Targeting Parental Overcontrol in Cognitive Behavior Therapy for Anxious Youth

Abstract

Many parent factors have been associated with child anxiety, and researchers have examined how parents may be most beneficially involved in cognitive behavior therapy (CBT) for anxious youth. Results have been mixed as to whether parent CBT, family CBT, and parent interventions addressing parental anxiety or overcontrol have an added benefit over youth-focused CBT. The present study compared (a) a parent group intervention targeting autonomy granting, (b) a parent CBT skills group, and (c) a parent support control group, all provided in conjunction with individual CBT for anxious youth ages 7 to 17. Randomly assigned group conditions, as well as variance in overall parent attendance across conditions, were examined as predictors of change in parenting behaviors and in child anxiety. No significant differences in youth anxiety outcomes were found across parent group conditions, and parental beliefs and involvement improved most for the support control group. However, youth whose parents attended more group sessions showed a significantly greater decrease in anxiety severity than youth whose parents attended fewer (0, 1) sessions, which was mediated by a significantly greater decrease in parental avoidance of child anxiety. The results suggest that additional parent participation in treatment may have an added benefit, even with an unstructured support group format, but do not offer clarity about the benefit of targeted interventions for parents.