3 - (SYM 88) Using Digital Tools to Optimize Parent-led Exposure-focused CBT for Children with Anxiety Disorders

Cognitive-Behavioral Therapy (CBT) - the first-line treatment for pediatric anxiety disorders -typically integrates anxiety management strategies such as cognitive restructuring and relaxation, followed by exposure. There is evidence to indicate that treatment involving a greater number of in-session exposures, and more challenging exposures, leads to better child outcomes. Despite the importance of this strategy for improving outcomes, in practice there is limited implementation of the technique strategy due to a range of notable barriers. This often leads to the prioritization of other potentially less effective strategies over exposure techniques. To address this gap, and improve the delivery of exposures for children, we have co-developed the "Courage Quest" program, a novel parent-led digital intervention designed for children aged 8 to 12 with anxiety disorders. Developed in collaboration with children experiencing anxiety and their parents, this innovative digital tool aims to increase access to exposure-focused techniques that can be used with varying degrees of therapist support or as an adjunct to therapy. Under parental guidance, children gain insights into anxiety and apply newly acquired skills to confront their fears using principles of exposure-focused CBT. 

Methods: “Courage Quest” is currently being evaluated in two trials. The first is a pilot trial involving 7 child-parent dyads dealing with clinical anxiety. The second trial employs a factorial treatment design to determine the optimal delivery of exposure techniques. Outcome measures encompass child- and/or parent-reported anxiety levels as well as diagnostic remission.

Results: The outcomes of these trials will provide preliminary evidence regarding the feasibility, acceptability, efficacy, and optimization of exposure-focused CBT through a parent-led digital format for children. 

Conclusion: Empowering parents and clinicians to deliver exposure-focused CBT through the innovative digital platform "Courage Quest" holds the potential to reduce anxiety symptoms and increase remission rates in children with anxiety disorders. Digital interventions offer immediate access to treatment delivered with consistent high fidelity, promising enhanced support for the use of exposure in the treatment of anxiety disorders in children.