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Evaluating the Impact of an App-Based Homework Program Following One-Session Treatment for Childhood Phobias: A
Annelieke Hagen1, Thomas H Ollendick2, Robin Zimmermann3
1Leiden University, Leiden, the Netherlands.
Objective:
Specific phobias are among the most common, earliest-onset psychiatric disorders in youth. Although One-Session Treatment (OST) is a well-established intervention, 35-40% of children do not reach full remission. This study examined whether supplementing OST with a child-focused, app-supported homework program enhances outcomes.
Method:
A total of 172 children (ages 7-14; M = 10.65, SD = 2.09; 59% girls) meeting criteria for any specific phobia participated in a parallel-group randomized superiority trial and received standard OST before randomization to therapist-provided homework (OST-only) or an app-supported program (OST + app). Assessments occurred before and after a 3-week baseline, post-OST, post-practice, and at 6-month follow-up. Primary outcomes were diagnostic status and clinician-rated severity; secondary outcomes included behavioral avoidance, self-reported fear and avoidance, and functional impairment. Mixed-effects linear models were used.
Results:
Both groups showed significant improvements on all outcomes, with medium-to-large effect sizes and gains maintained through post-practice and follow-up. Remission rates were 25.2% post-OST, 46.0% post-practice, and 69.6% at follow-up. Children in both conditions practiced frequently. The app-supported homework program did not enhance outcomes or at-home practice. Families in the OST + app condition reported higher treatment satisfaction. Children with blood-injection-injury phobias showed lower remission rates than those with other phobias.
Conclusion:
Findings underscore the effectiveness of OST across diverse clinical settings. The app-supported homework program did not enhance outcomes, while families reported higher treatment satisfaction, suggesting potential value warranting investigation. Future research should clarify whether specific child or symptom profiles may benefit from app-based support and strengthen OST implementation.
