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Internet-Delivered Therapy for Parents With Health Anxiety by Proxy: Protocol for a Single-Case Experimental Design

Katrine Ingeman^1,2,3, Lisbeth Frostholm^2,3, Kaare Bro Wellnitz³

¹Research Unit, Department of Child and Adolescent Psychiatry, Aarhus University Hospital Psychiatry, Aarhus, Denmark.

JMIR Research Protocols

|November 24, 2023

Summary

Health anxiety (HA) by proxy is a distressing condition for parents. The PROXY study investigates an internet-delivered treatment for parents with HA by proxy, using a single-case experimental design to assess its effects on parental anxiety.

Keywords:

SCED health anxiety health anxiety by proxy internet-delivered treatment protocol single-case experimental design

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Area of Science:

Psychology
Clinical Psychology
Digital Health

Background:

Health anxiety (HA) by proxy involves parental obsessive worries about a child's health, causing distress and potential maladaptive coping in children.
No targeted treatments currently exist for parents with HA by proxy.
The PROXY internet-delivered treatment was developed using CBT and ACT principles in collaboration with experts and affected parents.

Purpose of the Study:

To outline the protocol for a study evaluating the efficacy of the PROXY treatment.
To investigate the potential effects of PROXY on parental health anxiety by proxy.

Main Methods:

A replicated randomized single-case experimental design (SCED) involving 5 parents with HA by proxy.
Participants undergo an 8-week treatment phase (phase B) after a randomized baseline period (phase A) and a follow-up (phase C).
Daily anxiety levels are monitored via SMS, with self-report questionnaires assessing HA by proxy and general HA administered throughout the 96-day study.

Main Results:

Recruitment commenced in June 2022, with 4 parents included as of March 2023.
Data collection was anticipated to conclude in April 2023.

Conclusions:

This protocol details the sole study to date investigating treatment for HA by proxy.
The SCED methodology is suitable for this condition due to the potential for few participants, allowing for robust individual treatment effect analysis.
Study findings will guide future research on treatment mechanisms, refinement, and delivery for HA by proxy.