Stepped-Care Internet Cognitive Behaviour Therapy for Childhood and Adolescent Anxiety: Parent Perspectives

ObjectiveBy exploring parental views, we can better understand how stepped-care models with internet cognitive behavioural therapy (ICBT) interventions are experienced by young people and their families. A qualitative approach was used to understand parents' perceptions of the acceptability and appropriateness of a stepped-care ICBT intervention. Specifically, what elements were effective, what barriers existed and how treatment expectations could inform adjustments to enhance overall outcomes for young people.MethodsTwenty parents of children and adolescents (aged 9-16 years) who completed the BRAVE Stepped-Care randomised controlled trials for anxiety participated in semi-structured interviews informed by Proctor et al.'s implementation science framework. Data were analysed using deductive reflexive thematic analysis.ResultsFour overarching themes were identified, (1) comfort with stepped-care approach, (2) desire for support that feels personalised, (3) parental involvement perceived as helpful and (4) importance of family flexibility.ConclusionsThe self-directed component of ICBT was well received, particularly with parental involvement. Parents valued personalised support, especially via videoconferencing, and the flexible stepped-care ICBT approach suited busy family schedules. Finding suggest that stepped-care ICBT can be effectively implemented in routine care when parental engagement and flexible, personalised support are prioritised, potentially improving adherence, outcomes and scalability.