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The Challenge
Recent surveys have indicated a concerning rise in anxiety problems among children and young people. Traditional Cognitive Behavioural Therapy (CBT) is known to be effective, but long waiting lists and other barriers often prevent timely access to treatment. In fact, a 2020 study showed that fewer than 3% of children diagnosed with anxiety disorders received CBT.
The Innovation
To address this gap, Prof Creswell spearheaded the development of an online, parent-led CBT programme. This digital intervention includes text, audio, and video content, along with practical exercises, worksheets, and quizzes. Parents receive remote, brief therapist support to implement CBT strategies in their children's daily lives.
Prof Creswell explained the rationale behind the approach: "Our online platform provides practical tools with guidance and support to help address these issues from home. Parents and guardians are supported to deliver the treatment, with support from a therapist, making it a flexible and family-centred approach."
Rigorous Evaluation
The effectiveness of this innovative approach was put to the test in a large-scale clinical trial involving 444 children aged 5-12 from 34 child and adolescent mental health services across England and Northern Ireland. The study compared the online intervention with standard care, which typically involved face-to-face CBT sessions.
The results were striking. At 26 weeks, children in both groups showed similar meaningful reductions in anxiety. Importantly, the online intervention required less therapist time (3 hours compared to 5 hours for standard care) and had lower treatment delivery costs.
Parents and carers found the intervention highly acceptable.
One parent shared, "I just thought it was really easy to navigate. It was very straightforward working through the modules." Another noted a significant improvement in their relationship with their child: "Personally, me and my daughter are now closer. We got to a stage where we were sort of quite estranged...and we can now see a brighter future..."
From Research to Real-World Impact
The success of the clinical trial has paved the way for widespread implementation. From September 2024, this online therapy is being rolled out across NHS trusts, mental health facilities, schools, and colleges. Over 20 areas have already committed to the programme, including West Sussex, Oxfordshire, Buckinghamshire, Leicestershire, Manchester, North Tyneside, and North East London.
Looking Ahead
The impact of this intervention extends beyond the initial rollout. Over 1,000 families are already using the intervention outside of research trials. Ongoing studies are evaluating its implementation through schools and exploring adaptations for other conditions such as obsessive-compulsive disorder (OCD), selective mutism, and anxiety in autistic children.
Prof Creswell and her team are also addressing potential barriers to access. They are actively working with clinical teams to understand and overcome issues of digital exclusion, exploring solutions such as providing reimbursement for mobile data costs and making devices available to families that don't have them.
By empowering parents and leveraging technology, this intervention is poised to significantly increase access to effective treatment for childhood anxiety, aligning perfectly with the NHS's commitment to improving mental health care accessibility.
A version of this story was originally published on the ARC OxTV website here.
More on this can also be found here.