Mothers and Fathers in Family Cognitive-Behavioral Therapy for Anxious Youth
Cognitive-behavioral therapy (CBT) for anxiety disorders in youth has been evaluated in randomized clinical trials and found to be an efficacious treatment. Studies have investigated the effects of increased parental/family involvement in treatment. In the majority of these studies, however, parental involvement is synonymous with maternal involvement leaving the role of fathers unknown. Studies including parents in treatment have yet to examine the independent contribution of mothers and fathers to child outcome. We examined the relationship between both mother (n = 45) and father (n = 45) attendance and engagement in therapy sessions, maternal and paternal psychopathology, and child (n = 45) treatment outcome when parents were included in a Family CBT program for anxiety-disordered youth. Some indications were found for the notion that greater rates of mother and father attendance in session, as well as higher ratings of mother and father engagement in session, are associated with improved child outcome. Parental psychopathology was not associated with attendance, engagement, or child outcome. Recommendations for future research are offered.
KeywordsChild anxiety Cognitive-behavior therapy Father involvement Mother involvement Treatment outcome
- Achenbach, T. M. (1991). Integrative guide to the 1991 CBCL/4–18, YSR, and TRF profiles. Burlington, VT: University of Vermont.Google Scholar
- Achenbach, T., & Edelbrock, C. (1991). Manual for the CBCL and 1991Profile. Burlington, VT: University of Vermont.Google Scholar
- Bodden, D. H. M., Bögels, S. M., Nauta, M. H., de Haan, E., Ringrose, J., Appelboom, C., Brinkman, A. G., & Appelboom-Geerts, K. C. M. M. J. (2010). Efficacy of individual versus family cognitive behavioural therapy in clinically anxious youth (submitted).Google Scholar
- DiNardo, P. A., Brown, T. A., & Barlow, D. H. (1994). Anxiety disorders interview schedule for DSM-IV: Lifetime Version (ADIS-IV-L). Albany, NY: Graywind.Google Scholar
- DiNardo, P., Moras, K., Barlow, D. R., Rapee, R., & Brown, T. (1993). Reliability of DSM-II/-R anxiety categories: Using the ADIS-R. Archives of General Psychiatry, 50, 251–256.Google Scholar
- Edmunds, J. M., O’Neil, K. A., & Kendall, P. C. (2010). A review of cognitive-behavioral therapy for anxiety disorders in children and adolescents: Current status and future directions. Journal of the Norwegian Psychological Association (in press). Google Scholar
- Ginsburg, G., & Schlossberg, M. C. (2002). Family-based treatment of childhood anxiety disorders. International Journal of Psychiatry, 14, 142–153.Google Scholar
- Guy, W. (Ed.). (1976). Clinical global impressions. In: ECDEU Assessment Manual for Psychopharmacology, revised. Rockville, MD: National Institute of Mental Health.Google Scholar
- Howard, B., Chu, B.C., Krain, A.L., Marrs-Garcia, M.A., & Kendall, P.C. (2000). Cognitive-behavioral family therapy for anxious children: Therapist manual (2nd ed.). Ardmore, PA: Workbook Publishing. www.WorkbookPublishing.com.
- Hudson, J. L., & Rapee, R. (2004). From anxious temperament to disorder: An etiological model of generalized anxiety disorder. In R. Heimberg, C. Turk, & D. Mennin (Eds.), Generalized anxiety disorder: Advances in research and practice. New York: Guilford Press.Google Scholar
- Kendall, P. C. (2006). Guiding theory for therapy with children and adolescents. In P. C. Kendall (Ed.), Child, adolescent therapy: Cognitive-behavioral procedures (3rd ed.). New York: Guilford Press.Google Scholar
- Kendall, P. C., & Hedtke, K. A. (2006). Cognitive-behavioral therapy for anxious children: Therapist manual and workbook (3rd ed.).Ardmore, PA: Workbook. www.WorkbookPublishing.com.
- Kendall, P. C., Hudson, J. L., Gosch, E., Flannery-Schroeder, E., & Suveg, C. (2008). Cognitive-behavioral therapy for anxiety disordered youth” A randomized clinical trail evaluating child and family modalities. Journal of Consulting and Clinical Psychology, 76, 282–297.PubMedCrossRefGoogle Scholar
- Kendall, P.C., Podell, J., & Gosch, E. (2010). The Coping Cat: Parent Companion. Ardmore, PA: Workbook Publishing. www.WorkbookPublishing.com.
- Lamb, M. E. (2004). The role of fathers in child development (4th ed.). Hoboken, NJ: Wiley.Google Scholar
- McBride, B. A., & Lutz, M. M. (2004). Intervention: Changing the nature and extent of father involvement. In M. E. Lamb (Ed.), The role of the father in child development (4th ed., pp. 446–475). New York: Wiley.Google Scholar
- Mendlowitz, S. L., Manassis, K., Bradley, S., Scapillato, D., Miezitis, S., & Shaw, B. F. (1999). Cognitive–behavioral group treatments in childhood anxiety disorders: The role of parental involvement. Journal of the American Academy of Child & Adolescent Psychiatry, 38, 1223–1229.CrossRefGoogle Scholar
- Nauta, M., Scholing, A., Emmelkamp, P., & Minderaa, R. (2003). Cognitive-behavioral therapy for children with anxiety disorders in a clinical setting: No additional effect of a cognitive parent training. Journal of the American Academy of Child and Adolescent Psychiatry, 42, 1270–1278.PubMedCrossRefGoogle Scholar
- Ollendick, T. & King, N. (2010) Empirically supporter treatments for children and adolescents. In Kendall, P. C. (Ed). Child and adolescent therapy: Cognitive-behavioral procedures (4th ed.) New York: Guilford Press (in press).Google Scholar
- Shirk, S. Jungbluth, N., & Karver, M. (2010). Change processes in cognitive-behavioral therapy for children and adolescents. In Kendall, P. C. (Ed). Child and adolescent therapy: Cognitive-behavioral procedures (4th ed.) New York: Guilford Press (in press).Google Scholar
- Silverman, W. K., & Albano, A. M. (1997). Anxiety disorders interview schedule for DSM-IV: Child and parent versions. Boulder, CO: Graywind Publications Incorporated.Google Scholar
- Silverman, W. K., Kurtines, W. M., & William, M. (2005). Progress in developing an exposure- based transfer-of-control approach to treating internalizing disorders in youth. In E. D. Hibbs & P. S. Jensen (Eds.), Psychosocial treatments for child and adolescent disorders: Empirically based strategies for clinical practice (2nd ed., pp. 97–119). Washington, DC: American Psychological Association.Google Scholar
- Silverman, W. K., Saavedra, L. M., & Pina, A. A. (2001). Test-retest reliability of anxiety symptoms and diagnoses with anxiety disorders interview schedule for DSM-IV: Child and parent versions. Journal of the American Academy of Child and Adolescent Psychiatry, 40, 937–943.PubMedCrossRefGoogle Scholar