Telephone-assisted, parent-mediated CBT for rural Latino youth with anxiety: A feasibility trial

Abstract

Objective: In this study, we tailor a child anxiety cognitive-behavior therapy (CBT) program to fit the needs of rural Latino/a Spanish-speaking families and examine the feasibility, acceptability, tolerability, and safety of this intervention using 2 modes of service delivery.

Method: Children (n = 31; age 8-13) with anxiety disorders were recruited from primary care settings and randomized to 1 of 2 modes of parent-mediated CBT bibliotherapy: (1) telephone-delivered, therapist-assisted bibliotherapy (TTB; n = 15), and (2) a more minimal contact, self-directed, bibliotherapy condition (SB; n = 16). Independent evaluators administered a diagnostic interview at baseline and posttreatment; demographic and engagement-related questionnaires were also administered.

Results: In the TTB group, 10 of 15 parents (66.7%) completed the requisite number of therapist-assisted bibliotherapy sessions, and in the SB group, 4 of 16 parents (25%) completed the requisite number of self-directed bibliotherapy modules; this comparison was significant, χ2(1) = 5.43, p = .02. In the TTB condition, treatment length and session duration were longer than reported in previous studies. Barriers that were most strongly endorsed were stressors and obstacles competing with treatment, as well as treatment demandingness. Findings revealed good satisfaction across the conditions, although ratings were significantly higher in the TTB group, F = 5.67, p = .028. Remission rates (i.e., no anxiety disorder) for those that provided posttreatment data (N = 25) were 50% and 36% for the TTB and SB groups, respectively, χ2(1) = .465, p = .50.

Conclusions: Implications of these feasibility findings and suggestions for future research are discussed. (clinicaltrials.gov unique identifier: NCT01491880). (PsycINFO Database Record

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Figures

Figure 1

Consort Chart

Figure 2

Mean Adherence and Competence Ratings by Session (S). Note on Y axis; Adherence ratings (0 = 0%, 1 = 25%, 2 = 50%, 3 = 75%, and 4 = 100%) and Competence ratings (0 = no adherence - 4 = perfect adherence).