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Parental Involvement in Cognitive Behavior Therapy for Children with Anxiety Disorders: 3-Year Follow-Up

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Abstract

Parental factors have been linked to childhood anxiety, hence, parental involvement in cognitive behavioral therapy (CBT) for anxious children has been examined. However, findings do not consistently show added effects of parent-enhanced CBT, longitudinal investigations are scarce and long-term effects unclear. In the present study, 40 out of 54 families who, 3 years previously, completed one of two types of CBT treatment: with limited or active parental involvement, were assessed using semi-structured diagnostic interviews. Diagnostic status at 3-years follow-up was compared between groups. Changes in diagnostic status across assessment points: posttreatment, 6-month and 3-year follow-up were analyzed within groups. Diagnostic change from 6-month to 3-year follow-up was compared between groups. Intent-to-treat analyses revealed no significant difference in diagnostic status between groups at 3-year follow-up. Nonetheless, children whose parents actively participated in treatment showed significantly more remission from 6-month to 3-year follow-up than children with limited parental participation.

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References

  1. Bögels SM, Brechman-Toussaint ML (2006) Family issues in child anxiety: attachment, family functioning, parental rearing and beliefs. Clin Psychol Rev 26(8):34–856

    Google Scholar 

  2. Barrett PM, Dadds MR, Rapee RM (1996) Family treatment of childhood anxiety: a controlled trial. J Consult Clin Psychol 64:333–342

    Article  PubMed  Google Scholar 

  3. Cobham VE, Dadds MR, Spence SH (1998) The role of parental anxiety in the treatment of childhood anxiety. J Consult Clin Psychol 66:893–905

    Article  PubMed  Google Scholar 

  4. Kendall PC, Hudson JL, Gosch E, Flannery-Schroeder E, Suveg C (2008) Cognitive–behavioral therapy for anxiety disordered youth: a randomized clinical trial evaluating child and family modalities. J Consult Clin Psychol 76:282–297

    Article  PubMed  Google Scholar 

  5. McLeod BD, Wood JJ, Weisz JR (2007) Examining the association between parenting and childhood anxiety: a meta-analysis. Clin Psychol Rev 27:155–172

    Article  PubMed  Google Scholar 

  6. Crawford AM, Manassis K (2001) Familial predictors of treatment outcome in childhood anxiety disorders. J Am Acad Child Adolesc Psychiatry 40:1182–1189

    Article  PubMed  Google Scholar 

  7. Ginsburg GS, Silverman WK, Kurtines WK (1995) Family involvement in treating children with phobic and anxiety disorders: a look ahead. Clin Psychol Rev 15:457–473

    Article  Google Scholar 

  8. Barmish AJ, Kendall PC (2005) Should parents be co-clients in cognitive–behavioral therapy for anxious youth? J Clin Child Adolesc Psychol 34:569–581

    Article  PubMed  Google Scholar 

  9. Nauta MH, Scholing A, Emmelkamp PMG, Minderaa RB (2001) Cognitive–behavioural therapy for anxiety disordered children in a clinical setting: does additional cognitive parent training enhance treatment effectiveness? Clin Psychol Psychother 8:330–340

    Article  Google Scholar 

  10. Wood JJ, Piancentini JC, South-Gerow M, Chu BC, Sigman M (2006) Family cognitive behavioral therapy for child anxiety disorders. J Am Acad Child Adolesc Psychiatry 45:314–321

    Article  PubMed  Google Scholar 

  11. Breinholst S, Esbjørn BH, Reinholdt-Dunne ML, Stallard P (2012) CBT for the treatment of child anxiety disorders: a review of why parental involvement has not enhanced outcomes. J Anxiety Disord 26:416–424

    Article  PubMed  Google Scholar 

  12. Reynolds S, Wilson C, Austin J, Hooper L (2012) Effects of psychotherapy for anxiety in children and adolescents: a meta-analytic review. Clin Psychol Rev 32:251–262

    Article  PubMed  Google Scholar 

  13. Manassis K, Lee TC, Bennett K, Zhao XY, Mendlowitz S, Duda S et al (2014) Types of parental involvement in CBT with anxious youth: a preliminary meta-analysis. J Consult Clin Psychol 92:1163–1172

    Article  Google Scholar 

  14. Barrett PM, Duffy AL, Dadds MR, Rapee RM (2001) Cognitive–behavioral treatment of anxiety disorders in children: long-term (6-year) follow-up. J Consult Clin Psychol 69:135–141

    Article  PubMed  Google Scholar 

  15. Cobham VE, Dadds MR, Spence SH, McDermott B (2010) Parental anxiety in the treatment of childhood anxiety: a different story three years later. J Clin Child Adolesc Psychol 39:410–420

    Article  PubMed  Google Scholar 

  16. Manassis K, Avery D, Butalia S, Mendlowitz S (2004) Cognitive–behavioral therapy with childhood anxiety disorders: functioning in adolescence. Depress Anxiety 19:209–216

    Article  PubMed  Google Scholar 

  17. Mendlowitz SL, Manassis K, Bradley S, Scapillato D, Miezitis S, Shaw BE (1999) Cognitive–behavioral group treatments in childhood anxiety disorders: the role of parental involvement. J Am Acad Child Adolesc Psychiatry 38:1223–1229

    Article  PubMed  Google Scholar 

  18. Ginsburg GS, Becker EM, Keeton CP, Sakolsky D, Piacentini J, Albano AM et al (2014) Naturalistic follow-up of youths treated for pediatric anxiety disorders. JAMA Psychiatry 71:310–318

    Article  PubMed  PubMed Central  Google Scholar 

  19. Esbjørn BH, Reinholdt-Dunne ML, Nielsen SK, Smith AC, Breinholst S, Leth I (2015) Exploring the effect of case formulation driven CBT for children with anxiety disorders: a feasibility study. Behav Cognit Psychother 43:20–30

    Article  Google Scholar 

  20. Silverman WK, Albano AM (1996) Anxiety Disorders Interview Schedule for DSM- IV. Oxford University Press, Oxford

    Google Scholar 

  21. Silverman WK, Saavedra LM, Pina AA (2001) Test-retest reliability of anxiety symptoms and diagnoses with the Anxiety Disorders Interview Schedule for DSM-IV: child and parent versions. J Am Acad Child Adolesc Psychiatry 40:937–944

    Article  PubMed  Google Scholar 

  22. Beck AT, Epstein N, Brown G, Steer RA (1988) An inventory for measuring clinical anxiety: psychometric properties. J Consult Clin Psychol 56:893–897

    Article  PubMed  Google Scholar 

  23. Creamer M, Foran J, Bell R (1995) The Beck Anxiety Inventory in a non- clinical sample. Behav Res Ther 33:477–485

    Article  PubMed  Google Scholar 

  24. Corp IBM (2011) IBM SPSS Statistics for Windows, Version 20.0. IBM Corp, Armonk, NY

    Google Scholar 

  25. Fagerland MW, Lydersen S, Laake P (2013) The McNemar test for binary matched- pairs data: mid-p and asymptotic are better than exact conditional. BMC Med Res Methodol 13:1–8

    Article  Google Scholar 

  26. McDonald JH (2009) Handbook of biological statistics. Sparky House Publishing, Baltimore

    Google Scholar 

  27. Sharpe D (2015) Your Chi-square test is statistically significant: now what? Pract Assess Res Eval 20:2–10

    Google Scholar 

  28. Gillis MM, Haaga DAF, Ford GT (1995) Normative values for the Beck Anxiety Inventory, Fear Questionnaire, Penn State Worry Questionnaire, and Social Phobia and Anxiety Inventory. Psychol Assessment 7:450–455

    Article  Google Scholar 

  29. Loerinc AG, Meuret AE, Twohig MP, Rosenfield D, Bluett EJ, Craske MG (2015) Response rates for CBT for anxiety disorders: need for standardized criteria. Clin Psychol Rev 42:72–82

    Article  PubMed  Google Scholar 

  30. Grills AE, Ollendick TH (2003) Multiple informant agreement and the anxiety disorders interview schedule for parents and children. J Am Acad Child Adolesc Psychiatry 42:30–40

    Article  PubMed  Google Scholar 

  31. Esbjørn BH, Sømhovd MJ, Nielsen SK, Normann N, Leth I, Reinholdt-Dunne ML (2014) Parental changes after involvement in their anxious child’s cognitive behavior therapy. J Anxiety Disord 28:664–670

    Article  PubMed  Google Scholar 

  32. Carroll KM, Rounsaville BJ (2008) Efficacy and effectiveness in developing treatment manuals. In: Nezu AM, Nezu CM (eds) Evidence-based outcome research: a practical guide to conducting randomized controlled trials for psychosocial inter-ventions. Oxford University Press, New York, pp 219–243

    Google Scholar 

  33. Southam-Gerow MA, Rodríguez A, Chorpita BF, Daleiden EL (2012) Dissemination and implementation of evidence based treatments for youth: challenges and recommendations. Prof Psychol Res Pract 43:527–534

    Article  Google Scholar 

  34. Lundkvist-Houndoumadi I, Thastum M, Hougaard E (2016) Effectiveness of an individualized case formulation-based CBT for non-responding youths with anxiety disorders. J Child Fam Stud 2:503–517

    Article  Google Scholar 

  35. Nevo GA, Manassis K (2009) Outcomes for treated anxious children: a critical review of long-term-follow-up studies. Depress Anxiety 26:650–660

    Article  PubMed  Google Scholar 

Download references

Acknowledgments

The study was supported by grants to the Center for Anxiety from the Egmont (Grant Number 831-2205), and Helse Foundation (Grant Numbers 2008A438 and 2009A617). We wish to thank all participating children and parents for contributing to this study, as well as all staff and students who have assisted in the process.

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Correspondence to Monika Walczak.

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The authors: Monika Walczak, Barbara H. Esbjørn, Sonja Breinholst and Marie Louise Reinholdt-Dunne have no conflict of interest with respect to this publication.

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Walczak, M., Esbjørn, B.H., Breinholst, S. et al. Parental Involvement in Cognitive Behavior Therapy for Children with Anxiety Disorders: 3-Year Follow-Up. Child Psychiatry Hum Dev 48, 444–454 (2017). https://doi.org/10.1007/s10578-016-0671-2

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