Departments of Experimental Psychology and Psychiatry, University of Oxford, Oxford, UK.
School of Psychology and Clinical Language Sciences, University of Reading, Reading, UK.
Behav Cogn Psychother. 2023 Nov;51(6):512-532. doi: 10.1017/S1352465822000546. Epub 2022 Dec 2.
Anxiety problems have a particularly early age of onset and are common among children. As we celebrate the anniversary of the BABCP, it is important to recognise the huge contribution that cognitive behavioural therapy (CBT) has made to the treatment of anxiety problems in children. CBT remains the only psychological intervention for child anxiety problems with a robust evidence base, but despite this, very few children with anxiety problems access CBT. Creative solutions are urgently needed to ensure that effective treatments can be delivered at scale. Here we focus on parent-led CBT as this offers a potential solution that is brief and can be delivered by clinicians without highly specialised training. Over the last decade there has been a substantial increase in randomised controlled trials evaluating this approach with consistent evidence of effectiveness. Nonetheless clinicians, and parents, often have concerns about trying the approach and can face challenges in its delivery.
We draw on empirical evidence and our clinical experience to address some of these common concerns and challenges, with particular emphasis on the key principles of empowering parents and working with them to provide opportunities for new learning for their children.
We conclude by highlighting some important directions for future research and practice, including further evaluation of who does and does not currently benefit from the approach, determining how it should be adapted to optimise outcomes among groups that may not currently get maximum benefits and across cultures, and capitalising on recent technological developments to increase engagement and widen access.
焦虑问题的发病年龄尤其早，在儿童中很常见。在我们庆祝 BABCP 成立周年之际，重要的是要认识到认知行为疗法 (CBT) 对儿童焦虑问题治疗的巨大贡献。CBT 仍然是唯一具有强大证据基础的儿童焦虑问题心理干预方法，但尽管如此，只有极少数焦虑问题儿童接受 CBT。迫切需要创造性的解决方案来确保可以大规模提供有效的治疗方法。在这里，我们专注于父母主导的 CBT，因为它提供了一种简短的潜在解决方案，并且可以由没有高度专业化培训的临床医生来提供。在过去的十年中，已经有大量的随机对照试验评估了这种方法，一致证明其有效。尽管如此，临床医生和家长通常对尝试这种方法存在担忧，并且在实施过程中可能会面临挑战。
我们借鉴实证证据和临床经验来解决其中的一些常见问题和挑战，特别强调赋予父母权力的关键原则，并与他们合作，为孩子提供新的学习机会。
我们最后强调了未来研究和实践的一些重要方向，包括进一步评估谁目前受益于该方法，谁没有受益，确定如何对其进行调整以优化可能目前无法获得最大收益的群体的结果，以及跨文化，以及利用最近的技术发展来提高参与度并扩大覆盖面。
