Mental health issues affect approximately one in five children and young people in England, as well as internationally. Consequently, mental health services are often overwhelmed, leading to long waiting lists and some children and young people not receiving the necessary support. In response to this challenge, the focus of this blog is on a recent randomized controlled trial (RCT) conducted by Cathy Creswell and colleagues in 2024. The study aimed to determine whether a digitally augmented psychological therapy (OSI) could effectively treat child anxiety, compared to treatment as usual (TAU), while also considering the acceptability and cost-effectiveness of the intervention.
Unlike traditional RCTs that aim to prove the superiority of a treatment, this study focused on non-inferiority, meaning it sought to determine if OSI was at least as effective as TAU in treating child anxiety. The study included children aged 5-12 within Child and Adolescent Mental Health Services (CAMHS) and involved two treatment arms: OSI plus therapist support and TAU. Participants completed online questionnaires and assessments at specific intervals, and qualitative interviews were conducted to gather additional feedback.
The results of the study indicated that OSI was not inferior to TAU in terms of treating child anxiety, with similar outcomes observed in both treatment arms. Additionally, OSI proved to be more cost-effective, requiring significantly less therapist time compared to TAU. Both parents and therapists found OSI to be acceptable, with positive feedback about the convenience and support provided by the digitally augmented treatment. Overall, the study showcased the potential of digitally augmented interventions to increase treatment accessibility and efficiency without compromising effectiveness.
Strengths of the study included its real-world application within routine CAMHS, diverse therapist backgrounds, and comprehensive evaluation through quantitative, economic, and qualitative measures. Limitations included potential biases in the sample diversity and the study’s focus on child anxiety in a specific age group. Despite these limitations, the findings offer promising insights into the effectiveness and cost-effectiveness of digitally augmented therapy for child anxiety, paving the way for future research and implementation in mental health services.
