Study preregistration: targeting parental risk factors for children's anxiety: a factorial experiment with three intervention components

Anxiety is one of the most common mental health problems in childhood, and causes severe and persistent impairment in children’s lives. Parents can play a key role in the development of children’s anxiety symptoms; yet, the evidence of parent-focused interventions is relatively thin. This may be because little is known about what the optimal content of these interventions should be. Interventions typically either use parents as lay therapists, or target multiple different family risk factors at the same time. Traditional randomized trials of these “package deal” interventions provide little insight into what specific parental risk factors should be targeted to most effectively reduce children’s anxiety. We will examine the effects of targeting distinct parental risk factors to provide more information on the role of these factors in children’s anxiety, and to guide the development of intervention programs.
First, family accommodation, the process by which family members change their behaviors and expectations to reduce children’s anxiety, facilitates avoidance and increases children’s anxiety. Accommodation can be targeted by making parents aware of this, and by constructing a plan to reduce accommodating behaviors (component A). Second, low parental warmth can lead to the child developing less self-competence and a perception of the world as threatening and hostile. This can be targeted by increasing parental empathetic reactions to children’s anxiety (component B). Third, parental maladaptive cognitions about children’s anxiety interfere with parents’ ability to effectively support their anxious child, and can be targeted by cognitive restructuring (component C).
We will test whether the components reduce parent-reported children’s anxiety (research question 1), clinician-rated children’s anxiety symptoms (research question 2), and children’s life interference (research question 3). We will investigate whether the components reduce the risk factor that they target (research question 4), and will examine wider and boundary effects (research question 5).