Benefits of child-focused anxiety treatments for parents and family functioning

Depress Anxiety. 2013 Sep;30(9):865-72. doi: 10.1002/da.22055. Epub 2013 Feb 6.

Abstract

Background: To examine (1) changes in parent (global psychological distress, trait anxiety) and family (dysfunction, burden) functioning following 12 weeks of child-focused anxiety treatment, and (2) whether changes in these parent and family factors were associated with child's treatment condition and response.

Methods: Participants were 488 youth ages 7-17 years (50% female; mean age 10.7 years) who met DSM-IV-TR criteria for social phobia, separation anxiety, and/or generalized anxiety disorder, and their parents. Youth were randomly assigned to 12 weeks of "Coping Cat" individual cognitive-behavioral therapy (CBT), medication management with sertraline (SRT), their combination (COMB), or medication management with pill placebo (PBO) within the multisite Child/Adolescent Anxiety Multimodal Study (CAMS). At pre- and posttreatment, parents completed measures of trait anxiety, psychological distress, family functioning, and burden of child illness; children completed a measure of family functioning. Blinded independent evaluators rated child's response to treatment using the Clinical Global Impression-Improvement Scale at posttreatment.

Results: Analyses of covariance revealed that parental psychological distress and trait anxiety, and parent-reported family dysfunction improved only for parents of children who were rated as treatment responders, and these changes were unrelated to treatment condition. Family burden and child-reported family dysfunction improved significantly from pre- to posttreatment regardless of treatment condition or response.

Conclusions: Findings suggest that child-focused anxiety treatments, regardless of intervention condition, can result in improvements in nontargeted parent symptoms and family functioning particularly when children respond successfully to the treatment.

Keywords: child anxiety; cognitive-behavioral therapy; family functioning; family outcomes; parent anxiety; parent psychopathology; pharmacotherapy; randomized controlled trial; treatment.

Publication types

  • Multicenter Study
  • Randomized Controlled Trial
  • Research Support, N.I.H., Extramural

MeSH terms

  • Adolescent
  • Anxiety Disorders / therapy*
  • Anxiety, Separation / therapy
  • Child
  • Cognitive Behavioral Therapy / methods*
  • Combined Modality Therapy / methods
  • Double-Blind Method
  • Family Health*
  • Female
  • Humans
  • Male
  • Parents / psychology*
  • Patient-Centered Care / methods
  • Phobic Disorders / therapy
  • Selective Serotonin Reuptake Inhibitors / therapeutic use*
  • Sertraline / therapeutic use*
  • Treatment Outcome

Substances

  • Serotonin Uptake Inhibitors
  • Sertraline