Children may be better off without their parents when receiving anxiety treatment

20 Jun 2023

Working with children one-on-one when treating anxiety may be more effective than involving parents, University of Queensland research has found.

Dr Simon Byrne from UQ’s School of Psychology conducted a review of systematic reviews spanning almost 20 years to determine what treatment was most effective.

“There has been a long-held assumption that parent-involvement in child anxiety treatment is preferable, however, our results suggest this may not always be the case,” Dr Byrne said.

“We analysed 25 reviews which compared parental involvement versus no parental involvement in child anxiety treatments.

“We found cognitive behaviour therapy (CBT), which is most effective for treating anxiety in children, can be more effective when it focuses on working solely on the child rather than the whole family.

“By participating in the treatment independently, children are able to learn skills to comfortably face their fears and not rely on the ‘safety net’ of their parents.

“However, when it comes to younger children and longer-term outcomes, we found parental involvement may be better, as parents can provide greater direction and ongoing coaching.”

Child anxiety is one of the leading causes of disability among Australian children and can stem from a variety of fears such as being alone, talking to strangers, or being in the dark.

It is normal for children to experience irrational fears, however, it can turn into clinical anxiety when it causes problems or stops them from doing everyday activities.

Dr Byrne said when a child experiences ongoing emotional distress, it may seem natural that parents should be involved their child’s treatment, yet it’s not always the best way to deliver therapy.

“CBT teaches strategies to help children face their fears and learn skills to manage their symptoms.

“Asking parents to lead exposure therapy seems intuitive as they are always present, however, it depends on how the parent and child interact,” Dr Byrne said.

“For example, an anxious child who becomes distressed when facing their fears and they may cry and cling to their parent for care and the parent may respond by shielding the child rather than allowing them to work through that fear themselves.

“In these cases, children may be better off conducting exposure therapy independently to remove that security blanket and help them learn to confront their fears on their own.

“This way they can learn and practice CBT skills independently.”

The research is published in Clinical Child and Family Psychology Review.

Media: UQ Communications; Bridget Druery, +61 435 221 246 @UQHealth.