Types of parental involvement in CBT with anxious youth: A preliminary meta-analysis

Katharina Manassis, Trevor Changgun Le, Kathryn Bennett, Xiu Yan Zhao, Sandra Mendlowitz, Stephanie Duda, Michael Saini, Pamela Wilansky, Susan Baer, Paula Barrett, Denise Bodden, Vanessa E. Cobham, Mark R. Dadds, Ellen Flannery-Schroeder, Golda Ginsburg, David Heyne, Jennifer L. Hudson, Philip C. Kendall, Juliette Liber, Carrie Masia-WarnerMaaike H. Nauta, Ronald M. Rapee, Wendy Silverman, Lynne Siqueland, Susan H. Spence, Elisabeth Utens, Jeffrey J. Wood

Research output: Contribution to journalArticle

66 Citations (Scopus)

Abstract

Objective: Meta-analytic studies have not confirmed that involving parents in cognitive behavior therapy (CBT) for anxious children is therapeutically beneficial. There is also great heterogeneity in the type of parental involvement included. We investigated parental involvement focused on contingency management (CM) and transfer of control (TC) as a potential outcome moderator using a meta-analysis with individual patient data. Method: Investigators of randomized controlled trials (RCTs) of CBT for anxious children, identified systematically, were invited to submit their data. Conditions in each RCT were coded based on type of parental involvement in CBT (i.e., low involvement, active involvement without emphasis on CM or TC, active involvement with emphasis on CM or TC). Treatment outcomes were compared using a 1-stage meta-analysis. Results: All cases involved in active treatment (894 of 1,618) were included for subgroup analyses. Across all CBT groups, means of clinical severity, anxiety, and internalizing symptoms significantly decreased posttreatment and were comparable across groups. The group without emphasis on CM or TC showed a higher proportion with posttreatment anxiety diagnoses than the low-involvement group. Between posttreatment and 1-year follow-up, the proportion with anxiety diagnoses significantly decreased in CBT with active parental involvement with emphasis on CM or TC, whereas treatment gains were merely maintained in the other 2 groups. Conclusions: CBT for anxious children is an effective treatment with or without active parental involvement. However, CBT with active parental involvement emphasizing CM or TC may support long-term maintenance of treatment gains. Results should be replicated as additional RCTs are published.

Original languageEnglish
Pages (from-to)1163-1172
Number of pages10
JournalJournal of Consulting and Clinical Psychology
Volume82
Issue number6
DOIs
StatePublished - 1 Jan 2014

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Cognitive Therapy
Meta-Analysis
Anxiety
Randomized Controlled Trials
Therapeutics
Parents
Research Personnel

Keywords

  • Anxiety disorders
  • Anxious children
  • Cognitive behavior therapy
  • Parental involvement

Cite this

Manassis, K., Changgun Le, T., Bennett, K., Zhao, X. Y., Mendlowitz, S., Duda, S., ... Wood, J. J. (2014). Types of parental involvement in CBT with anxious youth: A preliminary meta-analysis. Journal of Consulting and Clinical Psychology, 82(6), 1163-1172. https://doi.org/10.1037/a0036969
Manassis, Katharina ; Changgun Le, Trevor ; Bennett, Kathryn ; Zhao, Xiu Yan ; Mendlowitz, Sandra ; Duda, Stephanie ; Saini, Michael ; Wilansky, Pamela ; Baer, Susan ; Barrett, Paula ; Bodden, Denise ; Cobham, Vanessa E. ; Dadds, Mark R. ; Flannery-Schroeder, Ellen ; Ginsburg, Golda ; Heyne, David ; Hudson, Jennifer L. ; Kendall, Philip C. ; Liber, Juliette ; Masia-Warner, Carrie ; Nauta, Maaike H. ; Rapee, Ronald M. ; Silverman, Wendy ; Siqueland, Lynne ; Spence, Susan H. ; Utens, Elisabeth ; Wood, Jeffrey J. / Types of parental involvement in CBT with anxious youth : A preliminary meta-analysis. In: Journal of Consulting and Clinical Psychology. 2014 ; Vol. 82, No. 6. pp. 1163-1172.
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abstract = "Objective: Meta-analytic studies have not confirmed that involving parents in cognitive behavior therapy (CBT) for anxious children is therapeutically beneficial. There is also great heterogeneity in the type of parental involvement included. We investigated parental involvement focused on contingency management (CM) and transfer of control (TC) as a potential outcome moderator using a meta-analysis with individual patient data. Method: Investigators of randomized controlled trials (RCTs) of CBT for anxious children, identified systematically, were invited to submit their data. Conditions in each RCT were coded based on type of parental involvement in CBT (i.e., low involvement, active involvement without emphasis on CM or TC, active involvement with emphasis on CM or TC). Treatment outcomes were compared using a 1-stage meta-analysis. Results: All cases involved in active treatment (894 of 1,618) were included for subgroup analyses. Across all CBT groups, means of clinical severity, anxiety, and internalizing symptoms significantly decreased posttreatment and were comparable across groups. The group without emphasis on CM or TC showed a higher proportion with posttreatment anxiety diagnoses than the low-involvement group. Between posttreatment and 1-year follow-up, the proportion with anxiety diagnoses significantly decreased in CBT with active parental involvement with emphasis on CM or TC, whereas treatment gains were merely maintained in the other 2 groups. Conclusions: CBT for anxious children is an effective treatment with or without active parental involvement. However, CBT with active parental involvement emphasizing CM or TC may support long-term maintenance of treatment gains. Results should be replicated as additional RCTs are published.",
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author = "Katharina Manassis and {Changgun Le}, Trevor and Kathryn Bennett and Zhao, {Xiu Yan} and Sandra Mendlowitz and Stephanie Duda and Michael Saini and Pamela Wilansky and Susan Baer and Paula Barrett and Denise Bodden and Cobham, {Vanessa E.} and Dadds, {Mark R.} and Ellen Flannery-Schroeder and Golda Ginsburg and David Heyne and Hudson, {Jennifer L.} and Kendall, {Philip C.} and Juliette Liber and Carrie Masia-Warner and Nauta, {Maaike H.} and Rapee, {Ronald M.} and Wendy Silverman and Lynne Siqueland and Spence, {Susan H.} and Elisabeth Utens and Wood, {Jeffrey J.}",
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Manassis, K, Changgun Le, T, Bennett, K, Zhao, XY, Mendlowitz, S, Duda, S, Saini, M, Wilansky, P, Baer, S, Barrett, P, Bodden, D, Cobham, VE, Dadds, MR, Flannery-Schroeder, E, Ginsburg, G, Heyne, D, Hudson, JL, Kendall, PC, Liber, J, Masia-Warner, C, Nauta, MH, Rapee, RM, Silverman, W, Siqueland, L, Spence, SH, Utens, E & Wood, JJ 2014, 'Types of parental involvement in CBT with anxious youth: A preliminary meta-analysis', Journal of Consulting and Clinical Psychology, vol. 82, no. 6, pp. 1163-1172. https://doi.org/10.1037/a0036969

Types of parental involvement in CBT with anxious youth : A preliminary meta-analysis. / Manassis, Katharina; Changgun Le, Trevor; Bennett, Kathryn; Zhao, Xiu Yan; Mendlowitz, Sandra; Duda, Stephanie; Saini, Michael; Wilansky, Pamela; Baer, Susan; Barrett, Paula; Bodden, Denise; Cobham, Vanessa E.; Dadds, Mark R.; Flannery-Schroeder, Ellen; Ginsburg, Golda; Heyne, David; Hudson, Jennifer L.; Kendall, Philip C.; Liber, Juliette; Masia-Warner, Carrie; Nauta, Maaike H.; Rapee, Ronald M.; Silverman, Wendy; Siqueland, Lynne; Spence, Susan H.; Utens, Elisabeth; Wood, Jeffrey J.

In: Journal of Consulting and Clinical Psychology, Vol. 82, No. 6, 01.01.2014, p. 1163-1172.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Types of parental involvement in CBT with anxious youth

T2 - A preliminary meta-analysis

AU - Manassis, Katharina

AU - Changgun Le, Trevor

AU - Bennett, Kathryn

AU - Zhao, Xiu Yan

AU - Mendlowitz, Sandra

AU - Duda, Stephanie

AU - Saini, Michael

AU - Wilansky, Pamela

AU - Baer, Susan

AU - Barrett, Paula

AU - Bodden, Denise

AU - Cobham, Vanessa E.

AU - Dadds, Mark R.

AU - Flannery-Schroeder, Ellen

AU - Ginsburg, Golda

AU - Heyne, David

AU - Hudson, Jennifer L.

AU - Kendall, Philip C.

AU - Liber, Juliette

AU - Masia-Warner, Carrie

AU - Nauta, Maaike H.

AU - Rapee, Ronald M.

AU - Silverman, Wendy

AU - Siqueland, Lynne

AU - Spence, Susan H.

AU - Utens, Elisabeth

AU - Wood, Jeffrey J.

PY - 2014/1/1

Y1 - 2014/1/1

N2 - Objective: Meta-analytic studies have not confirmed that involving parents in cognitive behavior therapy (CBT) for anxious children is therapeutically beneficial. There is also great heterogeneity in the type of parental involvement included. We investigated parental involvement focused on contingency management (CM) and transfer of control (TC) as a potential outcome moderator using a meta-analysis with individual patient data. Method: Investigators of randomized controlled trials (RCTs) of CBT for anxious children, identified systematically, were invited to submit their data. Conditions in each RCT were coded based on type of parental involvement in CBT (i.e., low involvement, active involvement without emphasis on CM or TC, active involvement with emphasis on CM or TC). Treatment outcomes were compared using a 1-stage meta-analysis. Results: All cases involved in active treatment (894 of 1,618) were included for subgroup analyses. Across all CBT groups, means of clinical severity, anxiety, and internalizing symptoms significantly decreased posttreatment and were comparable across groups. The group without emphasis on CM or TC showed a higher proportion with posttreatment anxiety diagnoses than the low-involvement group. Between posttreatment and 1-year follow-up, the proportion with anxiety diagnoses significantly decreased in CBT with active parental involvement with emphasis on CM or TC, whereas treatment gains were merely maintained in the other 2 groups. Conclusions: CBT for anxious children is an effective treatment with or without active parental involvement. However, CBT with active parental involvement emphasizing CM or TC may support long-term maintenance of treatment gains. Results should be replicated as additional RCTs are published.

AB - Objective: Meta-analytic studies have not confirmed that involving parents in cognitive behavior therapy (CBT) for anxious children is therapeutically beneficial. There is also great heterogeneity in the type of parental involvement included. We investigated parental involvement focused on contingency management (CM) and transfer of control (TC) as a potential outcome moderator using a meta-analysis with individual patient data. Method: Investigators of randomized controlled trials (RCTs) of CBT for anxious children, identified systematically, were invited to submit their data. Conditions in each RCT were coded based on type of parental involvement in CBT (i.e., low involvement, active involvement without emphasis on CM or TC, active involvement with emphasis on CM or TC). Treatment outcomes were compared using a 1-stage meta-analysis. Results: All cases involved in active treatment (894 of 1,618) were included for subgroup analyses. Across all CBT groups, means of clinical severity, anxiety, and internalizing symptoms significantly decreased posttreatment and were comparable across groups. The group without emphasis on CM or TC showed a higher proportion with posttreatment anxiety diagnoses than the low-involvement group. Between posttreatment and 1-year follow-up, the proportion with anxiety diagnoses significantly decreased in CBT with active parental involvement with emphasis on CM or TC, whereas treatment gains were merely maintained in the other 2 groups. Conclusions: CBT for anxious children is an effective treatment with or without active parental involvement. However, CBT with active parental involvement emphasizing CM or TC may support long-term maintenance of treatment gains. Results should be replicated as additional RCTs are published.

KW - Anxiety disorders

KW - Anxious children

KW - Cognitive behavior therapy

KW - Parental involvement

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