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Parent-Delivered Cognitive Behavioral Therapy May Help Children With Anxiety

There are a variety of anxiety disorders that can affect children including generalized anxiety, social phobias, separation anxiety, school phobia, and panic disorder. The anxiety disorders not only affect their current wellness but can also affect future psychological health and increase the risk of substance abuse. Cognitive behavioral therapy (CBT) is a type of therapy used for anxiety disorders that helps people understand negative thought patterns and change their response to anxious situations. However, time commitment, resources, and costs can make it difficult for some to follow and complete treatment.

Researchers from England wanted to know if a form of CBT delivered by parents and guided by professionals could help children with anxiety disorders. The study, published in the British Journal of Psychiatry, found that parent-delivered CBT was an effective treatment option for children with anxiety disorders.

About the Study    TOP

The randomized trial included 194 children, aged 7-12 years, with a diagnosed anxiety disorder. The children were randomized to parent delivered CBT with full guidance, parent delivered CBT with brief guidance, or the waitlist. Parents in the full guidance group received four face to face and four telephone sessions with professionals to support their efforts. Those in the brief guidance group had two face to face and two support telephone calls. Those on the wait list received standard care.

Presence of anxiety disorder, improvements in anxiety presentation, and symptom severity were recorded before and after treatment and in a 6 month follow-up. At the end of the treatment period 50% of children in the full guided group had recovered, compared to 39% with brief guidance and 25% on the waitlist. Children with full guidance therapy were also:

  • 3 times more likely to have fully recovered from anxiety disorder than those on the waitlist
  • 2.6 times more likely to have "much improved" or "very much improved" symptoms than those on the waitlist

Of the children who had recovered by the end of treatment, all but one maintained their recovery through the 6 month assessment. Those that did not reach recovery during treatment period did show improvements in symptoms by 6 month assessment. The experience of the therapist did not play a role in outcomes.

How Does this Affect You?    TOP

A randomized control trial is considered a reliable form of research. However, this is one of the first trials to assess this type of treatment being done by parents. More research may be done to compare this treatment to others to determine which may be most effective. It is important to note that the full guidance was more beneficial than waitlist but the changes in the brief guidance were not significantly different from the waitlist. Although the parents were delivering the care it appeared to be important that the parent keep in close contact with a health professional for appropriate guidance.

A parent involved program offers a more convenient way to deliver CBT and a way to keep parents active in the process. There are different types of therapy to help your child manage their anxiety disorder. Talk to your doctor about the different options to help determine which may work best for your family. No matter which program you choose, it is important for parents to stay involved by learning about anxiety disorders, understanding a child's triggers, and knowing what steps to take during difficult moments.


American Academy of Pediatrics
Anxiety and Depression Association of America


Thirlwall K, Cooper PJ, et al. Treatment of child anxiety disorders via guided parent-delivered cognitive-behavioural therapy: randomised controlled trial. Br J Psychiatry. 2013 Dec;203(6):436-44.
Last reviewed January 2014 by Michael Woods, MD

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This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.

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