Evaluation of anxiety treatment for children through online education (ACE)

Child anxiety is very common and can potentially have lasting, harmful effects. Cognitive behavioural therapy (CBT) is an effective treatment for child anxiety, but access to traditionally delivered (i.e., face-to-face) CBT is limited. Low-intensity interventions are more accessible to families and less time-consuming for therapists, allowing for therapists to help more families. Anxiety Treatment for Children Through Online Education (ACE) is a low-intensity, therapist-guided, parent-directed, Internetdelivered cognitive behavioural therapy (ICBT) intervention for child anxiety. The implementation of ACE has yet to be comprehensively evaluated. This intervention is relatively unique within the field. Past research on ACE has aimed to investigate participant engagement with the ACE program (Mazenc, 2021). While this past research is important, little is known at this time about parental experiences with the program and the extent to which the program has been effectively implemented. The Updated DeLone and McLean Model of Information Systems Success (D&M Model; DeLone et al., 2003) offers a model for examining implementation of the program, and involves measuring various aspects of online information systems (e.g., information quality, system quality, service quality, intention to use/use, user satisfaction, net benefits). The purpose of the current study was to conduct a process evaluation exploring parents’ experiences with the ACE program, while at the same time assessing the utility of the model. Ninety-one parents of 7-12 year old children with anxiety participated in the ACE program, with 47 completing the program. Descriptive statistics for information quality, service quality, system quality, intention to use/use, user satisfaction, and net benefits were computed. Parents were satisfied with ACE’s content, online platform, e-therapist, and overall experience. Paired sample t-tests revealed significant improvements throughout the intervention in terms of therapeutic alliance, child anxiety symptoms, negative parental beliefs about anxiety, and parenting confidence. High ratings of content satisfaction were positively significantly correlated with perceived credibility, expectancy, and overall satisfaction of ACE. Participants who were satisfied with the website’s visual aesthetics reported significantly more overall satisfaction, and those who reported a good working alliance with their e-therapist perceived ACE to be significantly more credible and overall satisfactory. Further, improvements in parenting confidence were associated with greater overall satisfaction, and reductions in negative parental beliefs about anxiety was associated with greater number of weeks in the program. A multiple regression showed that program credibility/expectancy, number of weeks in the program, and overall satisfaction did not predict child symptom improvement. Thus, while using the D&M Model provided a comprehensive framework to assess parents’ perceptions of the ACE program, the utility of the model was not fully supported. Qualitative responses to relevant questions were organized into themes (e.g., The content was engaging, The layout was user-friendly). This research yields significant implications for future implementation of low-intensity parent-directed therapist-assisted ICBT interventions, as results demonstrate that ACE completion is associated with improvement in child anxiety symptoms and good satisfaction was observed across ACE content, website, and e-therapist support. Results from this study may inform aspects of related interventions that need to be improved upon in order to maximize impact (i.e., inclusion of supplementary materials, videos, summaries). Keywords: Parent-delivered, guided, ICBT, child anxiety, D&M model, evaluation

Name thesis:degree_name

Master of Science (MSc)

Level thesis:degree_level

Master's

Discipline thesis:degree_discipline

Clinical Psychology

Grantor dc:publisher

Faculty of Graduate Studies and Research, University of Regina

Year dc:date.issued

2023

Author dc:creator

• Lento, Nicole Maria

Advisor dc:contributor.advisor

• Loutzenhiser, Lynn

Committee members dc:contributor.committeemember

• Hadjistavropoulos, Heather
• Wright, Kristi

Language dc:language.iso

en

DOI

https://doi.org/10.82465/4202

OAI identifier oai:identifier

oai:uregina.scholaris.ca:10294/16472