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

Objective

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.

Method

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.

Results

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.

Conclusion

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.