a Centre for Emotional Health, Department of Psychology , Macquarie University.
J Clin Child Adolesc Psychol. 2014;43(3):370-80. doi: 10.1080/15374416.2013.807734. Epub 2013 Jul 11.
Parental anxiety is a risk to optimal treatment outcomes for childhood anxiety disorders. The current trial examined whether the addition of a brief parental anxiety management (BPAM) program to family cognitive behavioral therapy (CBT) was more efficacious than family CBT-only in treating childhood anxiety disorders. Two hundred nine children (aged 6-13 years, 104 female, 90% Caucasian) with a principal anxiety disorder were randomly allocated to family CBT with a five-session program of BPAM (n = 109) or family CBT-only (n = 100). Family CBT comprised the Cool Kids program, a structured 12-week program that included both mothers and fathers. Overall, results revealed that the addition of BPAM did not significantly improve outcomes for the child or the parent compared to the CBT-only group at posttreatment or 6-month follow-up. Overall, however, children with nonanxious parents were more likely to be diagnosis free for any anxiety disorder compared to children with anxious parents at posttreatment and 6-month follow-up. BPAM did not produce greater reductions in parental anxiety. The results support previous findings that parent anxiety confers poorer treatment outcomes for childhood anxiety disorders. Nevertheless the addition of BPAM anxiety management for parents in its current format did not lead to additional improvements when used as an adjunct to family CBT in the treatment of the child's anxiety disorder. Future benefits may come from more powerful methods of reducing parents' anxiety.
父母焦虑是影响儿童焦虑障碍最佳治疗效果的一个风险因素。本试验旨在探讨在家庭认知行为疗法(CBT)的基础上增加一个简短的父母焦虑管理(BPAM)方案是否比单纯家庭 CBT 更能有效治疗儿童焦虑障碍。共有 209 名(年龄 6-13 岁,女性 104 名,90%为白种人)患有主要焦虑障碍的儿童被随机分配至接受家庭 CBT 联合 5 次 BPAM 方案(n = 109)或单纯家庭 CBT(n = 100)。家庭 CBT 包含 Cool Kids 项目,这是一个有组织的为期 12 周的项目,包括母亲和父亲。总体而言,结果表明,与单纯 CBT 组相比,BPAM 的添加并没有显著改善儿童或父母在治疗后或 6 个月随访时的治疗效果。然而,总的来说,与父母焦虑的儿童相比,父母不焦虑的儿童在治疗后和 6 个月随访时更有可能被诊断为没有任何焦虑障碍。BPAM 并没有使父母的焦虑程度显著降低。研究结果支持了之前的发现,即父母的焦虑会对儿童焦虑障碍的治疗效果产生更差的影响。然而,在当前形式下,BPAM 焦虑管理方案作为家庭 CBT 的辅助治疗儿童焦虑障碍时,并没有带来额外的改善。未来的益处可能来自于更有效的减轻父母焦虑的方法。