Preventing family transmission of anxiety: feasibility RCT of a brief intervention for parents

Objectives. Children of anxious parents are at high risk of anxiety disorders themselves. The evidence suggests that this is due to environmental rather than genetic factors. However, we currently do little to reduce this risk of transmission. There is evidence that supporting parenting in those with mental health difficulties can ameliorate this risk. Therefore, the objective of this study was to test the feasibility of a new one-session, group-based, preventive parenting intervention for parents with anxiety disorders. Design. Feasibility Randomised Controlled Trial. Methods. 100 parents with anxiety disorders, recruited from adult mental health services in England (and child aged 3-9 years) were randomised to receive the new intervention (a one-day, group workshop), or to treatment as usual. Children’s anxiety disorder and anxiety symptoms were assessed to 12-months by outcome assessors who were blind to group allocation. Exploratory analyses were conducted on an intention to treat basis, as far as possible. Results. 51 participants were randomized to the intervention condition and 49 to the control condition (82% and 80% followed to 12-months, respectively). The attendance rate was 59%, and the intervention was highly acceptable to parents who received it. The RCT was feasible and 12-month follow-up attrition rates were low. Children whose parents were in the control condition were 16.5% more likely to have an anxiety disorder at follow-up than those in the intervention group. No adverse events were reported. Conclusions. An inexpensive, light-touch, psycho-educational intervention may be useful in breaking the intergenerational cycle of transmission of anxiety disorders. A substantive trial is warranted.