Evaluating the Impact of an App-Based Homework Program Following One-Session Treatment for Childhood Phobias: A Randomized Controlled Trial.

OBJECTIVE

Specific phobias are among the most common, earliest-onset psychiatric disorders in youth. Although one-session treatment (OST) is a well-established intervention, 35% to 40% of children do not reach full remission. This study examined whether supplementing OST with a child-focused, app-supported homework program would enhance outcomes.

METHOD: In this parallel-group randomized superiority trial, 172 children (7-14 years old; mean [SD] age = 10.65 [2.09] years; 59% girls) meeting criteria for any specific phobia received standard OST before randomization to therapist-provided homework (OST-only group) or an app-supported program (OST + app group). Assessments occurred before and after a 3-week baseline, post-OST, post-practice, and at 6-month follow-up. Primary outcomes were diagnostic status and clinician-rated severity; secondary outcomes included behavioral avoidance, self-reported fear and avoidance, and functional impairment. Mixed-effects linear models were used.

RESULTS

Both groups showed significant improvements on all outcomes, with medium to large effect sizes and gains maintained through post-practice and follow-up. Remission rates were 25.2% post-OST, 46.0% post-practice, and 69.6% at follow-up. Children in both groups practiced frequently. The app-supported homework program did not enhance outcomes or at-home practice. Families in the OST + app group reported higher treatment satisfaction. Children with blood-injection-injury phobias showed lower remission rates than children with other phobias.

CONCLUSION

Findings underscore the effectiveness of OST across diverse clinical settings. The app-supported homework program did not enhance outcomes, though families reported higher treatment satisfaction, suggesting potential value warranting investigation. Future research should clarify whether specific child or symptom profiles may benefit from app-based support and strengthen OST implementation.

STUDY REGISTRATION INFORMATION: Early Intervention and Treatment Prediction in Childhood Specific Phobias: Combining One-Session-Treatment With App-Based Technology; https://onderzoekmetmensen.nl/en/trial/55077.