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Young girl looking anxious

A new study involving researchers at Oxford Population Health’s Health Economics Research Centre has found that online, parent-led with therapist support, cognitive behavioural therapy (CBT) for children with anxiety problems can make treatment accessible to more children in a timely manner. The study is published in The Lancet Psychiatry.

Child mental health services are notoriously stretched around the world with significant gaps between the care that is needed and the care that is available. The UK is no exception. Online-based treatments have the potential to dramatically increase capacity within clinical services.

CBT has been shown to be an effective treatment for childhood anxiety problems, but only a minority of children with anxiety problems are able to access this evidence-based treatment. Families face extensive barriers to treatment, including a high demand for mental health services, limited available support, and long waiting lists.

This study compared a newly developed online parent-led and therapist-supported CBT approach with usual treatment (generally much longer forms of CBT) in the UK Child and Adolescent Mental Health Services context. The aim was to establish whether empowering parents, through an online platform, to work with therapists to address their children’s fears and worries was a clinically effective intervention for childhood anxiety problems and was good value for money. The children who participated in the study were randomly assigned to receive either the new online, parent-led with therapist support approach or usual treatment.

Key findings:

  • The online-based treatment was found to have similar good clinical outcomes when compared with usual treatment;
  • The online-based treatment brought substantial savings in terms of the average time that the therapists spent delivering the treatment (182 minutes compared with 307 minutes for usual treatment) and was considered to be cost-effective in several scenarios;
  • Parents whose children participated in the study reported high-levels of acceptability for the online-based treatment in terms of usability, effort, time, and perceived outcomes for their child;
  • There were no serious adverse events or outcomes associated with the online-based treatment.

Mara Violato, Associate Professor at Oxford Population Health, said ‘Anxiety problems often start in early childhood and there is good evidence to suggest that they often persist into adolescence and adulthood, with serious implications for several areas of daily life. The economic evaluation included in this study has demonstrated that the new online approach to treatment is likely to be good value for money and is accessible without comprising outcomes for children with anxiety problems so may be able to prevent future anxiety-related challenges.’

The study included 444 families and children aged between five and 12 years in England and Northern Ireland who approached 29 NHS trusts and five local authority or voluntary/community sector providers for getting help for child anxiety problems. The study excluded any children who required more specialised care as a result of an additional condition such as an autism diagnosis or a learning disability, and any children who had self-harmed or expressed suicidal intent.

The study researchers have also published an opinion piece explaining the study results in The Conversation.