Parents/guardians who are concerned about their child's emotional development, especially difficulties related to excessive anxiety and stress, are in a valuable position to serve as change-agents for their children. Unfortunately, they are typically unaware of when to try to help, or how best to help their children. This Phase II project aims to design, develop, evaluate and eventually provide to the public an affordable web-based parent training (WPT) program that will be user-friendly and inform parents about evidence-based strategies they can use to help their children manage excessive and distressing anxiety and anxiety-related symptoms/disorders. The WPT will be (a) a stand-alone self-guided program as well as (b) an adjunctive component for parents of youth who receive treatment (e.g., cognitive-behavioral therapy;CBT) for anxiety. In Phase I, we developed and piloted a sample of one chapter of the 10-module WPT program. We worked with parents of anxious youth (in both clinical and non-clinical samples) and with CBT experts. The preliminary data indicated that the web-based modality is acceptable and feasible for use in this population, and the data support the further development and evaluation of such a program in a large-scale randomized controlled trial. This Phase II proposed project will involve (a) the development of the full 10-module WPT program and (b) the evaluation of the feasibility, acceptability, and effectiveness of the program compared to Bibliotherapy (BPT) and a Waitlist Control (WLC) in (a) parents concerned about their child (ages 7-14) suffering subclinical anxiety (non clinic sample) and (b) in parents of youth (ages 7-14) who are concurrently receiving cognitive-behavioral therapy (CBT) for youth anxiety (clinic sample), in producing improvement in parent understanding of anxiety, strategies to support their child in managing anxiety, and evidence-based practice.
As many as 14 million youth suffer from anxiety (based on Census Report, 2009;Achenbach et al. 1995;Gurley et al. 1996;Shaffer et al. 1996). Recently, an increased incidence of child anxiety has been linked to pressures associated with national educational testing, natural disasters (LaGreca & Silverman, 2010), and threat of terrorism (Comer &Kendall, 2007). Parents/guardians who are concerned about their child's emotional development, especially difficulties related to excessive anxiety and stress, are in a valuable position to serve as change-agents for their children. Unfortunately, they are typically unaware of when to try to help, or how best to help their children. Parents often turn to self-help printed materials (bibliotherapy) as an option for getting information on how to help their children (Elgar &McGrath, 2003). However, there are a number of shortcomings to bibliotherapy. First, there exists a degree of questionable quality and limited or lacking empirical support associated with many of the available sources (Scogin, 2003; Redding, Herber, Forman, &Gaudiano, 2007). Reading materials are often not individualized to a satisfactory degree, and several of the sources are not particularly engaging. In addition, many self-help resources are difficult to implement because they lack step-by-step audio/visual guides and/or interactive learning experiences. An alternate, equally accessible, equally private and convenient, but reliable and engaging resource for parents who would like to learn more about their child's difficulties and help their child better manage anxiety and anxious distress is sorely needed (Spence, Holmes, March, &Lipp, 2006). Despite evidence for the effectiveness of treatments for child anxiety, only a small proportion of anxious youth receive professional treatment (Essau, Conradt, &Petermann, 2002). Giving concerned parents access to web-based information may facilitate and promote attention to and initiation of empirically-supported treatments for youth who are in need (Kenardy, McCafferty &Rosa, 2003). This Phase II project will result in the development and evaluation of the first online web-based parent training program that can offer parents an easily accessible, affordable, confidential, convenient and reliable resource from which to learn about anxiety and the empirically-supported strategies to help their child develop adaptive coping skills. The web-based platform can also help widen and ease access to care (New Freedom Commission, 2004), helping parents overcome barriers to seeking treatment while becoming more educated consumers of mental health services, and subsequently, could facilitate the dissemination of empirically- supported treatments for anxious youth (Kenardy, McCafferty &Rosa, 2003;Marks, Cavanagh, &Gega, 2007; Ritterband, 2006). An engaging and interactive multimedia format may increase the likelihood of both parents (mothers and fathers) being informed and involved. As an adjunctive component of CBT for child anxiety, a web-based parent-training program has the potential to enhance child treatment outcomes as well as family functioning, to reduce clinician effort/time, and to increase consistency of care (Khanna &Kendall, 2007). From both a public health and commercial perspective, there is substantial potential in self-administered (e.g., self- help) interventions to improve the mental health of children and families who suffer from mental disorders and related emotional problems but who are unable to access services (Scogin, 2003).