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Parent-delivered cognitive therapy more cost-effective for pediatric anxiety

Brief guided parent-delivered CBT was not more effective than solution-focused brief therapy for childhood anxiety disorders; however, it was more cost-effective, according to recent findings.

“Effective treatments for anxiety disorders in children exist; however, fewer than a third of children with an anxiety disorder access professional help,” Cathy Creswell, PhD, of the University of Reading, United Kingdom, and colleagues wrote. “Both parental preferences and treatment side-effect profiles indicate the use of psychological treatments as the first-line treatment, yet evidence-based psychological treatments are typically lengthy (eg, 14 to 16 hours-long sessions) and studies have mainly been done in specialist settings. Cost-effective psychological treatments suitable for routine clinical practice are needed.”

To compare clinical outcomes and cost-effectiveness of brief-guided parent-delivered CBT and solution-focused brief therapy for childhood anxiety disorders, researchers conducted a randomized controlled trial among 136 children aged 5 to 12 years who were referred to primary child and mental health services for anxiety difficulties. Study participants received brief guided parent-delivered CBT (n = 68) or solution-focused brief therapy (n = 68).

After treatment, 59% of participants who received brief guided parent-delivered CBT and 69% of those who received solution-focused brief therapy exhibited “much or very much” improvement in Clinical Global Impressions of Improvement (CGI-I) score, with no significant differences in clinical or economic outcomes.

However, brief guided parent-delivered CBT was associated with lower costs, with a mean difference of –£448 (P = .07).

When accounting for sampling uncertainty, researchers reported brief guided parent-delivered CBT was likely to be a cost-effective use of resources, compared with solution-focused brief therapy.

“Although brief guided parent-delivered CBT was not clinically superior to solution-focused brief therapy, our study provides evidence to support its use as a likely cost-effective, brief psychological approach for treatment of childhood anxiety problems,” the researchers concluded. – by Amanda Oldt

Disclosure: Creswell authored a published book for parents that was used in the brief guided parent-delivered cognitive behavioral therapy group of this trial and receives royalties from sales of this book. Please see the study for a full list of relevant financial disclosures.