Clinical Child and Family Psychology Review ( IF 5.5 ) Pub Date : 2024-11-07 , DOI: 10.1007/s10567-024-00505-3 Meri M. V. Grajdan, Evren Etel, Lara J. Farrell, Caroline L. Donovan
Cognitive behavioural therapy (CBT) is an efficacious intervention for child anxiety that has been translated into accessible digital formats, many of which involve parents in treatment. However, the value of parental involvement in treatment is not clearly understood. This systematic review examined characteristics of parental involvement (i.e., format and content of sessions, level of therapist guidance, and parent session compliance) in digital CBT for child anxiety (mean child age ≤ 12 years) and their relation to child outcomes (primary disorder remission, clinician-, parent-, and child-rated anxiety, and global functioning). Systematic searches in CINAHL, Embase, ERIC, PsychINFO, PubMed, and Scopus up to 14th August 2023, and citation searching, identified 27 articles (as 23 studies) assessing 14 interventions. Two were parent-only programmes for 3–6-year-old children, with the remaining being parent–child programmes targeting older children. Parents were actively involved as coaches/collaborators, assisting their children with anxiety management and exposure, and less often as co-clients working on their own difficulties. Benefits of treatment were observed across interventions, except for one, psychoeducation-based programme. Higher remission rates were more frequently observed in interventions delivered in controlled settings, those with fewer parent-only sessions, or those incorporating more parent- or therapist-led exposure sessions. Most studies were conducted with affluent samples, limiting generalisability, and several received a high risk of bias rating. Future research should examine parent and family related mechanisms of change and modify interventions for improved adherence, such as restricting the number of modules parents are required to complete and teaching key therapeutic strategies such as exposure early in the programme.
中文翻译:
父母参与儿童焦虑数字认知行为疗法干预的系统评价
认知行为疗法 (CBT) 是一种针对儿童焦虑症的有效干预措施,已被转化为可访问的数字格式,其中许多格式涉及父母参与治疗。然而,父母参与治疗的价值尚不清楚。本系统评价检查了父母参与儿童焦虑数字 CBT 的特征(即会议的形式和内容、治疗师指导水平和家长会议依从性)(儿童平均年龄≤ 12 岁)及其与儿童结局的关系(原发性疾病缓解、临床医生、父母和儿童评定的焦虑,以及整体功能)。截至 2023 年 8 月 14 日,在 CINAHL、Embase、ERIC、PsychINFO、PubMed 和 Scopus 中进行系统检索和引文检索,确定了 27 篇文章(作为 23 项研究),评估了 14 项干预措施。两项是针对 3-6 岁儿童的纯父母项目,其余是针对年龄较大儿童的亲子项目。家长作为教练/合作者积极参与,帮助他们的孩子进行焦虑管理和暴露,而较少作为共同客户解决他们自己的困难。在所有干预措施中观察到治疗的益处,除了一项基于心理教育的项目。在受控环境中进行的干预、仅由父母进行的干预较少或包含更多由父母或治疗师主导的暴露会议的干预中,更频繁地观察到较高的缓解率。大多数研究是使用富裕样本进行的,限制了普遍性,并且有几项研究获得了高偏倚风险评级。 未来的研究应检查与父母和家庭相关的变化机制,并修改干预措施以提高依从性,例如限制父母需要完成的模块数量,并在计划早期教授关键治疗策略,例如暴露。