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Budagzad-Jacobson RS, Musicaro RM, Marin CE, Silverman WK, Lebowitz ER. Family Accommodation in Anxious Irritable and Anxious Nonirritable Youth. Behav Ther 2024; 55:913-921. [PMID: 39174269 PMCID: PMC11341947 DOI: 10.1016/j.beth.2024.03.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2023] [Revised: 02/13/2024] [Accepted: 03/04/2024] [Indexed: 08/24/2024]
Abstract
Family accommodation is a significant contributor to the maintenance and course of youth anxiety. There is also high co-occurrence of anxiety and irritability in youth. Research is lacking, however, on the influence of irritability in the association between anxiety and family accommodation, including among youth with clinically diagnosed anxiety disorders. We therefore examined this issue in a sample of clinic-referred anxious irritable and anxious nonirritable youth. Youth (N = 645, Mage = 9.86 years, SD = 2.92) and their parents completed diagnostic interviews and questionnaires assessing youth anxiety, irritability, and family accommodation. Based on both youth and parent ratings, family accommodation was significantly and positively associated with youth anxiety and irritability. Anxious irritable youth rated family accommodation significantly higher than anxious nonirritable youth. In addition, youth self-rated irritability levels significantly moderated the association between their anxiety and family accommodation. No moderation effect was found for the parent ratings. Based on the youth ratings, our overall findings show that parents of anxious irritable youth are more accommodating of their children's anxiety, compared with parents of anxious nonirritable youth. Anxiety levels also predict family accommodation more strongly in youth with lower levels of irritability. Our findings provide novel insights about accommodation behaviors in families of anxious irritable youth and suggest its potential utility as a treatment target when working with anxious irritable youth.
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Affiliation(s)
| | | | - Carla E Marin
- Child Study Center, Yale University School of Medicine
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2
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Allen KB, Tan PZ, Sullivan JA, Baumgardner M, Hunter H, Glovak SN. An Integrative Model of Youth Anxiety: Cognitive-Affective Processes and Parenting in Developmental Context. Clin Child Fam Psychol Rev 2023; 26:1025-1051. [PMID: 37819403 DOI: 10.1007/s10567-023-00458-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/14/2023] [Indexed: 10/13/2023]
Abstract
Multiple theoretical frameworks have been proposed to provide a more comprehensive picture of the risk factors that influence anxiety-related developmental trajectories. Nonetheless, there remains a need for an integrative model that outlines: (1) which risk factors may be most pertinent at different points in development, and (2) how parenting may maintain, exacerbate, or attenuate an affective style that is characterized by high negative emotional reactivity to unfamiliar, uncertain, and threatening situations. A developmentally informed, integrative model has the potential to guide treatment development and delivery, which is critical to reducing the public health burden associated with these disorders. This paper outlines a model integrating research on many well-established risk mechanisms for anxiety disorders, focusing on (1) the developmental progression from emotional reactivity constructs early in life to those involving higher-level cognitive processes later in youth, and (2) potential pathways by which parenting may impact the stability of youth's cognitive-affective responses to threat-relevant information across development.
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Affiliation(s)
- Kristy Benoit Allen
- Departments of Applied Behavioral Science and Psychology, University of Kansas, Lawrence, KS, USA.
| | - Patricia Z Tan
- Department of Psychiatry/Mental Health, VA Greater Los Angeles Healthcare System, Los Angeles, CA, USA
- Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at University of California, Los Angeles (UCLA), Los Angeles, CA, USA
| | | | - Megan Baumgardner
- Department of Psychology, University of Tennessee, Knoxville, TN, USA
| | - Hannah Hunter
- Department of Psychology, University of Tennessee, Knoxville, TN, USA
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3
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Taliercio JR, Wigod T, Shen J, Yang L, Davino S, Servidio E, McGinn LK, Miller AL. Coping with Transitions: A Promising Intensive Outpatient DBT Program for Emerging Adults and Their Families. JOURNAL OF CONTEMPORARY PSYCHOTHERAPY 2023:1-9. [PMID: 37363718 PMCID: PMC10193327 DOI: 10.1007/s10879-023-09583-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/09/2023] [Indexed: 06/28/2023]
Abstract
Emerging adulthood is a period of significant exploration, transformation, variability, and growth. Simultaneously, this developmental period presents unique challenges as emerging adults work to achieve developmental milestones including self-identity formation, the establishment of long-term intimate relationships, career advancement, and independence from parents. For those who are vulnerable, this period is also marked by the development of significant mental health problems and associated impairment, which prevents individuals from successfully reaching these developmental milestones. To address the various challenges unique to this developmental period, we created and implemented a multifaceted DBT treatment protocol to specifically address emotional dysregulation within emerging adults. The current study presents an evaluation of a novel, intensive, outpatient DBT program called System for Adult Growth and Emergence-Foundations (SAGE-F). We aim to first introduce the SAGE-F treatment protocol, and then to assess both its short and long-term therapeutic value. Participants enrolled in SAGE-F were administered a testing battery assessing symptom severity, functioning capacities, and coping strategies at intake, upon completion of the program 6-weeks later, and at 3-month follow-up. It was found participants who completed SAGE-F reported significant reductions in depression and anxiety symptoms, as well as non-suicidal self-injurious behaviors. Simultaneously, participants also reported improvements in their daily functioning and coping capacities. Follow-up assessments indicated therapeutic progress remained.
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Affiliation(s)
- Joseph R. Taliercio
- Cognitive and Behavioral Consultants, 1 North Broadway, Suite 704, White Plains, NY 10601 USA
| | - Talia Wigod
- Cognitive and Behavioral Consultants, 1 North Broadway, Suite 704, White Plains, NY 10601 USA
| | - Joy Shen
- Cognitive and Behavioral Consultants, 1 North Broadway, Suite 704, White Plains, NY 10601 USA
- Ferkauf Graduate School of Psychology, Yeshiva University, Bronx, NY USA
| | | | - Suzanne Davino
- White Cedar Cognitive and Behavioral Health, Ridgefield, CT USA
| | - Elaina Servidio
- Cognitive and Behavioral Consultants, 1 North Broadway, Suite 704, White Plains, NY 10601 USA
| | - Lata K. McGinn
- Cognitive and Behavioral Consultants, 1 North Broadway, Suite 704, White Plains, NY 10601 USA
- Ferkauf Graduate School of Psychology, Yeshiva University, Bronx, NY USA
- Montefiore Medical Center-Albert Einstein College of Medicine, Bronx, NY USA
| | - Alec L. Miller
- Cognitive and Behavioral Consultants, 1 North Broadway, Suite 704, White Plains, NY 10601 USA
- Montefiore Medical Center-Albert Einstein College of Medicine, Bronx, NY USA
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4
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Shiloh G, Gal E, David A, Kohn E, Hazan A, Stolar O. The Relations between Repetitive Behaviors and Family Accommodation among Children with Autism: A Mixed-Methods Study. CHILDREN (BASEL, SWITZERLAND) 2023; 10:children10040742. [PMID: 37189991 DOI: 10.3390/children10040742] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Revised: 04/07/2023] [Accepted: 04/17/2023] [Indexed: 05/17/2023]
Abstract
Restricted and repetitive behaviors and interests (RRBI) are a significant component in diagnosing autism spectrum disorder (ASD). They often pose the main challenge in day-to-day functions for children with ASD and their families. Research addressing family accommodation behaviors (FAB) in the ASD population is scarce, and associations with the characteristics of the children's behaviors are unclear. This sequential mixed-methods study assessed the correlation between RRBI and FAB within the ASD group to deepen the understanding of parents' subjective experiences regarding their children's RRBI. It included a quantitative phase with a follow-up qualitative study. A total of 29 parents of children with autism (5-13 yr) completed the study questionnaires; a total of 15 also were interviewed regarding their children's RRBI and related FAB. We used the Repetitive Behavior Scale-Revised (RBS-R) to assess RRBI, and the Family Accommodation Scale (FAS-RRB) to assess FAS. In-depth interviews from phenomenological methodology were used in the qualitative phase. We found significant positive correlations between the RRBI and FAB overall and their subscores. Qualitative research supports these findings, adding descriptive examples of the accommodations families make to address the RRBI-related challenges. The results indicate relations between RRBI and FAB and the importance of practically addressing children with autism's RRBI and their parents' experiences. Both affect and are affected by the children's behaviors.
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Affiliation(s)
- Gal Shiloh
- Department of Occupational Therapy, Faculty of Social Welfare & Health Sciences, University of Haifa, Haifa 3490002, Israel
| | - Eynat Gal
- Department of Occupational Therapy, Faculty of Social Welfare & Health Sciences, University of Haifa, Haifa 3490002, Israel
| | - Ayelet David
- Department of Occupational Therapy, Faculty of Social Welfare & Health Sciences, University of Haifa, Haifa 3490002, Israel
| | - Elkana Kohn
- Clinical Pharmacology and Toxicology, Shamir Medical Center (Assaf Harofeh), Zerifin 6093000, Israel
| | - Ariela Hazan
- Clinical Pharmacology and Toxicology, Shamir Medical Center (Assaf Harofeh), Zerifin 6093000, Israel
| | - Orit Stolar
- The Autism Center/ALUT, Shamir Medical Center (Assaf Harofeh), Zerifin 6093000, Israel
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5
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Birk SL, Sung JY, Schleider JL, Olino TM. Unpacking parental accommodation: Relationship to parent distress tolerance and cognitive styles. J Anxiety Disord 2022; 92:102639. [PMID: 36274566 DOI: 10.1016/j.janxdis.2022.102639] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Revised: 09/06/2022] [Accepted: 10/04/2022] [Indexed: 11/18/2022]
Abstract
Accommodation, or changes to parent behaviors or routines to avoid or alleviate child distress related to psychopathology, is one maladaptive parent response that is common in anxiety disorders and associated with poor youth outcomes. Little is known about the processes in parents that contribute to accommodation. Thus, the current study examined how accommodation relates to parent distress tolerance and cognitive styles. The present study utilized data from 295 parents (289 female) of children ages 4-10 who were recruited for a randomized trial of an internet-based single-session intervention targeting parent accommodation (NCT04453865). Results indicate a positive relationship between parent rumination and worry and accommodation, highlighting the influence of parent cognitive processes on their tendency to accommodate. In addition, results suggest a positive relationship between reduced parent distress tolerance and greater accommodation, and this relationship may be influenced by other factors. Future research that uses multiple methods of assessment will add to effective interventions for parent accommodation that can be used to improve youth outcomes.
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Alcan E, Anderson T, Lebowitz ER. Frequency and Correlates of Fathers' Accommodation in Pediatric Anxiety Disorders. Child Psychiatry Hum Dev 2022; 53:1047-1061. [PMID: 34009552 PMCID: PMC9470656 DOI: 10.1007/s10578-021-01190-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/10/2021] [Indexed: 11/18/2022]
Abstract
Previous studies investigating family accommodation (FA) in pediatric anxiety disorders have primarily relied on mothers' reports, while data on FA by fathers remains scarce. We examined the frequency and correlates of fathers' FA of anxious children and compared fathers' and mothers' reports of FA. Participants were 69 parents of treatment-seeking children and adolescents with a primary anxiety disorder. FA was highly prevalent amongst fathers, with the majority of fathers participating in symptom-related behaviors and modifying family routines due to child anxiety. Fathers' accommodation levels were significantly correlated with fathers' reports of child internalizing symptoms, child externalizing symptoms, and fathers' own anxiety symptoms. Fathers' and mothers' reports of FA were moderately correlated, whereas their reports of their respective distress related to the need to accommodate were only weakly correlated. Fathers reported a significantly lower frequency of FA than did mothers. These findings highlight the importance of obtaining reports from both fathers and mothers when assessing FA. Results are particularly relevant to family-focused and parent-based interventions designed to address and reduce FA amongst parents of clinically anxious children.
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Affiliation(s)
- Ena Alcan
- Department of Clinical Psychology, Experimental Psychopathology, and Psychotherapy, Institute of Psychology, Philipps-University Marburg, Gutenbergstraße 18, 35037, Marburg, Germany.
| | - Tess Anderson
- Yale Child Study Center, Yale School of Medicine, New Haven, CT, USA
| | - Eli R Lebowitz
- Yale Child Study Center, Yale School of Medicine, New Haven, CT, USA
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Galea S, Wade C, Salvaris CA, Yap MBH, Lawrence KA. Acceptability of an enhanced transdiagnostic CBT intervention for adults with anxiety disorders who are parenting an anxious child. CLIN PSYCHOL-UK 2022. [DOI: 10.1080/13284207.2022.2055965] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Affiliation(s)
- Samantha Galea
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Clayton, Victoria, Australia
| | - Catherine Wade
- Parenting Research Centre, East Melbourne, Victoria, Australia
| | - Chloe A. Salvaris
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Clayton, Victoria, Australia
| | - Marie B. H. Yap
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Clayton, Victoria, Australia
- Melbourne School of Population and Global Health, University of Melbourne, Carlton, Victoria, Australia
| | - Katherine A. Lawrence
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Clayton, Victoria, Australia
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Bidirectional Relationship Between Family Accommodation and Youth Anxiety During Cognitive-Behavioral Treatment. Child Psychiatry Hum Dev 2022; 54:905-912. [PMID: 34997892 PMCID: PMC10140011 DOI: 10.1007/s10578-021-01304-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/06/2021] [Indexed: 12/12/2022]
Abstract
Family accommodation is associated with an increase in anxiety and has recently received attention as a target for intervention for youth anxiety. Existing theories posit that the increase in family accommodation increases youth anxiety and can attenuate the effect of psychotherapy. However, the directionality between family accommodation and youth anxiety has not been investigated. A cross-lagged cross-panel design was used to assess accommodation and anxiety for 10 sessions for 73 youths with an anxiety disorder, who were receiving cognitive-behavioral therapy. The analysis revealed a bidirectional relationship, such that to some extent previous session family accommodation increased youth anxiety symptoms (β = 0.11, 95% CI [0.06, 0.17]), but to an even greater extent previous session youth-rated anxiety symptoms increased family accommodation (β = 0.23, 95% CI [0.08, 0.38]). Family accommodation is an important target for reducing youth anxiety but should be addressed simultaneously as interventions directly targeting youth anxiety.
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Goodwin J, Rob P, Freeston M, Garland D, Grahame V, Kernohan A, Labus M, Osborne M, Parr JR, Wright C, Rodgers J. Caregiver perspectives on the impact of uncertainty on the everyday lives of autistic children and their families. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2021; 26:827-838. [PMID: 34291688 PMCID: PMC9014769 DOI: 10.1177/13623613211033757] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
LAY ABSTRACT Anxiety is common in autistic children. Research shows that this may be related to intolerance of uncertainty, which is a tendency to react negatively to uncertain situations. Understanding when, why and how autistic children respond to uncertainty is important in the development of anxiety programmes. We asked 53 (including 3 dyads) parents of autistic children about the types of uncertain situations that cause difficulties for their child and how uncertainty impacts on daily life for them and their families. We found that uncertain situations made autistic children and their families feel sad, worried, frustrated and angry through the themes: child's reactions to uncertainty, trying to reduce uncertainty, the impact of difficulties with uncertainty, the impact of uncertainty on parenting and the impact on parents. There are lots of situations that are anxiety provoking for autistic children because of uncertainty, such as school. Programmes to reduce anxiety and increase autistic children's ability to cope with everyday uncertain situations could improve quality of life for autistic children and their families.
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Harris O, Lloyd S, Ward J. Integrating elements of teddy bear therapy into cognitive behavioral therapy for a child with obsessive-compulsive disorder: A case study. JOURNAL OF CHILD AND ADOLESCENT PSYCHIATRIC NURSING 2021; 34:243-252. [PMID: 34057270 DOI: 10.1111/jcap.12328] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Revised: 03/29/2021] [Accepted: 05/08/2021] [Indexed: 11/28/2022]
Abstract
PROBLEM Childhood obsessive-compulsive disorder (OCD) can chronically affect functioning across a multitude of areas. Cognitive behavioral therapy (CBT) is well-evidenced as an effective treatment option, however, there is less research on how CBT for OCD can best be adapted to meet the specific needs of younger children. Integrating CBT with forms of therapy that incorporate play and externalization may be particularly appropriate for this age group. However, more research is needed detailing how this could be carried out in clinical settings. METHODS This study meets this need by describing the treatment of an 8-year-old boy with OCD. An evidence-based CBT approach was used integrated with teddy-bear therapy (TBT). This study employs a single-case A-B design to explore the acceptability and benefits of using an integrated CBT/TBT treatment approach. FINDINGS AND CONCLUSIONS A reduction in ritualistic behavior and anxiety was seen following treatment, with qualitative feedback from the client and his family showing the inclusion of TBT to be experienced as acceptable and useful. All therapy goals were met by the end of treatment, though the parental scores on the Revised Child Anxiety and Depression Scale indicated ongoing clinically significant OCD symptoms. Implications for clinical practice and future research are discussed.
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Affiliation(s)
- Olivia Harris
- Department of Psychology, University of Bath, Bath, UK
| | - Susannah Lloyd
- Melksham Child and Adolescent Mental Health Service, Melksham Hospital, Bath, UK
| | - Jayne Ward
- Highly Specialist Family & Systemic Psychotherapist, Basingstoke Child and Adolescent Mental Health Service, Basingstoke, UK
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Galea S, Salvaris CA, Yap MBH, Norton PJ, Lawrence KA. Feasibility and acceptability of an enhanced cognitive behavioural therapy programme for parent-child dyads with anxiety disorders: a mixed-methods pilot trial protocol. Pilot Feasibility Stud 2021; 7:109. [PMID: 34001265 PMCID: PMC8127293 DOI: 10.1186/s40814-021-00846-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Accepted: 04/28/2021] [Indexed: 01/02/2023] Open
Abstract
BACKGROUND Cognitive behavioural therapy (CBT) is the most widely recognised and efficacious psychological therapy for the treatment of anxiety disorders in children and adults. However, suboptimal remission rates indicate room for improvement in treatments, particularly when both children and their parents have anxiety disorders. Bidirectional transmission and maintenance of anxiety within parent-child dyads could be better targeted by CBT, to improve treatment outcomes for children and parents with anxiety disorders. This study aimed to develop and evaluate the feasibility and acceptability of a concurrent parent-child enhanced CBT intervention that targets the individual's anxiety disorder(s), as well as the bidirectional factors that influence and maintain anxiety in the dyad. METHODS Feasibility and acceptability of the proposed CBT protocol will be evaluated in an open-label pilot trial of the intervention utilising qualitative and quantitative data collection. Ten parent-child dyad participants (n = 20) with anxiety disorders will be recruited for the proposed intervention. The intervention is based on an empirically supported 10-week CBT programme for anxiety disorders in adults, adapted to be delivered to parent-child dyads concurrently, and to target anxious modelling and overprotective behaviours through joint observational exposures. Intervention feasibility will be explored by pre-post symptom change on a range of clinician- and self-report measures to determine preliminary indications of participants' intervention response and effect size calculations to estimate sample size for a future definitive randomised controlled trial (RCT). Additional feasibility measures will include recruitment rates, completion rates, and adherence to programme requirements. To explore participant acceptability of the intervention, qualitative interviews will be conducted with five parent-child dyads who complete the intervention (n = 10), along with five parent-child dyads with anxiety symptoms who express interest in the intervention (n = 10). Acceptability measures will include prospective and retrospective quantitative self-report and qualitative interview data. DISCUSSION This pilot trial will utilise a mixed-methods design to determine the feasibility and acceptability of delivering an enhanced CBT intervention for the concurrent treatment of parent-child dyads with anxiety disorders. The results of this trial will inform the development and implementation of a future definitive randomised clinical trial to evaluate intervention efficacy. TRIAL REGISTRATION Australian and New Zealand Clinical Trials Registry, ANZCTR1261900033410 . Prospectively registered: pre-results. Registered 04 March 2019.
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Affiliation(s)
- Samantha Galea
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Level 4, Bldg 18 Innovation Walk, Clayton, Victoria, 3800, Australia
| | - Chloe A Salvaris
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Level 4, Bldg 18 Innovation Walk, Clayton, Victoria, 3800, Australia
| | - Marie B H Yap
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Level 4, Bldg 18 Innovation Walk, Clayton, Victoria, 3800, Australia.,Melbourne School of Population and Global Health, University of Melbourne, Carlton, Melbourne, Victoria, Australia
| | - Peter J Norton
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Level 4, Bldg 18 Innovation Walk, Clayton, Victoria, 3800, Australia.,Cairnmillar Institute, Hawthorn East, Melbourne, Victoria, Australia
| | - Katherine A Lawrence
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Level 4, Bldg 18 Innovation Walk, Clayton, Victoria, 3800, Australia.
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12
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The use of acceptance and commitment therapy (ACT) in addressing family accommodation (FA) for child anxiety. COGNITIVE BEHAVIOUR THERAPIST 2021. [DOI: 10.1017/s1754470x21000064] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Abstract
Many parents of children with anxiety tend to engage in varying levels of family accommodation (FA) in order to alleviate anxiety symptoms. This can exacerbate anxiety symptoms and have adverse effects for psychological treatments. A small number of general and specific interventions have been developed for FA but treatment research is at a nascent stage. Acceptance and commitment therapy (ACT) may be an effective treatment for FA. This article reviews the potential advantages and uses of ACT and how ACT’s six core processes can help target particular features of FA. The theoretical support for ACT is reviewed relevant to FA. The article concludes by conjecturing how ACT may be a useful and adaptive treatment in targeting FA.
Key learning aims
(1)
To understand how FA impacts on child anxiety.
(2)
To help provide an overview of how ACT may be a relevant treatment in addressing FA.
(3)
To look at how each of the six core processes may address specific components of FA.
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Kendall PC, Norris LA, Rabner JC, Crane ME, Rifkin LS. Intolerance of Uncertainty and Parental Accommodation: Promising Targets for Personalized Intervention for Youth Anxiety. Curr Psychiatry Rep 2020; 22:49. [PMID: 32666277 PMCID: PMC8098646 DOI: 10.1007/s11920-020-01170-3] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
PURPOSE OF REVIEW After reviewing predictors of differential outcomes of cognitive behavioral therapy (CBT) for pediatric anxiety, we identify and discuss recent evidence for the role of (a) intolerance of uncertainty (IU) and (b) parental accommodation as meaningful targets for personalized intervention. RECENT FINDINGS Few studies to date have identified promising, theory-driven predictors of differential CBT outcomes. Recent findings suggest that increased IU and high levels of parental accommodation are associated with a poorer response to CBT. Several adaptations of CBT and new interventions targeting either IU or parental accommodation have been developed and found to be efficacious in preliminary studies. IU and parental accommodation are promising constructs for personalizing intervention, both in the identification of who will respond to treatment and in the development of targeted intervention. We recommend that future work test if individuals high in IU and/or parental accommodation will respond more optimally to treatments that specifically target these constructs. The results of this future work may help to move the field closer to personalized intervention.
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Affiliation(s)
- Philip C Kendall
- Department of Psychology, Temple University, Weiss Hall, 1701 N. 13th Street, Philadelphia, PA, 19122, USA.
| | - Lesley A Norris
- Department of Psychology, Temple University, Weiss Hall, 1701 N. 13th Street, Philadelphia, PA, 19122, USA
| | - Jonathan C Rabner
- Department of Psychology, Temple University, Weiss Hall, 1701 N. 13th Street, Philadelphia, PA, 19122, USA
| | - Margaret E Crane
- Department of Psychology, Temple University, Weiss Hall, 1701 N. 13th Street, Philadelphia, PA, 19122, USA
| | - Lara S Rifkin
- Department of Psychology, Temple University, Weiss Hall, 1701 N. 13th Street, Philadelphia, PA, 19122, USA
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