Wright, Barry, Tindall, Lucy, Scott, Alexander J, Lee, Ellen, Cooper, Cindy, Biggs, Katie, Bee, Penny, Wang, Han-I, Gega, Lina, Hayward, Emily et al (show 18 more authors)
(2023)
One session treatment (OST) is equivalent to multi-session cognitive behavioral therapy (CBT) in children with specific phobias (ASPECT): results from a national non-inferiority randomized controlled trial.
JOURNAL OF CHILD PSYCHOLOGY AND PSYCHIATRY, 64 (1).
pp. 39-49.
Abstract
<h4>Background</h4>5%-10% children and young people (CYP) experience specific phobias that impact daily functioning. Cognitive Behaviour Therapy (CBT) is recommended but has limitations. One Session Treatment (OST), a briefer alternative incorporating CBT principles, has demonstrated efficacy. The Alleviating Specific Phobias Experienced by Children Trial (ASPECT) investigated the non-inferiority of OST compared to multi-session CBT for treating specific phobias in CYP.<h4>Methods</h4>ASPECT was a pragmatic, multi-center, non-inferiority randomized controlled trial in 26 CAMHS sites, three voluntary agency services, and one university-based CYP well-being service. CYP aged 7-16 years with specific phobia were randomized to receive OST or CBT. Clinical non-inferiority and a nested cost-effectiveness evaluation was assessed 6-months post-randomization using the Behavioural Avoidance Task (BAT). Secondary outcome measures included the Anxiety Disorder Interview Schedule, Child Anxiety Impact Scale, Revised Children's Anxiety Depression Scale, goal-based outcome measure, and EQ-5DY and CHU-9D, collected blind at baseline and six-months.<h4>Results</h4>268 CYPs were randomized to OST (n = 134) or CBT (n = 134). Mean BAT scores at 6 months were similar across groups in both intention-to-treat (ITT) and per-protocol (PP) populations (CBT: 7.1 (ITT, n = 76), 7.4 (PP, n = 57), OST: 7.4 (ITT, n = 73), 7.6 (PP, n = 56), on the standardized scale-adjusted mean difference for CBT compared to OST -0.123, 95% CI -0.449 to 0.202 (ITT), mean difference -0.204, 95% CI -0.579 to 0.171 (PP)). These findings were wholly below the standardized non-inferiority limit of 0.4, suggesting that OST is non-inferior to CBT. No between-group differences were found on secondary outcomes. OST marginally decreased mean service use costs and maintained similar mean Quality Adjusted Life Years compared to CBT.<h4>Conclusions</h4>One Session Treatment has similar clinical effectiveness to CBT for specific phobias in CYP and may be a cost-saving alternative.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | Specific phobia, children and young people, one session treatment, cognitive behavioral therapy, randomized controlled trial, non-inferiority |
| Divisions: | Faculty of Health and Life Sciences Faculty of Health and Life Sciences > Clinical Directorate |
| Depositing User: | Symplectic Admin |
| Date Deposited: | 01 Feb 2024 09:36 |
| Last Modified: | 01 Feb 2024 09:36 |
| DOI: | 10.1111/jcpp.13665 |
| Open Access URL: | https://doi.org/10.1111/jcpp.13665 |
| Related URLs: | |
| URI: | https://livrepository.liverpool.ac.uk/id/eprint/3178259 |
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