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.

Autor: Wright B; Leeds and York Partnership NHS Foundation Trust, York, UK., Tindall L; Leeds and York Partnership NHS Foundation Trust, York, UK., Scott AJ; Keele University, Keele, UK., Lee E; University of Sheffield, Sheffield, UK., Cooper C; University of Sheffield, Sheffield, UK., Biggs K; University of Sheffield, Sheffield, UK., Bee P; University of Manchester, Manchester, UK., Wang HI; University of York, York, UK., Gega L; University of York, York, UK., Hayward E; Leeds and York Partnership NHS Foundation Trust, York, UK., Solaiman K; University of Sheffield, Sheffield, UK., Teare MD; Keele University, Keele, UK., Davis T; Louisiana State University, Baton Rouge, LA, USA., Wilson J; Norfolk and Suffolk NHS Foundation Trust, Norwich, UK., Lovell K; University of Manchester, Manchester, UK., McMillan D; University of York, York, UK., Barr A; University of Sheffield, Sheffield, UK., Edwards H; Leeds and York Partnership NHS Foundation Trust, York, UK., Lomas J; University of Sheffield, Sheffield, UK., Turtle C; University of Sheffield, Sheffield, UK., Parrott S; University of York, York, UK., Teige C; Leeds and York Partnership NHS Foundation Trust, York, UK., Chater T; University of Sheffield, Sheffield, UK., Hargate R; Leeds and York Partnership NHS Foundation Trust, York, UK., Ali S; University of York, York, UK., Parkinson S; Leeds and York Partnership NHS Foundation Trust, York, UK., Gilbody S; University of York, York, UK., Marshall D; University of York, York, UK.
Jazyk: angličtina
Zdroj: Journal of child psychology and psychiatry, and allied disciplines [J Child Psychol Psychiatry] 2023 Jan; Vol. 64 (1), pp. 39-49. Date of Electronic Publication: 2022 Aug 01.
DOI: 10.1111/jcpp.13665
Abstrakt: Background: 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.
Methods: 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.
Results: 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.
Conclusions: One Session Treatment has similar clinical effectiveness to CBT for specific phobias in CYP and may be a cost-saving alternative.
(© 2022 The Authors. Journal of Child Psychology and Psychiatry published by John Wiley & Sons Ltd on behalf of Association for Child and Adolescent Mental Health.)
Databáze: MEDLINE
Externí odkaz:
Nepřihlášeným uživatelům se plný text nezobrazuje