Caregiver mind-mindedness training as an early intervention for social anxiety in children: A protocol for a randomised controlled trial

Hiva Javadian*, Mary E. Stewart, Minu Mathews, Andrew James Williams, Daniel Hale

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

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Abstract

Background
This paper describes a randomised controlled trial (RCT) protocol aimed at investigating the efficacy of caregivers’ Mind-Mindedness training as an early intervention for preschoolers with social anxiety. Mind-mindedness, a caregiver’s ability to recognise and respond to a child as an individual with their own thoughts, feelings, and intentions, is associated with secure attachment and socioemotional skills. While previous studies indicate brief Mind-Mindedness training may increase caregiver mentalisation in high-risk groups, there is a lack of rigorous evidence assessing its impact specifically on child social anxiety symptoms. Building on the well-established link between caregivers’ Mind-Mindedness and positive socioemotional outcomes in children, this study aims to bridge the existing research gap by directly testing the impact of Mind-Mindedness training on social anxiety.

Methods
This randomised controlled trial aims to recruit 100 caregivers of preschool-aged 4–7-year-old children with social anxiety from the UK and Iran. The caregivers will be randomly assigned to either a mind-mindedness training group (n = 50) or a peer support (control) group(n = 50). The mind-mindedness training will involve three online sessions, each of one hour duration, focused on teaching strategies for using mind-minded comments with their children, across three consecutive weeks. The peer support (control) group will have access to a private online peer-support platform for sharing experiences. Measures of mind-mindedness, child social anxiety, attachment, and theory of mind will be assessed at baseline, post-intervention, and 3-month follow-up using established assessment tools.

Discussion
The study aims to evaluate the effectiveness of a mind-mindedness parental intervention for social anxiety in children and to uncover the potential mediating roles of attachment and theory of mind in the relationship between mind-mindedness and child anxiety. The cross-cultural design, involving participants from the UK and Iran, will offer valuable information on the cultural aspect of the intervention. The training group is hypothesised to lead to increased mind-mindedness and reduced child social anxiety versus a peer support (control) group. This research can establish evidence for mind-mindedness training as an early intervention approach for childhood social anxiety, with implications for global mental health strategies targeting early caregiver-child relationships.

Trial registration
Prospectively registered on ClinicalTrials.gov (ID: NCT06657014; registered on 23rd October 2024) and on the Iranian Registry of Clinical Trials (IRCT) Version 1 (ID: 80088; approved on 2nd November 2024). These registrations promote transparency and ensure compliance with international standards for reporting clinical trials.
Original languageEnglish
Article numbere0315150
JournalPLoS ONE
Volume20
Issue number9
DOIs
Publication statusPublished - 22 Sept 2025

Keywords

  • Anxiety
  • Caregivers
  • Child
  • Child, Preschool
  • Female
  • Humans
  • Iran
  • Male
  • Randomized Controlled Trials as Topic
  • United Kingdom

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