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Parenting, Family Functioning and Anxiety-Disordered Children: Comparisons to Controls, Changes After Family Versus Child CBT

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Abstract

We examined (1) whether families of clinic-referred anxiety-disordered children are characterized by anxiety-enhancing parenting and family functioning, compared to control families; (2) whether family cognitive-behavioral therapy (FCBT) for anxiety-disordered children decreases anxiety-enhancing parenting and family functioning more so than child-focused cognitive-behavioral therapy (CCBT); (3) whether anxiety-disordered children benefit more from therapy in the long-term when parents display less anxiety enhancing parenting and family functioning. The referred sample consisted of 104 anxiety-disordered children (8–18 year-olds) and their families, randomized to FCBT or CCBT. The control sample consisted of 44 families from the general population. At pretreatment (referred and control sample), posttreatment, 3-months and 1-year follow up (referred sample), children’s anxiety disorders were assessed by the ADIS-C/P. Child and parents’ anxiety symptoms, parenting behaviors (autonomy granting, overprotection, rejection) and family functioning (relational functioning, family control) were assessed with questionnaires. Parent-reported autonomy granting and family relational functioning were lower in the referred versus control families. Child-reported autonomy granting was higher in the referred families. Anxiety-enhancing parenting/family functioning decreased after FCBT and CCBT, with no differences between treatments. Good family relational functioning at posttreatment predicted more improvement on anxiety measurements at the long term for adolescents, but not for school-aged children. The generally hold idea that certain parenting styles and family functioning cause child anxiety, and need to be specifically targeted in the treatment of anxious children, is not supported. Good relational functioning within adolescent’s families however is associated with better long-term outcome on anxiety, suggesting that families can support the maintenance of treatment gains.

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Acknowledgments

The authors would like to acknowledge all children, families, and therapist for their participation in the study and Denise Bodden for her elaborate work on the project during her time as a PhD student. The project was financially supported by a grant from ZonMw to Susan Bögels, Grant number 945-02-052. Clinical trial registration information—Family-versus child-alone CBT for children with anxiety disorders. URL: http://www.trialregister.nl/trialreg/admin/rctview.asp?TC=1203. Unique identifier: NTR1203.

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  1. Research Institute of Child Development and Education, University of Amsterdam, Nieuwe Prinsengracht 130, 1018 VZ, Amsterdam, The Netherlands

    Loes Jongerden & Susan Maria Bögels

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  1. Loes Jongerden
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  2. Susan Maria Bögels
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Correspondence to Loes Jongerden.

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Jongerden, L., Bögels, S.M. Parenting, Family Functioning and Anxiety-Disordered Children: Comparisons to Controls, Changes After Family Versus Child CBT. J Child Fam Stud 24, 2046–2059 (2015). https://doi.org/10.1007/s10826-014-0005-6

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