New treatment for childhood anxiety works by changing parent behavior

Evidence from a randomized clinical trial shows parent-based treatment is as efficacious as cognitive-behavioral therapy in treating childhood and adolescent anxiety disorders

Washington, DC, April 2, 2020 – A study in the Journal of the American Academy of Child and Adolescent Psychiatry (JAACAP), published by Elsevier, reports that an entirely parent-based treatment, SPACE (Supportive Parenting for Anxious Childhood Emotions), is as efficacious as individual cognitive-behavioral therapy (CBT) for the treatment of childhood and adolescent anxiety disorders.

Anxiety disorders, including social phobia, separation anxiety, generalized anxiety, are the most common mental health problems in childhood, causing significant distress to the child and family. With up to one-third of youth experiencing a clinically impairing anxiety disorder by the time they reach adulthood, such disorders lead to impairment in personal, social and academic functioning. When not treated successfully, anxiety disorders in childhood can cause long term impairment and an increased risk of additional physical and mental health problems.

This new study enrolled 124 children with existing clinical anxiety disorders and randomly assigned them to receive either the current front-line CBT treatment, or SPACE–developed by Yale researcher, Dr. Eli Lebowitz and his team at the Yale Child Study Center, Yale School of Medicine, New Haven, CT, USA.

SPACE teaches parents to reduce their accommodation and to respond to a child’s anxiety symptoms in a supportive manner that conveys acceptance of the child’s genuine distress along with confidence in the child’s ability to cope with anxiety.

The authors found that children whose parents participated in 12 sessions of SPACE were as likely to overcome their anxiety disorder as children who participated in 12 sessions of CBT, the best-established evidence-based treatment for child anxiety.

Anxious children look to their parents for help in coping with their anxiety and avoiding the things that make them feel afraid. Parents of anxious children typically become entangled in their child’s symptoms through a process known as family accommodation. For example, a child who is chronically worried may rely on a parent for constant reassurance, or a child with separation anxiety may require a parent to stay at home with them or sleep next to them at night.

For children with social phobia, parents often speak in place of the child or avoid having guests over to the home. Research indicates that family accommodation can contribute to maintaining the child’s anxiety symptoms over time.

For both treatments, approximately 60 percent of children no longer met diagnostic criteria for any anxiety disorder following treatment, based on assessments conducted by independent evaluators who were unaware of which treatment children received. An even greater proportion (87.5 percent for SPACE and 75.5 percent for CBT) showed significant improvement in their symptoms. Anxiety symptom questionnaires completed by children and by their parents also showed equivalent improvement for SPACE and CBT. Parents and children rated both treatments as highly satisfactory.

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Notes for editors

The article is “Parent-Based Treatment as Efficacious as Cognitive-Behavioral Therapy for Childhood Anxiety: A Randomized Noninferiority Study of Supportive Parenting for Anxious Childhood Emotions,” by Eli R. Lebowitz, PhD, Carla Marin, PhD, Alyssa Martino, MS, Yaara Shimshoni, PhD, Wendy K. Silverman, PhD (https://doi.org/10.1016/j.jaac.2019.02.014). It appears in the Journal of the American Academy of Child and Adolescent Psychiatry, volume 59, issue 3 (March 2020), published by Elsevier.

Dr. Lebowitz is Associate Professor at the Yale Child Study Center where he studies and treats childhood and adolescent anxiety and directs the Program for Anxiety Disorders. His research focuses on the development, neurobiology, and treatment of anxiety and related disorders, with special emphasis on family dynamics and the role of parents in these disorders. Dr. Lebowitz’s work has been recognized by private and public organizations including the Brain and Behavior Foundation, the National Institute of Mental Health and The National Center for Advancing Translational Science.

Copies of this paper are available to credentialed journalists upon request; please contact Mary Billingsley at [email protected] or +1 202 587 9672. Journalists wishing to interview the authors, please contact Dr. Eli R. Lebowitz, PhD, at [email protected]

About JAACAP

Journal of the American Academy of Child and Adolescent Psychiatry (JAACAP) is the official publication of the American Academy of Child and Adolescent Psychiatry. JAACAP is the leading journal focusing exclusively on today’s psychiatric research and treatment of the child and adolescent. Published twelve times per year, each issue is committed to its mission of advancing the science of pediatric mental health and promoting the care of youth and their families.

The Journal‘s purpose is to advance research, clinical practice, and theory in child and adolescent psychiatry. It is interested in manuscripts from diverse viewpoints, including genetic, epidemiological, neurobiological, cognitive, behavioral, psychodynamic, social, cultural, and economic. Studies of diagnostic reliability and validity, psychotherapeutic and psychopharmacological treatment efficacy, and mental health services effectiveness are encouraged. The Journal also seeks to promote the well-being of children and families by publishing scholarly papers on such subjects as health policy, legislation, advocacy, culture and society, and service provision as they pertain to the mental health of children and families. http://www.jaacap.org

About Elsevier

Elsevier is a global information analytics business that helps scientists and clinicians to find new answers, reshape human knowledge, and tackle the most urgent human crises. For 140 years, we have partnered with the research world to curate and verify scientific knowledge. Today, we’re committed to bringing that rigor to a new generation of platforms. Elsevier provides digital solutions and tools in the areas of strategic research management, R&D performance, clinical decision support, and professional education; including ScienceDirect, Scopus, SciVal, ClinicalKey and Sherpath. Elsevier publishes over 2,500 digitized journals, including The Lancet and Cell, 39,000 e-book titles and many iconic reference works, including Gray’s Anatomy. Elsevier is part of RELX, a global provider of information-based analytics and decision tools for professional and business customers. http://www.elsevier.com

Media contact

Mary Billingsley

JAACAP Editorial Office

+1 202 587 9672

[email protected]

Media Contact
Mary Billingsley
[email protected]

Related Journal Article

https://www.elsevier.com/about/press-releases/research-and-journals/new-treatment-for-childhood-anxiety-works-by-changing-parent-behavior
http://dx.doi.org/10.1016/j.jaac.2019.02.014

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