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    PARENTAL RESISTANCE IN COGNITIVE BHAVIORAL THERAPY FOR ANXIOUS YOUTH

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    Genre
    Thesis/Dissertation
    Date
    2020
    Author
    Knepley, Mark cc
    Advisor
    Kendall, Philip C.
    Committee member
    Alloy, Lauren B.
    Fauber, Robert L.
    McCloskey, Michael S.
    Giovannetti, Tania
    Heimberg, Richard G.
    Department
    Psychology
    Subject
    Clinical Psychology
    Anxiety
    Cognitive Behavioral Therapy
    Exposures
    Resistance
    Youth
    Permanent link to this record
    http://hdl.handle.net/20.500.12613/282
    
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    DOI
    http://dx.doi.org/10.34944/dspace/266
    Abstract
    Objective: Resistance is a therapeutic process variable that can play an important role in treatment. The present study examined whether observer-rated parental resistance during parent-only sessions of cognitive-behavioral therapy (CBT) for anxious youth predicted the number of parent-reported between-session exposures completed, posttreatment outcome, and 36-week follow-up. Method: Participants (N = 272) were parents or adult caregivers of youth (age 7 to 17 years old) who received CBT for an anxiety disorder as participants in the Child/Adolescent Anxiety Multimodal study (CAMS). Parent-only therapy sessions were rated for resistance by observers. Measures of anxiety and overall symptom severity were completed at posttreatment and 36-week follow-up. Mediation analyses examined the indirect effect of the number of parent-reported exposures completed on the relationship between parent in-session resistance and therapy outcomes at posttreatment and 36-week follow-up. Additionally, resistance levels in participants in the CBT-only condition of CAMS were compared with resistance levels for participants in the CBT plus sertraline condition. Results: Analyses demonstrated that there was no significant difference in mean resistance scores between the CBT-only group and the CBT plus sertraline group. None of the 12 mediation tests found statistically significant indirect effects of the number of parent-reported exposures completed on the relationship between parent in-session resistance and therapy outcomes at posttreatment and 36-week follow-up. A significant relationship was found, however, between number of exposures completed and posttreatment Pediatric Anxiety Rating Scale (PARS) total scores, indicating a significant relationship between number of parent-reported exposures and posttreatment therapy outcomes. Conclusions: Parental resistance is not associated with outcomes for youth receiving CBT for anxiety. Number of exposures was significantly associated with one measure of posttreatment therapy outcomes.
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