Abstract

Background: Parental anxiety is a significant risk factor for child anxiety, yet evidence-based support remains inaccessible to most. The predecessor ‘Parenting with Anxiety’ (PWA) RCT evaluated an unguided online intervention across 1800 parents and demonstrated effectiveness but reached a homogeneous sample with only 19% completing all modules. Objective: To explore whether community embedding and brief therapist support could broaden reach and improve engagement. Method: A quasi-experimental design of 28 eligible parents (96% female; 46% from minoritised ethnic backgrounds; 50% experiencing financial hardship) were self-allocated to therapist-support (n = 13) or self-guided (n = 15) conditions. Primary outcomes were acceptability and engagement (logins; modules accessed and completed). Parental and child anxiety were assessed at baseline, post-intervention, and six-month follow-up using paired measures (n = 11). Results: In total, 80% of self-guided participants never logged in versus 31% of therapist-support participants; as arms differed in recruitment pathway, this cannot be attributed to therapist support alone. Therapist-support parents reported high satisfaction and parental anxiety improved reliably in four of 11 participants at post-intervention and four at follow-up, with none reliably deteriorating. Child anxiety showed no consistent pattern. Conclusions: Community-embedded, therapist-supported PWA delivery was feasible, acceptable, and associated with higher engagement, though self-selection and the small sample preclude causal interpretation.

Keywords