A Systematic Review of Parental Involvement in Digital Cognitive Behavioural Therapy Interventions for Child Anxiety

A Systematic Review of Guided, Parent-Led Digital Interventions for Preadolescent Children with Emotional and Behavioural Problems

Emotional and behavioural problems (EBP) are prevalent amongst children, and guided, parent-led digital interventions offer one method of improving access to effective treatments. This systematic review (PROSPERO: CRD42023484098) aimed to examine the evidence base for, and characteristics of, these types of interventions through a narrative synthesis. Systematic searches were conducted using Medline, EMBASE, PsycINFO, Scopus and Web of Science in January 2024 and February 2025, supplemented with hand searching in March/April 2024 and February 2025. Studies were eligible if they reported outcomes related to preadolescent EBP from a guided, fully parent-led, fully digital intervention. Thirteen studies were eligible, including 2643 children and covering eight interventions (addressing anxiety problems, comorbid anxiety and depression, attention deficit hyperactivity disorder, conduct disorder and disruptive behaviour). Studies included randomised controlled trials and pre-post studies. The QualSyst checklist was used to assess study quality; all studies were rated as good quality. All studies showed statistically significant improvements in the child's symptoms or interference levels, with small to very large effect sizes immediately post-treatment, and at least medium effect sizes by follow-up, suggesting a promising evidence base. A wide range of intervention characteristics were identified, forming a basis for future intervention development for childhood EBP. However, there was a lack of consistency in how information was reported across studies (such as completion rates) and studies lacked information on parent demographics and key intervention details. Further high quality randomised controlled trials for a wider range of EBP are needed to continue building the evidence base.

mHealth Applications for Childhood Anxiety Disorders: Current Landscape, Challenges, and Future Directions

Purpose of Review

We review the literature on mHealth applications for childhood anxiety disorders, highlighting current use, limitations, and future directions.

Recent Findings

Although mHealth apps targeting childhood anxiety disorders have recently increased, most have not been evaluated for clinical effectiveness, data security, or quality standards. Many apps do not contain scientifically based content and do not adequately incorporate the principles of exposure-based cognitive behavioral therapy. In addition, many apps have significant deficiencies in age-appropriateness, data security, privacy, cultural sensitivity, and accessibility. Limitations remain in terms of the standards for evaluating apps in pediatric populations.

Summary

While interest in mHealth applications for childhood anxiety disorders is increasing, more research is needed to develop effective, safe, and age-appropriate digital interventions. Priorities include scientific grounding, privacy, equitable access, gamification, and parental involvement. Studies in this direction will increase the quality of applications and strengthen equality in access to mental health services.

mHealth Applications for Childhood Anxiety Disorders: Current Landscape, Challenges, and Future Directions

PURPOSE OF REVIEW

We review the literature on mHealth applications for childhood anxiety disorders, highlighting current use, limitations, and future directions.

RECENT FINDINGS

Although mHealth apps targeting childhood anxiety disorders have recently increased, most have not been evaluated for clinical effectiveness, data security, or quality standards. Many apps do not contain scientifically based content and do not adequately incorporate the principles of exposure-based cognitive behavioral therapy. In addition, many apps have significant deficiencies in age-appropriateness, data security, privacy, cultural sensitivity, and accessibility. Limitations remain in terms of the standards for evaluating apps in pediatric populations. While interest in mHealth applications for childhood anxiety disorders is increasing, more research is needed to develop effective, safe, and age-appropriate digital interventions. Priorities include scientific grounding, privacy, equitable access, gamification, and parental involvement. Studies in this direction will increase the quality of applications and strengthen equality in access to mental health services.

Involving Parents in the Management and Treatment of Youth Anxiety

PURPOSE OF REVIEW

Childhood anxiety disorders are impairing and chronic unless addressed early. While cognitive behavioral therapy with exposures has a strong evidence base, many youth continue to experience symptoms posttreatment. Enlisting parents may help improve the management and treatment of childhood anxiety.

RECENT FINDINGS

Parental factors that influence childhood anxiety include family accommodation, parental emotion socialization, parental overcontrol, and parental anxiety. The merits of involving parents in childhood anxiety treatment have been debated. However, when specific, empirically- and theoretically-informed mechanisms are targeted, parental involvement in treatment appears efficacious and holds promise to increase access to care. Clinicians should consider the child's presentation, treatment barriers, and family dynamics to guide decision-making. Researchers and clinicians should also be aware of stressors that parents themselves face, considering ways to help children via supporting parents with their own mental health concerns.