{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,21]],"date-time":"2026-08-21T12:44:55Z","timestamp":1787316295797,"version":"build-2736575974"},"reference-count":120,"publisher":"National Institute for Health and Care Research","issue":"42","license":[{"start":{"date-parts":[[2022,10,1]],"date-time":"2022-10-01T00:00:00Z","timestamp":1664582400000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/www.nationalarchives.gov.uk\/doc\/non-commercial-government-licence\/non-commercial-government-licence.htm"}],"funder":[{"DOI":"10.13039\/501100000664","name":"Health Technology Assessment programme","doi-asserted-by":"publisher","award":["15\/38\/04"],"award-info":[{"award-number":["15\/38\/04"]}],"id":[{"id":"10.13039\/501100000664","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journalslibrary.nihr.ac.uk"],"crossmark-restriction":false},"short-container-title":["Health Technol Assess"],"abstract":"\n Background<\/jats:title>\n Up to 10% of children and young people have a specific phobia that can significantly affect their mental health, development and daily functioning. Cognitive\u2013behavioural therapy-based interventions remain the dominant treatment, but limitations to their provision warrant investigation into low-intensity alternatives. One-session treatment is one such alternative that shares cognitive\u2013behavioural therapy principles but has a shorter treatment period.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n This research investigated the non-inferiority of one-session treatment to cognitive\u2013behavioural therapy for treating specific phobias in children and young people. The acceptability and cost-effectiveness of one-session treatment were examined.<\/jats:p>\n <\/jats:sec>\n \n Design<\/jats:title>\n A pragmatic, multicentre, non-inferiority randomised controlled trial, with embedded economic and qualitative evaluations.<\/jats:p>\n <\/jats:sec>\n \n Settings<\/jats:title>\n There were 26 sites, including 12 NHS trusts.<\/jats:p>\n <\/jats:sec>\n \n Participants<\/jats:title>\n Participants were aged 7\u201316 years and had a specific phobia defined in accordance with established international clinical criteria.<\/jats:p>\n <\/jats:sec>\n \n Interventions<\/jats:title>\n Participants were randomised 1\u2009:\u20091 to receive one-session treatment or usual-care cognitive\u2013behavioural therapy, and were stratified according to age and phobia severity. Outcome assessors remained blind to treatment allocation.<\/jats:p>\n <\/jats:sec>\n \n Main outcome measures<\/jats:title>\n The primary outcome measure was the Behavioural Avoidance Task at 6 months\u2019 follow-up. Secondary outcomes included the Anxiety Disorder Interview Schedule, Child Anxiety Impact Scale, Revised Children\u2019s Anxiety and Depression Scale, a goal-based outcome measure, Child Health Utility 9D, EuroQol-5 Dimensions Youth version and resource usage. Treatment fidelity was assessed using the Cognitive Behaviour Therapy Scale for Children and Young People and the One-Session Treatment Rating Scale.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n A total of 274 participants were recruited, with 268 participants randomised to one-session treatment (\n n<\/jats:italic>\n \u2009=\u2009134) or cognitive\u2013behavioural therapy (\n n<\/jats:italic>\n \u2009=\u2009134). A total of 197 participants contributed some data, with 149 participants in the intention-to-treat analysis and 113 in the per-protocol analysis. Mean Behavioural Avoidance Task scores at 6 months were similar across treatment groups when both intention-to-treat and per-protocol analyses were applied [cognitive\u2013behavioural therapy: 7.1 (intention to treat), 7.4 (per protocol); one-session treatment: 7.4 (intention to treat), 7.6 (per protocol); on the standardised scale adjusted mean difference for cognitive\u2013behavioural therapy compared with one-session treatment \u20130.123, 95% confidence interval \u20130.449 to 0.202 (intention to treat), mean difference \u20130.204, 95% confidence interval \u20130.579 to 0.171 (per protocol)]. These findings were wholly below the standardised non-inferiority limit of 0.4, which suggests that one-session treatment is non-inferior to cognitive\u2013behavioural therapy. No between-group differences in secondary outcome measures were found. The health economics evaluation suggested that, compared with cognitive\u2013behavioural therapy, one-session treatment marginally decreased the mean service use costs and maintained similar mean quality-adjusted life-year improvement. Nested qualitative evaluation found one-session treatment to be considered acceptable by those who received it, their parents\/guardians and clinicians. No adverse events occurred as a result of phobia treatment.\n <\/jats:p>\n <\/jats:sec>\n \n Limitations<\/jats:title>\n The COVID-19 pandemic meant that 48 children and young people could not complete the primary outcome measure. Service waiting times resulted in some participants not starting therapy before follow-up.<\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n One-session treatment for specific phobia in UK-based child mental health treatment centres is as clinically effective as multisession cognitive\u2013behavioural therapy and highly likely to be cost-saving. Future work could involve improving the implementation of one-session treatment through training and commissioning of improved care pathways.<\/jats:p>\n <\/jats:sec>\n \n Trial registration<\/jats:title>\n This trial is registered as ISRCTN19883421.<\/jats:p>\n <\/jats:sec>\n \n Funding<\/jats:title>\n \n This project was funded by the National Institute for Health and Care Research (NIHR) Health Technology Assessment programme and will be published in full in\n Health Technology Assessment<\/jats:italic>\n ; Vol. 26, No. 42. See the NIHR Journals Library website for further project information.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.3310\/ibct0609","type":"journal-article","created":{"date-parts":[[2022,11,1]],"date-time":"2022-11-01T10:00:28Z","timestamp":1667296828000},"page":"1-174","update-policy":"https:\/\/doi.org\/10.3310\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":10,"title":["One-session treatment compared with multisession CBT in children aged 7\u201316 years with specific phobias: the ASPECT non-inferiority RCT"],"prefix":"10.3310","volume":"26","clinical-trial-number":[{"clinical-trial-number":"isrctn19883421","registry":"10.18810\/isrctn","type":"results"}],"author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8692-6001","authenticated-orcid":true,"given":"Barry","family":"Wright","sequence":"first","affiliation":[{"name":"COMIC Research Team, Leeds and York Partnership NHS Foundation Trust, Leeds, UK"},{"name":"Mental Health and Addictions Research Group, Hull York Medical 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