Overcoming Your Child's Fears and Worries: a randomised controlled trial of guided self-help for childhood anxiety disorders
|National Institute for Health Research (NIHR)
|Professor Peter Cooper and Dr Cathy Creswell, School of Psychology, University of Reading
Dr Emma McIntosh, Institute of Health and Wellbeing, University of Glasgow
Cognitive Behaviour Therapy (CBT) is known to be an effective treatment for childhood anxiety disorders, particularly for children whose mothers do not have a current anxiety disorder themselves. CBT is, however, expensive to deliver and difficult to access. Guided self-help CBT for childhood anxiety disorders has the potential to offer an accessible, effective treatment approach. Two approaches will be evaluated; full guided self-help CBT and a less intense form of guided self-help CBT.
This trial is a three-arm RCT which aims to investigate the efficacy of cognitive-behaviour therapy (CBT) for childhood anxiety disorders, delivered as guided self-help via parents. Parents of index children will receive either full guidance (i.e. 4 face to face and 4 telephone treatment sessions over eight weeks), or a less intense form of guidance (i.e. 2 face to face and 2 telephone treatment sessions, also over eight weeks), to guide their use of a self-help guide to overcoming their child’s anxiety problems. Children’s treatment outcome will be compared to a wait-list control condition.
Health Economic Assessment
An economic evaluation will be undertaken integral to the main trial. The economic analysis will estimate the incremental cost and effectiveness of both full guided self-help CBT and less intense guided self-help CBT in relation to the control group as well as their relative costs. Patient level resource use data, including all health and social care costs (staff costs for provision of full and less intense guided self-help CBT, GP costs, referrals, and other relevant services identified) as well as leisure and productivity estimates for the parents will be collected within trial forms and valued using appropriate unit costs. Staff training costs and the costs of staff supervision will also be identified and allocated pro-rata. The outcome measure for the cost-effectiveness analysis will be the ADIS as well as a measure of ‘days off school avoided’. In line with recent recommendations from the National Institute for Health and Clinical Excellence (NICE) the economic evaluation will also include generic quality of life instruments, the child friendly EuroQol EQ-5D (EuroQol, 1990; Hennesy & Kind, 2002) and HUI2 outcome measure (Feeny et al, 1995), on which normative data are available. Measures of the impact of anxiety disorders will also be included, using questionnaires administered to the child and mother (CAIS; Langley et al, 2004) and teacher (School Adjustment/ Teacher Report Form; Achenbach, 1986). These instruments will be administered at baseline, following treatment (12 week assessment) and at 6 months follow up.