Anxiogenic behaviours and cognitions in parents of anxious children : effects of a guided parent-delivered treatment programme

Parent involvement in treatment programmes for child anxiety disorders aims to change the parental behaviours and cognitions implicated in the development and maintenance of childhood anxiety disorders. However, very few studies have included parental behaviours and cognitions as outcomes, and the methodological shortcomings of those that have, preclude clear conclusions. This study aimed to provide the first comprehensive examination of change in parental behaviours and cognitions after a guided parent-delivered cognitive-behavioural therapy (CBT) programme compared to a waitlist control. The association between change in parental behaviours and cognitions with child treatment outcome was also considered. Eighty-eight children aged 7 to 12 years old with a diagnosed anxiety disorder were randomised to either an 8-week guided parent-delivered CBT programme (n=41) or waitlist control group (n=47). None of the parents met diagnostic criteria for an anxiety disorder. Observational measures of parental behaviours whilst their child completed an anxiety-provoking task were taken before and after the intervention. Parent expectations were also measured of their child's and own response in the laboratory task, as well as for hypothetical situations that were ambiguous for whether or not they presented a threat. The treatment programme was not associated with greater change in parental behaviours compared to the waitlist control. After the treatment programme there was a change in specific parental cognitions, in that parents perceived themselves and their child to have more control in hypothetical threat ambiguous situations. Change in parental behaviour and cognition was not significantly associated with child treatment outcomes. The results suggest that guided parent-delivered CBT can increase parental self-efficacy in the management of child anxiety. However, the absence of any association of treatment with other parental cognitions or behaviours questions the salience of parental change in the treatment of childhood anxiety disorders.