Family Intervention for Child and Adolescent Anxiety: A Meta-analytic Review of Therapy Targets, Techniques, and Outcomes

Peris, Tara S.; Thamrin, Hardian; Rozenman, Michelle

doi:10.1016/j.jad.2021.02.053

Cited by 33 publications

(20 citation statements)

References 96 publications

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“…Thus, our trial was successful in moving the field closer to realizing the discovery of parenting-based mechanisms. Given the absence of past data on parent/family mechanisms/mediators and the frequent calls for such data (e.g., Creswell et al, 2020;Herres et al, 2015;Manassis et al, 2014;Peris et al, 2021;Sun et al, 2018;Thulin et al, 2014), our findings acquire even further significance. Altogether, the findings pave the way for additional mechanistic research, such as how parental reinforcement might be used to optimize outcomes further (e.g., dose effects, personalized treatment).…”

Section: Discussionmentioning

confidence: 67%

Does Training Parents in Reinforcement Skills or Relationship Skills Enhance Individual Youths’ Cognitive Behavioral Therapy for Anxiety? Outcome, Specificity, and Mediation

Silverman

Rey

Marin

et al. 2021

Clinical Psychological Science

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We conducted a dismantling design treatment study comparing individual cognitive behavioral therapy (CBT), CBT targeting parents’ reinforcement skills (CBT + Reinf), and CBT targeting parents’ relationship skills (CBT+ Relat) in 341 youths with primary anxiety diagnoses. At posttreatment, youths in CBT with parent involvement had lower anxiety than youths in CBT. At 12-month follow-up, youths in CBT + Relat maintained lower anxiety relative to CBT. At posttreatment, negative reinforcement was significantly lower in CBT + Reinf than CBT + Relat and CBT; negative reinforcement partially mediated anxiety reduction in youths. Reducing parental negative reinforcement in CBT + Reinf was associated with lower parental psychological control, which also partially mediated anxiety reduction in youths. Some of these mediational dynamics continued through follow-up. Targeting concrete behavioral parenting skills, especially negative reinforcement, produced treatment specificity and partial mediation relative to less concrete targeting and enhanced CBT. Findings highlight complexities in identifying mechanisms through which targeting of parenting skills produces anxiety reduction in youths and suggest avenues for future research.

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Section: Discussionmentioning

confidence: 67%

Does Training Parents in Reinforcement Skills or Relationship Skills Enhance Individual Youths’ Cognitive Behavioral Therapy for Anxiety? Outcome, Specificity, and Mediation

Silverman

Rey

Marin

et al. 2021

Clinical Psychological Science

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“…Although the degree of caregiver involvement and specific family emotion regulation topics covered vary by specific model, FCBT for anxiety generally includes caregivers in at least some sessions in which they receive psychoeducation on the impact of their own emotional responses to their children’s anxiety and their behaviors (e.g., accommodation, overprotection, modeling) that may be maintaining it, and skills training to enhance their own emotion regulation, parenting, and emotion socialization behaviors (Wood et al, 2009 ). A substantial number of studies have been conducted on FCBT, and interestingly, evidence for the incremental benefit of FCBT over individual child CBT has been mixed, with several meta-analytic studies showing no benefit (Goger & Weersing, 2021 ; Peris et al, 2021 ). It may be that FCBT is incrementally beneficial for specific populations (e.g., families in which parents have an anxiety disorder; Kendall et al, 2008 ), or that for FCBT to be uniquely helpful, it must include certain parenting components (Manassis et al, 2014 ).…”

Section: Implications For Prevention and Interventionmentioning

confidence: 99%

“…It may be that FCBT is incrementally beneficial for specific populations (e.g., families in which parents have an anxiety disorder; Kendall et al, 2008 ), or that for FCBT to be uniquely helpful, it must include certain parenting components (Manassis et al, 2014 ). Peris and colleagues noted that the vast majority of FCBT studies include only child diagnosis and/or symptoms as an outcome measure, and surprisingly few included pre- and post-intervention assessment of the targeted family process (Peris et al, 2021 ). Thus, it is possible that lack of findings for FCBT’s incremental benefit is due not to family processes not being an important part of treatment for childhood anxiety, but rather, to current treatment approaches’ lack of efficacy in improving those family processes.…”

Section: Implications For Prevention and Interventionmentioning

confidence: 99%

“…This represents a gap in this work, given evidence that partner conflict is a maintaining factor for parental anxiety (Stuart Parrigon & Kerns, 2016 ) as well as the impact of sibling relationships on emotion socialization (Kramer, 2014 ) and the development of psychopathology (Feinberg et al, 2012 ). Thus, in addition to including measurement of the family processes identified as treatment targets (Peris et al, 2021 ), a next step for FCBT for childhood anxiety might be to incorporate intervention components for other family subsystems.…”

Section: Implications For Prevention and Interventionmentioning

confidence: 99%

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Conceptualizing Emotion Regulation and Coregulation as Family-Level Phenomena

Paley

Hajal

2022

Clin Child Fam Psychol Rev

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The ability to regulate one’s emotions is foundational for healthy development and functioning in a multitude of domains, whereas difficulties in emotional regulation are recognized as a risk factor for a range of adverse outcomes in childhood, adolescence, and adulthood. Caregivers play a key role in cultivating the development of emotion regulation through coregulation, or the processes by which they provide external support or scaffolding as children navigate their emotional experiences. The vast majority of research to date has examined coregulation in the context of caregiver–child dyads. In this paper, we consider emotion regulation and coregulation as family-level processes that unfold within and across multiple family subsystems and explore how triadic and whole family interactions may contribute to the development of children’s emotion regulation skills. Furthermore, we will examine the implications of a family-centered perspective on emotion regulation for prevention of and intervention for childhood emotional and behavioral disorders. Because emotion regulation skills undergo such dramatic maturation during children’s first several years of life, much of our focus will be on coregulation within and across the family system during early childhood; however, as many prevention and intervention approaches are geared toward school-aged children and adolescents, we will also devote some attention to later developmental periods.

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“…Adolescence is a critical period for anxiety intervention. Abundant evidence demonstrates that anxiety in adolescents is significantly connected to their family relationships (Peris et al, 2021).…”

Section: Paternal Adult Attachment and Adolescent Anxietymentioning

confidence: 99%

Relationship between paternal adult attachment and adolescent anxiety: The chain‐mediating effect of paternal psychological flexibility and father–adolescent attachment

Chen

Gong

et al. 2022

Int J Psychol

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Grounded in family systems theory and the internal working model of attachment, the present study tested the effects of paternal adult attachment, paternal psychological flexibility and father–adolescent attachment on adolescent anxiety. In total, 906 pairs of fathers and their adolescents completed a set of questionnaires, including the Experiences in Close Relationships Scale, Parental Psychological Flexibility Questionnaire, Inventory of Parent and Peer Attachment, and Trait Anxiety Inventory. The results revealed that paternal adult attachment avoidance had a positive impact on adolescent anxiety. The relationship between paternal adult attachment and adolescent anxiety was chain mediated by paternal psychological flexibility and father–adolescent attachment. The mediation effects contained two paths: the separate mediation effect of paternal psychological flexibility, and the chain mediation effect of paternal psychological flexibility and father–adolescent attachment. The results of the study show that the father's adult attachment can not only directly affect adolescent anxiety, but also indirectly affect adolescent anxiety through the paternal psychological flexibility and the quality of father–adolescent attachment. Fathers have an important effect on adolescent anxiety.

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Family Intervention for Child and Adolescent Anxiety: A Meta-analytic Review of Therapy Targets, Techniques, and Outcomes

Cited by 33 publications

References 96 publications

Does Training Parents in Reinforcement Skills or Relationship Skills Enhance Individual Youths’ Cognitive Behavioral Therapy for Anxiety? Outcome, Specificity, and Mediation

Does Training Parents in Reinforcement Skills or Relationship Skills Enhance Individual Youths’ Cognitive Behavioral Therapy for Anxiety? Outcome, Specificity, and Mediation

Conceptualizing Emotion Regulation and Coregulation as Family-Level Phenomena

Relationship between paternal adult attachment and adolescent anxiety: The chain‐mediating effect of paternal psychological flexibility and father–adolescent attachment

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