Randomized trial comparing standard versus light intensity parent training for anxious youth.

Objective: To examine the efficacy of the parent-led intervention Supportive Parenting for Anxious Childhood Emotions (SPACE) relative to a low-dose version of the protocol among children and adolescents with clinically significant anxiety and/or obsessive-compulsive disorder (OCD).
Method: 68 youth (7-17) with anxiety/OCD and their parents were randomized to receive 12 weekly telehealth SPACE sessions (SPACE-Standard) or bibliotherapy plus 4 telehealth sessions over 12 weeks (SPACE-light). After screening, assessments were conducted via videoconferencing at baseline, post-treatment, and one-month follow-up. Independent evaluators were blind to treatment condition.
Results: Treatment condition did not predict whether a participant responded to the intervention (SPACE-Standard = 70%; SPACE-Light = 68%), nor was treatment condition a predictor of anxiety severity, parent-reported anxiety, or parent-/child-reported functional impairment at post-treatment or one-month follow-up. Youth in SPACE-Light self-reported higher post-treatment anxiety than youth in SPACE-standard, though this was no longer significant at one-month follow-up. Parent-reported family accommodation total change scores were associated with anxiety severity at post-treatment across both arms.
Conclusion: This is the second randomized controlled trial (RCT) evaluating SPACE and provides further support for the efficacy of this intervention both in standard and low-dose formats. This study provides support for parent-led anxiety treatment targeting family accommodation as a primary mechanism of change and extends evidence of efficacy to a more clinically diverse sample.
Trial Registration: ClinicalTrials.gov Registry: NCT04922502.https://classic.
Clinicaltrials: gov/ct2/show/NCT04922502.
Competing Interests: Declaration of competing interest Dr. Storch reports receiving research funding to his institution from the Ream Foundation, International OCD Foundation, and NIH. He is a consultant for Brainsway and Biohaven Pharmaceuticals. He owns stock less than $5000 in NView. He receives book royalties from Elsevier, Wiley, Oxford, American Psychological Association, Guildford, Springer, Routledge, and Jessica Kingsley. Ms. Ayton, Dr. Guzikck, Dr. Palo, Ms. Kook, Dr. Candelari, Ms. Maye, Dr. McNeel, Ms. Trent, Ms. Garcia, Dr. Onyeka, and Ms Rast have no disclosures to report. Dr. Shimshoni receives royalties from books (including on SPACE, the treatment examined in this study) and revenue from clinical training workshops. Dr. Lebowitz receives royalties from books (including on SPACE, the treatment examined in this study) and revenue from clinical training workshops. Dr. Goodman receives research fundings from NIH, Biohaven, and the McNair Foundation and consulting fee from Biohaven. He receives royalties from Proem.
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