1 - (SYM 42) Pre-schoolers Overcoming Phobias: A Randomized Controlled Trial of Play-modified, One Session Exposure Treatment for Very Young Children with Specific Phobias

Background and Significance

Specific Phobias (SPs) are among the most common mental health disorders affecting children and adolescents (Egger and Angold, 2006), onset early in life (~3 years of age) and tend to persist over time (Bufferd et al., 2012). Aside from the significant distress and impairment associated with SP, compelling evidence from prospective longitudinal studies (Gregory et al., 2007; Lieb et al., 2016) suggests that SPs in childhood are a powerful marker of risk for the development of mental health disorders later in life. Notably, SPs can be effectively treated in just a single session; with robust evidence in support of the one-session treatment [OST] approach (Ollendick et al. 2009; Ollendick et al., 2015; Ost et al., 2001) for older youth (7 – 17 years) and adults. However, the one session approach has not yet been tested with preschool aged children. Given that OST has been deemed a well-established empirically-supported treatment for youth (Chambless and Ollendick, 2001) and striking evidence that SPs occur much younger than they are currently being treated, evidence for the efficacy of this innovative approach at the first signs of clinically significant impairment would be of enormous significance. The current RCT aimed to determine the efficacy of developmentally tailored OST for pre-school aged children (n=70) aged 3 to 6 years, relative to a credible attention control condition (Education Support Treatment, EST: n=70) and a Waitlist Control (WC, n = 40).

Methods: Children aged 3 to 6 years of age with a diagnosis of SP were and assessed at pre, post-treatment, and 6 months follow-up. Primary and secondary outcomes included; child SP clinician severity rating, child global assessment scale, behavioral approach (as indexed by a standardized, observational behavioral approach task) and comorbidity.

Results: Preliminary treatment outcomes will be presented for the current sample (n=120) using a likelihood based mixed-effects model, repeated measures approach. Rates of treatment response and remission will be compared across treatment conditions.

Conclusion: The preliminary efficacy of a play modified OST will be discussed, including the feasibility, acceptability and prevention potential of exposure therapy for very young children with SP.