Therapeutic Processes that Impact Child Outcomes Following Exposure Therapy for Child Specific Phobias

This study investigates the relationship between therapeutic process variables and child outcomes following exposure therapy for specific phobias (SPs) in children. SPs are a common childhood disorder and a predictor of future mental health conditions. While Cognitive Behavioural Therapy (CBT) and One-Session Treatment (OST) are effective in treating SPs, a notable percentage of children do not fully respond. The study examined key therapeutic process variables among a sample of 52 children and their parents who participated in the broader Preschoolers' Overcoming Phobias randomised controlled trial. Variables included child and parent therapeutic alliances, child motivation, homework adherence, therapist treatment fidelity, parent satisfaction, and parental confidence in implementing exposure and managing their own fears. Results indicated that child therapeutic alliance and parental confidence in managing fears were significant predictors of child outcomes at six months post-treatment. Specifically, parental confidence mediated the relationship between their ability to conduct exposure and the child's approach behaviour. This suggests that effective SP treatments should focus on both the child's direct therapy and supporting parents in managing their child's anxieties.