presence of specific phobias will be
      measured. Parents will also be asked to provide information about their child's school grades
      and school attendance for the year prior to participating in the study and up to 1 year after
      the child completes the treatment. The child's teacher may be asked to complete a
      questionnaire regarding the child's behavior in school. All of the information collected will
      help to determine how much progress each child has made as a result of treatment.
    

Intervention name(s): One-session exposure treatment; Augmented one-session exposure treatment
Intervention type(s): Behavioral; Behavioral
Intervention description(s): Participants receiving OST will attend one extended treatment session, lasting up to 3 hours in duration. During this session, the child will be taught a number of cognitive and behavioral skills to deal effectively with the feared situation or object. The child will also be exposed to the feared situation or object in a highly structured, safe, and controlled manner.; Family-enhanced OST (augmented OST) involves the parents of affected children and provides the parents with strategies to assist their children in overcoming phobias. Participants receiving augmented OST will attend the same type of extended treatment session, but, in addition, their parent or guardian will attend a 3-hour session.
Other intervention name(s): Family-enhanced OST
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: None (Open Label)
Primary purpose: Treatment
Keywords: Neuroses; Evidence-Based Treatment; Clinical Investigation; Young Patients; Phobic Disorders; Fear; Phobias