Types of parental involvement in CBT with anxious youth: A preliminary meta-analysis

Authors

Katharina Manassis, Hospital for Sick Children University of Toronto
Trevor Changgun Le, University of Toronto
Kathryn Bennett, McMaster University
Xiu Yan Zhao, Hospital for Sick Children University of Toronto
Sandra Mendlowitz, University of Toronto
Stephanie Duda, McMaster University
Michael Saini, University of Toronto
Pamela Wilansky, University of Toronto
Susan Baer, The University of British Columbia
Paula Barrett, Pathways Health and Research Centre
Denise Bodden, Utrecht University
Vanessa E. Cobham, The University of Queensland
Mark R. Dadds, UNSW Sydney
Ellen Flannery-Schroeder, University of Rhode Island
Golda Ginsburg, Johns Hopkins School of Medicine
David Heyne, Leiden University
Jennifer L. Hudson, Macquarie University
Philip C. Kendall, Temple University
Juliette Liber, Leiden University
Carrie Masia-Warner, William Paterson University
Maaike H. Nauta, University of Groningen
Ronald M. Rapee, Macquarie University
Wendy Silverman, Yale University
Lynne Siqueland, Children's Center for OCD and Anxiety
Susan H. Spence, Griffith University
Elisabeth Utens, Erasmus MC Sophia Children's Hospital
Jeffrey J. Wood, University of California, Los Angeles

Document Type

Article

Date of Original Version

1-1-2014

Abstract

Objective: Meta-analytic studies have not confirmed that involving parents in cognitive behavior therapy (CBT) for anxious children is therapeutically beneficial. There is also great heterogeneity in the type of parental involvement included. We investigated parental involvement focused on contingency management (CM) and transfer of control (TC) as a potential outcome moderator using a meta-analysis with individual patient data. Method: Investigators of randomized controlled trials (RCTs) of CBT for anxious children, identified systematically, were invited to submit their data. Conditions in each RCT were coded based on type of parental involvement in CBT (i.e., low involvement, active involvement without emphasis on CM or TC, active involvement with emphasis on CM or TC). Treatment outcomes were compared using a 1-stage meta-analysis. Results: All cases involved in active treatment (894 of 1,618) were included for subgroup analyses. Across all CBT groups, means of clinical severity, anxiety, and internalizing symptoms significantly decreased posttreatment and were comparable across groups. The group without emphasis on CM or TC showed a higher proportion with posttreatment anxiety diagnoses than the low-involvement group. Between posttreatment and 1-year follow-up, the proportion with anxiety diagnoses significantly decreased in CBT with active parental involvement with emphasis on CM or TC, whereas treatment gains were merely maintained in the other 2 groups. Conclusions: CBT for anxious children is an effective treatment with or without active parental involvement. However, CBT with active parental involvement emphasizing CM or TC may support long-term maintenance of treatment gains. Results should be replicated as additional RCTs are published.

Publication Title, e.g., Journal

Journal of Consulting and Clinical Psychology

Volume

82

Issue

6

Citation/Publisher Attribution

Manassis, Katharina, Trevor Changgun Le, Kathryn Bennett, Xiu Yan Zhao, Sandra Mendlowitz, Stephanie Duda, Michael Saini, Pamela Wilansky, Susan Baer, Paula Barrett, Denise Bodden, Vanessa E. Cobham, Mark R. Dadds, Ellen Flannery-Schroeder, Golda Ginsburg, David Heyne, Jennifer L. Hudson, Philip C. Kendall, Juliette Liber, Carrie Masia-Warner, Maaike H. Nauta, Ronald M. Rapee, Wendy Silverman, Lynne Siqueland, Susan H. Spence, Elisabeth Utens, and Jeffrey J. Wood. "Types of parental involvement in CBT with anxious youth: A preliminary meta-analysis." Journal of Consulting and Clinical Psychology 82, 6 (2014): 1163-1172. doi: 10.1037/a0036969.