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Alleviating Specific Phobias Experienced by Children Trial (ASPECT) (ASPECT)

5% to 10% children and young people have specific phobias that impact upon daily functioning.  Cognitive Behaviour Therapy (CBT) is recommended but has limitations.  One Session Treatment (OST), a low intensity alternative incorporating CBT principles, has demonstrated efficacy. ASPECT investigated the non-inferiority of OST compared to multi-session CBT for treating specific phobias in children and young people.

Methods: Children and young people aged 7- 16 years with specific phobia were randomised 1:1 to OST or CBT.  Non-inferiority was assessed six-months post-randomisation using the Behavioural Avoidance Task (BAT).  

Results: 268 children and young people were randomised to OST (n=134) or CBT (n=134). Mean BAT scores at six-months were similar across groups.  These findings suggested that OST is non-inferior to CBT. OST also marginally decreased mean service use costs.

Conclusions: OST has similar clinical effectiveness to CBT for specific phobias in CYP and may be a cost-saving alternative. 

Key publications: 

Wright, B., Tindall, L., Scott, A. J., Lee, E., Cooper, C., Biggs, K., ... & Marshall, D. (2022). One session treatment (OST) is equivalent to multi‐session cognitive behavioral therapy (CBT) in children with specific phobias (ASPECT): results from a national non‐inferiority randomized controlled trial. Journal of Child Psychology and Psychiatry. 

https://acamh.onlinelibrary.wiley.com/doi/full/10.1111/jcpp.13665

Hayward, E., Solaiman, K., Bee, P., Barr, A., Edwards, H., Lomas, J., ... & Wright, B. (2022). One-session treatment for specific phobias: Barriers, facilitators and acceptability as perceived by children & young people, parents, and clinicians. PloS one, 17(9), e0274424.

https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0274424

Wang, H., Wright, B., Tindall, L., Cooper, C., Biggs, K., Lee, E., Teare, M.D., Gega, L. et al. (2022).   Cost and effectiveness of one session treatment (OST) for children and young people with specific phobias compared to multi-session cognitive behavioural therapy (CBT): results from a randomised controlled trial.  BMC Psychiatry, 22, 547.

https://bmcpsychiatry.biomedcentral.com/articles/10.1186/s12888-022-04192-8

Tindall, L., Scott, A.J., Biggs, K., Hayward, E., Wilson, J., Cooper, C., Hargate, R., Wright, B. & Gega, L.  (2022).  The Alleviating Specific Phobias in Children Trial: Challenges and solutions to implementing a randomised controlled trial in clinical services (in press).  (Accepted for publication in Frontiers in Child and Adolescent Psychiatry Child Mental Health and Interventions).

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Collaborators

Professor Barry Wright, Chief Investigator, University of York Lucy Tindall, Trial Coordinator, Leeds and York Partnership NHS Foundation Trust Dr Alexander Scott, Trial Manager, Sheffield CTRU Dr Lina Gega, Co-applicant and PI, University of York Katie Biggs, Research Associate, Sheffield CTRU Professor Cindy Cooper, Clinical Trials Unit Director, Sheffield CTRU Dr Dawn Teare, Senior Statistician, University of Sheffield. Emily Hayward, Research Assistant, Leeds and York Partnership NHS Foundation Trust Amy Barr, Research Assistant, University of Sheffield Dr Shezhad Ali, Health Economist, University of York Dr Penny Bee, Co-applicant, University of Manchester Professor Karina Lovell, Co-applicant, University of Manchester Dr David Marshall, Co-applicant, University of York Rebecca Hargate, Co-applicant, Leeds and York Partnership NHS Foundation Trust Dr Dean McMillan, Co-applicant, University of York Professor Simon Gilbody, Co-applicant, University of York Dr Thompson E Davis, Co-applicant, Louisiana State University Trilby Breckman, Co-applicant, Triumph over Phobia