Objective
Examine the efficacy of a parent-augmented One-Session Treatment (A-OST) in treating specific phobias (SP) in youth by comparing this novel treatment to child-focused OST, a well-established treatment.
Method
A total of 97 youth (ages 6–15, 51.5% female, 84.5% White) who fulfilled diagnostic criteria for SP were randomized to either A-OST or OST. SPs were assessed with semistructured diagnostic interviews, clinician improvement ratings, and parent and child improvement ratings. In addition, measures of treatment satisfaction and parental self-efficacy were obtained. Blind assessments were completed pretreatment, posttreatment, and 1 month and 6 months following treatment. Analyses were undertaken using mixed models. In addition, gender, age, internalizing/externalizing problems, parent overprotection, and parent anxiety were examined as potential predictors and moderators of treatment outcome.
Results
Both treatment conditions produced similar outcomes with approximately 50% of youth in both treatments diagnosis free and judged to be much or very much improved at posttreatment and 1-month follow-up. At 6-month follow-up, however, the treatments diverged with OST resulting in marginally superior outcomes to A-OST, contrary to predictions. Only age of child predicted treatment outcome across the two treatments (older children did better); unexpectedly, none of the variables moderated treatment outcomes.
Conclusions
Parent augmentation of OST produced no appreciable gains in treatment outcomes. Directions for future research are highlighted.
Specific phobias (SPs), characterized by an excessive and persistent fear of a specific object or situation, are among the most common anxiety disorders (American Psychiatric Association, 2000 and American Psychiatric Association, 2013). The phobic stimulus is actively avoided or endured with intense fear or anxiety and, typically, the fear or anxiety persists over time. In children, the fear or anxiety may be expressed behaviorally as crying, tantrums, or clinging to one’s caretaker. Furthermore, the fear or anxiety is impairing and interferes with the individual’s daily functioning. SPs are categorized into five subtypes: animal type, natural environment type, blood-injection-injury type, situational type, and other type (e.g., choking, loud noises, costumed characters).
Clinically significant SPs are present in approximately 5% of children in community samples and in about 15% to 20% of children presenting at anxiety disorder clinics. The lifetime prevalence rates in children and adolescents range from 5% to 11%, depending on the type of SP (Kessler, Berglund, Demler, Jin, & Walters, 2005). For many children, phobias result in considerable academic, social, and personal distress, as well as interference in day-to-day functioning (Essau et al., 2000 and Ollendick et al., 2004). Moreover, they may lead to other anxiety, mood, and substance use disorders (Kendall, Safford, Flannery-Schroeder, & Webb, 2004).
