An examination of the relationship between parental accommodation and childhood anxiety through a cognitive-behavioral therapy intervention with parent-training

Cognitive Behavioral Therapy (CBT) is recognized as the most well-established and effective psychosocial treatment for anxiety disorders. However, there are still many children who do not respond to individual CBT or do not maintain their treatment gains over time. The adverse effects of parent accommodation for anxious youth have been substantiated in the last five years. Therefore, there is growing support to include parents in treatment in order to target this maladaptive parenting behavior. The present study is proposed as a means to further understand the relevance of addressing parental accommodation in the treatment of childhood anxiety and to further evaluate the added benefits of involving parents in treatment. Additionally, it examines the relationship between parental pathology and accommodation, and if parental pathology may impact a parent’s ability to reduce accommodation. A sample of 47 anxiety-disordered youth, ages 7 – 17, who are participating in an ongoing intervention study at an Austin-based mental health clinic, Texas Child Study Center (TCSC), was used. This study investigated the change in parental accommodation behaviors after a 12-week intervention with standard child CBT treatment and an additional parent-training component, as well as the relationship between parental accommodation and child treatment response. A secondary goal was to investigate the relationship between parental anxiety and parental accommodation levels, before and after parent-training.

 Analyses provided several significant findings. Parental accommodation decreased after involvement in a 12-week CBT treatment with parent training. Additionally, parental accommodation at post-treatment was predictive of child-impairment at post-treatment, as measured by both parent-report and clinician-rating, above and beyond pre-treatment impairment. Finally, parental accommodation significantly correlated with parental anxiety at post-treatment but not at pre-treatment, although prior studies have found this significant relationship for parents prior to treatment.

 This study lends support for the relevance of addressing parental accommodation in the treatment of childhood anxiety and highlights the benefits of involving parents in treatment. By addressing accommodation with parents of anxious children, clinicians may see more substantial or sustained improvements, treat children who may not have responded to traditional CBT techniques, and even help families of children who are treatment refusers.