Involving Parents in Cognitive-Behavioral Therapy for Child Anxiety Problems

Abstract

This case study examines how parents can be incorporated into all aspects of cognitive-behavioral therapy (CBT) for child anxiety problems. This is an important issue, because although there are strong theoretical and empirical reasons for incorporating parents into treatment, evidence from randomized controlled trials has so far been inconclusive about whether outcomes are improved by involving parents. This case study describes the clinical benefits of a balanced focus on parent and child factors for "Laura," an 8-year-old girl experiencing a range of fears and worries, including refusing to attend school. Treatment consisted of seven sessions of CBT, which targeted parent and child factors hypothesized to be critical to the development and maintenance of Laura's anxiety problems. The clinician's decision making and reasoning in carefully selecting CBT interventions to specifically address the presenting problems are illustrated. Laura showed marked reductions in avoidance behaviors and fears and returned full-time to school.

Family-Based Cognitive–behavioral Therapy for an Intelligent, Elementary School-Aged Child With Generalized Anxiety Disorder

“…Compared with traditional, child-focused, cognitive–behavioral interventions, the Building Confidence intervention shows benefits above and beyond those of traditional therapy (Wood, Piacentini, Southam-Gerow, Chu, & Sigman, 2006). Such findings build on the results of other case studies that describe successful outcomes when involving caregivers in the treatment of childhood anxiety problems (e.g., Anderson, 2004; Krain, Hudson, Coles, & Kendall, 2002; Michael, Payne, & Albright, 2012; Siddaway, Wood, & Cartwright-Hatton, 2014); however, descriptions of the Building Confidence intervention and its outcomes are rarer in the literature.…”

Technology Delivered Interventions for Depression and Anxiety in Children and Adolescents: A Systematic Review and Meta-analysis

“…Our results do however corroborate previous work with face to face CBT in children which suggests treatment outcomes can be improved with parental involvement (Barrett et al 1996 ; Creswell and Cartwright-Hatton 2007). It has been suggested that parental involvement may aid the successful learning and application of new skills, perspectives and applying specific strategies learned in therapy into real life (Siddaway et al 2014 ; Spence et al 2000 ; Stallard 2005 ; Thirlwall et al 2013 ). As such their children might be more likely to continue to understand and implement therapeutic strategies and so make therapeutic gains (Thirlwall et al 2013 ).…”

“…As such their children might be more likely to continue to understand and implement therapeutic strategies and so make therapeutic gains (Thirlwall et al 2013 ). Parental involvement may also aid changes in family processes and parental risk factors implicated in the development and maintenance of childhood anxiety (Barrett et al 1996 ; Siddaway et al 2014 ).…”

Evidence for Psychodynamic Play Therapy With Parent Consultation as a Treatment for Somatic Complaints in Childhood

“…It is possible that past treatment did produce meaningful change because it placed a primary focus on her anxiety but not the underlying environmental factors contributing and how they interacted with each other to impair Evie’s functioning. Indeed, Evie’s past treatment did not include parent consultation, which has been found to improve a child’s outcome in psychotherapy (Fricker-Elhai, Ruggiero, & Smith, 2005; LeBlanc & Ritchie, 2001; Siddaway, Wood, & Cartwright-Hatton, 2014) and entailed only behavioral coping skills for anxiety, per Evie’s mother’s report.…”