Internet-based family CBT versus parent-coached exposure for anxious kids and teens

Comparative Effectiveness of Internet-based Versus Parent-Coached Cognitive-Behavioral Therapy For Children and Adolescents With Anxiety and OCD

This test compares an online family CBT program with parent-coached exposure therapy to see which helps kids and teens (ages 7–17) with anxiety or OCD the most.

Quick facts

• Phase: NA
• Study type: Interventional
• Enrollment: 174 (estimated)
• Ages: 7 Years to 17 Years
• Sex: All
• Sponsor: Baylor College of Medicine (other)
• Locations: 1 site (Houston, Texas)
• Trial ID: NCT07024758 on ClinicalTrials.gov

What this trial studies

The trial enrolls children and adolescents aged 7–17 with clinically significant anxiety or OCD and one participating parent. Participants receive either a family-based, internet-delivered CBT program or parent-coached exposure therapy with parent-and-child sessions led by clinicians. Symptom severity (including the Pediatric Anxiety Rating Scale) and functional outcomes are measured before and after treatment and at follow-ups to compare effectiveness and efficiency. The study is run through Baylor College of Medicine in Houston and requires participants to be located in Texas.

Who should consider this trial

Good fit: Ideal candidates are children aged 7–17 with clinically significant anxiety or OCD (PARS ≥12), living with a parent who can participate, able to read English, and located in Texas, with an intellectual ability above the threshold reported (IQ >69).

Not a fit: Patients who are outside Texas, lack a parent/guardian able to participate, are non-English-speaking, have an IQ at or below the study cutoff, or whose anxiety/OCD is not the primary treatment target may not benefit from participating.

Why it matters

Potential benefit: If successful, the results could expand access to effective treatments by showing whether an online family CBT program or a parent-coached exposure approach better reduces anxiety and OCD symptoms in youth.

How similar studies have performed: Previous studies have shown family-based internet CBT and parent-coached exposure methods can reduce pediatric anxiety symptoms compared with usual care, but direct head-to-head comparisons are limited.

Eligibility criteria

Inclusion Criteria:

* The child is between the ages of 7 to 17 years inclusive at enrollment.
* The child has clinically significant symptoms of anxiety and/or OCD, as indicated by a score of 12 or higher on the Pediatric Anxiety Rating Scale (PARS).
* The child is appropriate for anxiety-focused treatment (e.g., anxiety or OCD is the primary or co-primary problem as diagnosed using the DIAMOND-KID).
* One parent/guardian is able and willing to participate in assessment and treatment (e.g., has sufficient English fluency, the decisional capacity to participate, and can commit to treatment duration).
* The participating parent/guardian lives with their child at least 50% of the time per self-report.
* Both parent and child can read and understand English.
* The participant has an IQ above 69, based on the KBIT-2, another valid test or clinician judgement (e.g., a previous assessment conducted, and report shared with study team).
* Participants must be in the state of Texas for treatment sessions/assessments.

Exclusion Criteria:

* The child has a diagnosis of a lifetime psychotic disorder and/or conduct disorder.
* The child has significant, current and active suicidality/homicidality and/or self-injury requiring medical intervention.
* The child has limited verbal communication abilities (e.g., no independent verbal communication).
* The child is receiving concurrent psychotherapy with anxiety and/or OCD as the primary focus. They can pause ongoing therapy to enroll.
* The child has initiated new antidepressant medication within 12-weeks of assessment (4-weeks for stimulants/benzodiazepines/antipsychotics) or during therapy.
* The child has changed psychotropic medication dosage within 4-weeks of assessment (2-weeks for stimulants/benzodiazepines/antipsychotics) or during therapy.
* The child requires a higher level of care than can be provided through the study (e.g., significant, current suicidal ideation).

Where this trial is running

Houston, Texas

• Baylor College of Medicine — Houston, Texas, United States (RECRUITING)

Study contacts

• Study coordinator: Joanna Zhou, B.A.

Conditions: Obsessive Compulsive Disorder, Anxiety Disorder of Childhood or Adolescence, Social Anxiety Disorder of Childhood, Generalized Anxiety Disorder, Separation Anxiety Disorder, Panic Disorder, Panic Attacks, Phobia, Specific