Strengthening Memory and Anxiety Reduction Trial (SMART)

Children will complete six weekly one-hour exposure therapy sessions targeting anxiety, along with between-session memory rehearsal training activities. Exposure therapy tasks will be tailored to each participants' specific anxiety disorder. For example, children with a primary fear of public speaking may engage in exposure tasks such as delivering a speech in front of their parents, presenting to one unfamiliar adult, or speaking in front of a small group of unfamiliar adults. In contrast, a child with a phobia of the dark might participate in activities such as playing with glowsticks in a dark room, playing hide-and-seek in a dimly lit environment, or taking a nighttime walk with a torch. Children will be guided through exposure tasks in a gradual, step-by-step manner at their own pace. Sessions will be delivered by Provisional, Registered and Clinical Psychologists with specialist training in conducting exposure therapy with children. The memory rehearsal training is designed to help children recall specific memories of completing their exposure tasks and strengthen recall for the safety learning they have gained during the session. Children will complete a brief (~10minute) online questionnaire three times per week between exposure sessions, which will involve answering a set of standardised questions focsued on recalling the exposure tasks they completed during the session, their original threat expectancies, whether the negative events happened, and what they learned by doing the exposure task(s). Parents will be sent a link to the child's memory rehearsal questionnaire via SMS and will asssit children to answer the standardised questions. Adherence will be monitored via online survey completion.