Cognitive Behaviour Therapy for Comorbid Anxiety and Sleep Disorders: A Randomized Controlled Trial

INTERVENTION: [1. Cognitive Behaviour Therapy for Adolescents with Anxiety and Sleep‐Related Problems (CBT‐A‐A‐SRP)] [2. Cognitive Behaviour Therapy for Parents of Adolescents with Anxiety and Sleep‐Related Problems (CBT‐P‐A‐SRP)] Parents of participants who were randomly allocated to participate in the Cognitive Behaviour Therapy for Anxiety and SRPs group will be asked to attend 4 90‐minute treatment sessions. These treatment sessions involve psychoeducation regarding anxiety and sleep‐related problems, contingency management strategies, cognitive restructuring strategies as well as effective techniques on how to support their child in maintaining the skills learnt within the treatment sessions. These sessions will be run concurrently with the CBT‐A‐A‐SRP group and will be held in Weeks 1, 4, 8 & 10. The four treatment sessions will be also be provided in small groups at the Griffith University Psychology Clinic and will also be run by provisionally registered Psychologists receiving advanced clinical training as part of their postgraduate studies. Sessions will be videotaped and blind observers utilised throughout the treatment phase to check for compliance with the treatment manual and ensure therapy tasks are equivalent across groups. Registered clinical psychologists will provide weekly supervision to therapists conducting the treatment. These sessions will capitalise on research findings highlighting the clinical benefits of parental involvement as well as providing parents an opportunity to meet each other and other parents whose children might be experiencing similar problems and support each other in learning strategies that may facilitate positive changes in their child’s anxiety and sleep habits. CONDITION: Anxiety Sleep‐Related Problems PRIMARY OUTCOME: Anxiety (Anxiety Disorders Interview Schedule) Insomnia (Insomnia Severity Index) SECONDARY OUTCOME: Anxiety (The Spence Child and Anxiety Scale) Beliefs about Worry (The Meta‐Cognitions Questionnaire) Emotional and Behavioural Problems (Youth Self‐Report) General Functioning (The Children’s Global Assessment Scale) Homework Compliance (Homework Compliance Measure developed by Park et al. 2014. Homework compliance will be assessed weekly and will based on parent and adolescent's report of the extent to which the assignment was completed). ; ; Interference in Functioning (The Child Anxiety Life Interference Scale) Obsessive Beliefs (Obsessive Beliefs Questionnaire) Perfectionism (Child and Adolescent Perfectionism Scale) Quality of Life (Paediatric Quality of Life InventoryTM) Sleep Patterns (The Children’s Report of Sleep Patterns) Sleep Quality (Consensus Sleep Diary) Sleeping Chronotype (Composite Scale of Morningness) Social Problem Solving (Social Problem Solving Inventory Revised) Suppression of Intrusive Thoughts (White Bear Suppression Inventory) Uncertainty (Intolerance of Uncertainty Scale) Worry (Penn State Worry Questionnaire) INCLUSION CRITERIA: Anxiety Disorder Sleep‐Related Problems Parent/Guardian willing to participate in the Parent Sessions Participants will be randomly allocated to one of two groups ‐ the CBT treatment group or waitlist control group. Participants who were randomly allocated to participate in the Cognitive Behaviour Therapy for Anxiety and SRPs group will be asked to attend 10 weekly 90‐minute treatment sessions. These treatment sessions involve learning more about their sleep patterns, sleep hygiene, stimulus control therapy and identifying unhelpful habits that may be contributing towards their sleep difficulties. Treatment sessions will also involve psychoeducation around anxiety as well as teaching contingency management, cognitive restructuring, relaxation training and stress management. Participants will be provided with an informational booklet during the program that contains relevant activities and worksheets that will be worked through in each of the treatment sessions. Participating in this form of therapy requires time and commitment. In order to make sustainable changes to their sleep habits and reduce their levels of anxiety, strategies that participants will learn in therapy need to be practiced in between sessions. Participants will therefore additionally be provided with a homework booklet that outlines relevant activities and strategies that must be completed in between treatment sessions. The time commitment required to complete homework tasks should not exceed 1 hour per week. Participants will be supported by provisionally registered Psychologists receiving advanced clinical training as part of their postgraduate studies. Sessions will be videotaped and blind observers utilised throughout the treatment phase to check for compliance with the treatment manual and ensure therapy tasks are equivalent across groups. Registered clinical psychologists will provide weekly supervision to therapists conducting the treatment. The 10 treatment sessions will be provided in small groups at the Griffith University Psychology Clinic. This will give participants an opportunity to meet each other and other people who are experiencing similar problems and support each other in making changes to their anxiety and sleep habits. Participants allocated to the waitlist control will receive the same CBT intervention however this will not be offered to participants until the post‐treatment phase.