Supporting children on therapy waitlists: A randomized controlled trial of a web-based parent-focused single session intervention for child anxiety.

Abstract

Many children experience significant, impairing anxiety, yet most never access evidence-based support; among those who do, most face long wait-times to be seen. This disconnect reflects a need for intervention approaches that provide rapid access to interim care. Single-session interventions (SSIs) may help mitigate the adverse impacts of long waitlists. This pilot parallel group RCT evaluated the effectiveness and acceptability of a self-guided, web-based SSI delivered to parents of children ages 4-13 (M_age = 8.84) with anxiety or OCD on a waitlist at a hospital-based Cognitive-Behavioral Therapy (CBT) clinic. The SSI, Project EMPOWER, targets parental accommodation, a family factor that can worsen child anxiety and impede efficacy of CBT. Parents were randomized to receive the SSI (N = 24) or waitlist as usual (N = 23). Parents completed a baseline diagnostic interview about their child and self-report questionnaires about their accommodation of child anxiety, child anxiety symptoms, and perceived ability to manage their child's anxiety (parent agency) at baseline, 2-week follow-up, and CBT intake. Relative to controls, parents who received the SSI reported significant reductions in their accommodation (d = 0.59, p = .046) and child anxiety (d = 1.25, p < .001) and significant increases in parent agency (d = 0.68, p = .02) from baseline to 2-week follow-up. Effects were maintained until children started CBT (mean time = 13.54 weeks). Additionally, parents rated the SSI as highly acceptable in accordance with preregistered benchmarks. Results support the effectiveness and acceptability of a web-based, self-guided SSI for parents of children on therapy waitlists, offering a scalable approach to support families while they wait for formal treatment. CLINICAL.TRIALS GOV IDENTIFIER: NCT06043271.