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

Area of Science:

• Child and Adolescent Psychiatry
• Clinical Psychology
• Behavioral Therapy

Background:

• Anxiety and obsessive-compulsive disorder (OCD) significantly impact youth development.
• Parent-led interventions show promise in managing pediatric anxiety and OCD.
• Family accommodation, where parents adjust routines to avoid child distress, is a key factor in maintaining these disorders.

Purpose of the Study:

• To compare the efficacy of the standard Supportive Parenting for Anxious Childhood Emotions (SPACE) program with a low-dose version (SPACE-light) for youth with anxiety/OCD.
• To evaluate if treatment format influences treatment response and symptom severity.
• To examine the role of family accommodation in treatment outcomes.

Main Methods:

• A randomized controlled trial (RCT) involving 68 youth (aged 7-17) with anxiety/OCD and their parents.
• Participants were assigned to either 12 weekly telehealth SPACE sessions (SPACE-Standard) or bibliotherapy with 4 telehealth sessions (SPACE-light).
• Assessments were conducted at baseline, post-treatment, and one-month follow-up by independent evaluators blind to treatment conditions.

Main Results:

• No significant difference in treatment response rates between SPACE-Standard (70%) and SPACE-light (68%).
• Neither treatment condition predicted anxiety severity or functional impairment at post-treatment or follow-up.
• Higher post-treatment self-reported anxiety was noted in the SPACE-light group, but this difference diminished at follow-up. Parent-reported family accommodation changes correlated with anxiety severity.

Conclusions:

• The SPACE intervention is effective in both standard and low-dose formats for treating anxiety and OCD in children and adolescents.
• Parent-led treatment targeting family accommodation is a viable approach for pediatric anxiety and OCD.
• This study extends the evidence base for SPACE to a more diverse clinical population.