Improving interventions for anxious youth: developing understanding and treatment of parents' cognitions and behaviours
Lead Research Organisation:
University of Reading
Department Name: Sch of Psychology and Clinical Lang Sci
Abstract
Cognitive-behaviour therapy (CBT) is a treatment approach that has achieved tremendous success in the treatment of many psychological disorders. It specifically focuses on helping patients to change their thinking styles and behaviours to help them to overcome distress. In recent years the approach has been imported to work with children, with varying degrees of success. One explanation for the mixed results is likely to relate to how children‘s caregivers are involved in the treatment. A good example of this is the treatment of child anxiety, in which treatment outcomes have varied enormously across studies (39-84% remitted following treatment). In recent years parental thinking styles and behaviours have been identified that may contribute to the development of emotional problems in young people. Based on a series of experiments with clinical and non-clinical groups of people, the proposed research aims to identify key thinking styles experienced by parents of clinically anxious children and examine how these thinking styles influence parents‘ behaviours, and consequently how children feel and behave. This research has the potential to have a significant impact on the development of clinical practice by providing understanding and therapeutic techniques for the successful adaptation of CBT to young populations.
Technical Summary
Aims
Personal, health and economic costs of emotional disorders are considerable and rising. Cognitive-behaviour therapy (CBT) is recognised as the first-line approach for many emotional disorders (in particular anxiety) both for adults and children. Outcomes for children, however, have been variable. One explanation for this is likely to relate to the manner in which caregivers are involved in treatment. There is evidence to suggest that caregivers engage in cognitive and behavioural processes that contribute to the development and maintenance of child disorders. The aims of the proposed research are to test a model of cognitive-behavioural family processes in the development of child anxiety and to establish effective CBT strategies for changing these processes.
Objectives
1. In parents of children with anxiety disorders and a non-clinical comparison group, to compare parental behaviours associated with child anxiety (verbal and non-verbal fear responses, reduced autonomy-granting and negativity) and parental cognitions (specifically: cognitions relating to threat and anticipated distress; expectations about their child‘s perceived threat and distress; and perceived control over their child‘s anxious behaviour); and to examine the association between these behaviours and cognitions.
2. In caregivers of a non-clinical population, to assess change in the identified parental behaviours and child response following experimentally inducing cognitive biases.
3. In caregivers of clinically anxious children, to assess change in identified parental behaviours and child response following a reduction in maladaptive cognitive biases.
Design
These objectives will be addressed by a series of experiments.
1. Measures will assess caregivers‘ cognitive biases such as interpretation of ambiguity. A video-mediated recall procedure will also be used to elicit parental cognitions following a challenging task with their child. Reliable coders will objectively assess parental behaviour during the task.
2. Interpretation biases in caregivers will be modified using established training methods that constrain solutions to ambiguous scenarios in a manner that is consistent or inconsistent with one of the key cognitive biases under investigation. Changes in caregiver behaviour and child response during a challenging task will be assessed and related to induced bias.
3. Benign interpretation biases will be induced with caregivers of clinically anxious children, using cognitive behavioural techniques and training procedures. Changes in parenting behaviour and child response to a challenging task will be assessed.
Scientific and medical opportunities
The proposed research will (i) increase understanding of the development of child anxiety, and (ii) provide specific clinical interventions that could significantly improve treatments for child anxiety disorder.
Personal, health and economic costs of emotional disorders are considerable and rising. Cognitive-behaviour therapy (CBT) is recognised as the first-line approach for many emotional disorders (in particular anxiety) both for adults and children. Outcomes for children, however, have been variable. One explanation for this is likely to relate to the manner in which caregivers are involved in treatment. There is evidence to suggest that caregivers engage in cognitive and behavioural processes that contribute to the development and maintenance of child disorders. The aims of the proposed research are to test a model of cognitive-behavioural family processes in the development of child anxiety and to establish effective CBT strategies for changing these processes.
Objectives
1. In parents of children with anxiety disorders and a non-clinical comparison group, to compare parental behaviours associated with child anxiety (verbal and non-verbal fear responses, reduced autonomy-granting and negativity) and parental cognitions (specifically: cognitions relating to threat and anticipated distress; expectations about their child‘s perceived threat and distress; and perceived control over their child‘s anxious behaviour); and to examine the association between these behaviours and cognitions.
2. In caregivers of a non-clinical population, to assess change in the identified parental behaviours and child response following experimentally inducing cognitive biases.
3. In caregivers of clinically anxious children, to assess change in identified parental behaviours and child response following a reduction in maladaptive cognitive biases.
Design
These objectives will be addressed by a series of experiments.
1. Measures will assess caregivers‘ cognitive biases such as interpretation of ambiguity. A video-mediated recall procedure will also be used to elicit parental cognitions following a challenging task with their child. Reliable coders will objectively assess parental behaviour during the task.
2. Interpretation biases in caregivers will be modified using established training methods that constrain solutions to ambiguous scenarios in a manner that is consistent or inconsistent with one of the key cognitive biases under investigation. Changes in caregiver behaviour and child response during a challenging task will be assessed and related to induced bias.
3. Benign interpretation biases will be induced with caregivers of clinically anxious children, using cognitive behavioural techniques and training procedures. Changes in parenting behaviour and child response to a challenging task will be assessed.
Scientific and medical opportunities
The proposed research will (i) increase understanding of the development of child anxiety, and (ii) provide specific clinical interventions that could significantly improve treatments for child anxiety disorder.