Targeting Parental Risk Factors for Children's Anxiety: A Factorial Randomized Trial with Three Intervention...

Parent-focused interventions have the potential to reduce parental risk factors for children's anxiety. We tested three theoretically distinct intervention components, targeting distinct parental risk factors, to improve understanding of the role of these factors in children's anxiety, and to guide intervention program development.

We used a 12-week factorial experiment with random allocation to any possible combination and order of three single-session online components: (1) reducing family accommodation, (2) increasing parental empathetic responses, and (3) cognitive restructuring for parental maladaptive cognitions. Assessments took place at baseline (T₀), after the first component (T₂), after all components (T₆), and at follow-up (T₁₂). Our primary outcome was parent-reported child anxiety at T₂. We used intention-to-treat regression-based ANCOVA models.

The components did not reduce parent-reported anxiety at T₂, but the empathetic responding component improved parental empathic responding at all timepoints and parent-reported anxiety at T₆ and T₁₂. The family accommodation component improved family accommodation at T₂, but this effect disappeared once parents received additional components. The cognitive restructuring component did not produce any effects.

Online, single-session components did not reduce parent-reported anxiety at the primary timepoint, and most outcomes did not change. Nevertheless, components targeting parental empathic responding and family accommodation can meaningfully change parental risk factors for children's anxiety. Targeting empathetic responses seems most promising for reducing children's anxiety. These findings may contribute to the development of more precise parent-focused interventions for children's anxiety.