Planning How Parents Will Reduce Accommodation

2019 ◽  
pp. 81-92
Author(s):  
Eli R. Lebowitz
Keyword(s):  
Parental Behavior ◽  
Child Anxiety ◽  
Childhood Anxiety ◽  
Anxiety Symptoms ◽  
Parental Attitude ◽  
Family Accommodation ◽  
The Common

Effectively helping parents to reduce family accommodation of childhood anxiety requires careful and thoughtful planning. This chapter provides guidance on formulating effective and realistic plans for changes in parental behavior aimed at reducing family accommodation of child anxiety symptoms. A well-crafted plan will be focused, specific, and pragmatic. It will also avoid the common pitfalls that can hinder implementation, which are discussed in the next chapter. This chapter also provides guidelines and examples for communicating the plan to the child and maintaining a supportive parental attitude. Clinical anecdotes and sample texts enrich the chapter and bring the content to life.

Obstacles to Addressing Accommodation

2019 ◽  
pp. 93-100
Author(s):  
Eli R. Lebowitz
Keyword(s):  
Working Alliance ◽  
Childhood Anxiety ◽  
Anxiety Symptoms ◽  
The Self ◽  
Family Accommodation ◽  
Clinical Vignettes ◽  
The Common ◽  
And Coping

This chapter covers some of the common obstacles and challenges that clinicians are likely to face in addressing family accommodation in the treatment of childhood anxiety symptoms. The chapter provides useful and practical tools for avoiding and overcoming these challenges. Among the common challenges discussed in the chapter are difficulty in fostering a cooperative and productive working alliance between two parents, coping with aggressive or disruptive responses in the child, and coping with threats to the self by the child in response to parents reducing accommodation. The chapter includes clinical vignettes and sample texts that illustrate the strategies for overcoming each challenge.

Why Accommodation Matters

2019 ◽  
pp. 29-38
Author(s):  
Eli R. Lebowitz
Keyword(s):  
Theoretical Model ◽  
Functional Impairment ◽  
Child Anxiety ◽  
Childhood Anxiety ◽  
Anxiety Symptoms ◽  
Family Accommodation ◽  
Parents And Children ◽  
Negative Cycle ◽  
Over Time ◽  
Motivation For Treatment

This chapter reviews the negative outcomes of parental accommodation of childhood anxiety. Family accommodation is associated with more severe child anxiety symptoms over time, greater functional impairment, and high levels of distress for the parents and family. The chapter lays out a theoretical model for the negative cycle of family accommodation and anxiety. The “accommodation trap” ensnares parents and children in an ongoing cycle in which parents accommodate to reduce child anxiety but the accommodation actually leads to more child anxiety, and to even more accommodation. The chapter also discusses some of the ways that accommodation maintains childhood anxiety including through promoting avoidant behavior in the child, reducing insight, and lowering the child’s motivation for treatment.

Introduction to Accommodation of Child Anxiety

2019 ◽  
pp. 3-20
Author(s):  
Eli R. Lebowitz
Keyword(s):  
Anxiety Disorders ◽  
Anxiety Symptom ◽  
Child Anxiety ◽  
Parenting Behavior ◽  
Anxiety Symptoms ◽  
Family Accommodation ◽  
The Common

This chapter introduces the concept of family accommodation and discusses its relation to other aspects of parenting behavior. The chapter provides definitions of family accommodation and illustrates the concept through examples of common accommodations of child anxiety symptoms. The chapter also describes two methods for categorizing accommodations. Accommodations can be classified based on either the form of accommodation provided or based on the domain of anxiety symptom that is being accommodated. Examples of each are provided, including illustrative examples of accommodation in each of the common anxiety disorders. The chapter also reviews accommodation provided by individuals other than parents, including teachers, siblings, and other relatives.

Is Your Child’s Anxiety Taking Over Your Family?

2020 ◽  
pp. 43-50
Author(s):  
Eli R. Lebowitz
Keyword(s):  
Behavioral Problems ◽  
Parental Behavior ◽  
Child Anxiety ◽  
Childhood Anxiety ◽  
Family Context ◽  
Emotional And Behavioral Problems ◽  
Childhood Disorders ◽  
Psychological Theories ◽  
Natural Tendency ◽  
The Family

This chapter addresses child anxiety in the family context, starting with the myth that parents cause anxiety problems in their children. The idea that parents are responsible for children’s emotional and behavioral problems stems in large part from inaccurate assumptions about human development; outdated psychological theories; misunderstandings of research on the links between parental behavior and childhood disorders; and an incorrect interpretation of family dynamics. On the other hand, a child’s anxiety problem is likely to have an impact on the parents and on the rest of the family. The reason that childhood anxiety, more than other problems, can have such a large impact on parents is that when a child is feeling anxious, they look to their parents to help them feel better. But why are anxious children so reliant on parents? The reason has to do with the very nature of anxiety in humans. The natural tendency of the child to look to the parents for protection and reassurance when feeling worried, scared, or stressed is essentially hardwired into the human brain.

Reducing Accommodation to Treat Child Anxiety

2019 ◽  
pp. 39-46
Author(s):  
Eli R. Lebowitz
Keyword(s):  
Family Functioning ◽  
Treatment Strategy ◽  
Positive Impact ◽  
Child Anxiety ◽  
Childhood Anxiety ◽  
Parent Child Relationship ◽  
Family Accommodation ◽  
Child Relationship ◽  
Direct Child ◽  
Parent Child

This chapter discusses reducing family accommodation as a means of treating childhood anxiety. The chapter covers both reducing family accommodation as a stand-alone treatment and reducing family accommodation as part of a broader treatment strategy that also includes direct child-based therapy. Research supporting the efficacy of reducing family accommodation to treat child anxiety is reviewed, and practical considerations such as when to introduce the topic of family accommodation and how to optimize the sequence of child and parent work are discussed. Additional benefits of reducing family accommodation, including improved family functioning, positive impact on siblings, and improved parent–child relationship are also discussed.

scholarly journals Maternal and paternal influences on the developmental trajectory of childhood anxiety symptoms: a genetically sensitive investigation

2017 ◽  
Author(s):  
Andy Peter Field ◽  
Kathryn J. Lester ◽  
Sam Cartwright-Hatton ◽  
Gordon Harold ◽  
Daniel S. Shaw ◽  
...  
Keyword(s):  
Growth Models ◽  
Environmental Influence ◽  
Child Anxiety ◽  
Childhood Anxiety ◽  
Anxiety Symptoms ◽  
Developmental Trajectory ◽  
Adoptive Parent ◽  
Parameter Estimates ◽  
Adopted Children ◽  
Mothers And Fathers

One theory suggests that anxious fathers may pose a greater environmental influence on childhood anxiety than anxious mothers. This study uses the Early Growth and Development Study (EGDS) to test rearing parent anxiety influences from mothers and fathers on child anxiety symptoms between 18 months and 4.5, while considering inherited influences. The EGDS is a longitudinal, multisite study of adopted children recruited through US adoption agencies, and their adoptive and birth parents. Bayesian latent growth models of the trajectory of child anxiety symptoms over 3 years predicted from inherited (birth parent anxiety) and adoptive parent anxiety influences were compared for maternal and paternal measures. Parameter estimates and their HPD intervals provided evidence that the slope for anxiety symptoms between 18 and 54 months is trivially affected by both rearing parent anxiety and inherited influences from both mothers and fathers. Similarly, rearing parental anxiety and inherited influence from both mothers and fathers had only a very small effect on the intercept for growth (anxiety symptoms at 18 months old). The evidence for differences between mothers and fathers for any of these parameters was, at best, weak. Contrary to theoretical predictions, anxiety in the rearing father is unlikely to have a more important role in fostering child anxiety symptoms than that in the rearing mother.

SPACE, Parent-Based Treatment for Childhood and Adolescent Anxiety: Clinical Case Illustration

2020 ◽  
Vol 34 (2) ◽  
pp. 107-118 ◽  
Author(s):  
Eli R. Lebowitz ◽  
Jennifer M. Majdick
Keyword(s):  
Recent Literature ◽  
Parental Behavior ◽  
Behavioral Therapy ◽  
Child Anxiety ◽  
Childhood Anxiety ◽  
Treatment Modalities ◽  
Childhood Anxiety Disorders ◽  
Adolescent Anxiety ◽  
Supportive Parenting ◽  
Efficacious Treatment

Efficacious treatments for childhood anxiety disorders include Cognitive Behavioral Therapy (CBT) and medications, yet there is urgent need for additional efficacious treatment modalities. Parent-based treatment provides such an alternative. Recent literature has supported that SPACE (Supportive Parenting for Anxious Childhood Emotions), an entirely parent-based treatment, is as efficacious as CBT in reducing child anxiety. SPACE focuses on systematically reducing family accommodation, or changes to parental behavior aimed at alleviating or avoiding a child's distress related to their anxiety disorder, while maintaining a supportive stance toward the child. To date, SPACE is the only intervention that places the reduction of parental accommodation at the center of its theoretical foundation and treatment objectives. This article provides theoretical and empirical background for SPACE and illustrates its implementation through a case description.

Parental Support

2019 ◽  
pp. 69-80
Author(s):  
Eli R. Lebowitz
Keyword(s):  
Parental Support ◽  
Childhood Anxiety ◽  
Anxiety Symptoms ◽  
Family Accommodation ◽  
Parental Responses

This chapter introduces the concept of supportive parental responses to childhood anxiety symptoms, a key concept in addressing family accommodation. Supportive responses are defined as parental responses that convey to the child two messages: a message of acceptance and validation of the child’s anxiety, and a message of confidence in the child’s ability to cope with and to tolerate anxiety-related distress. When parents combine both acceptance and confidence they are being supportive of the child’s anxiety. The chapter includes several examples, clinical anecdotes, suggested texts for explaining the concept of support to parents, and tools for practicing formulating supportive statements that parents can use with their child.

The use of acceptance and commitment therapy (ACT) in addressing family accommodation (FA) for child anxiety

2021 ◽  
Vol 14 ◽  
Author(s):  
Gary Byrne
Keyword(s):  
Acceptance And Commitment Therapy ◽  
Child Anxiety ◽  
Anxiety Symptoms ◽  
List Type ◽  
Family Accommodation ◽  
Adaptive Treatment ◽  
Theoretical Support ◽  
Commitment Therapy ◽  
Acceptance And Commitment ◽  
Treatment Research

Abstract Many parents of children with anxiety tend to engage in varying levels of family accommodation (FA) in order to alleviate anxiety symptoms. This can exacerbate anxiety symptoms and have adverse effects for psychological treatments. A small number of general and specific interventions have been developed for FA but treatment research is at a nascent stage. Acceptance and commitment therapy (ACT) may be an effective treatment for FA. This article reviews the potential advantages and uses of ACT and how ACT’s six core processes can help target particular features of FA. The theoretical support for ACT is reviewed relevant to FA. The article concludes by conjecturing how ACT may be a useful and adaptive treatment in targeting FA. Key learning aims (1) To understand how FA impacts on child anxiety. (2) To help provide an overview of how ACT may be a relevant treatment in addressing FA. (3) To look at how each of the six core processes may address specific components of FA.

scholarly journals Toddler Temperament Mediates the Effect of Prenatal Maternal Stress on Childhood Anxiety Symptomatology: The QF2011 Queensland Flood Study

2019 ◽  
Vol 16 (11) ◽  
pp. 1998 ◽  
Author(s):  
Mia A. McLean ◽  
Vanessa E. Cobham ◽  
Gabrielle Simcock ◽  
Sue Kildea ◽  
Suzanne King
Keyword(s):  
Maternal Stress ◽  
Child Anxiety ◽  
Childhood Anxiety ◽  
Internalizing Behaviors ◽  
Anxiety Symptoms ◽  
Prenatal Maternal Stress ◽  
Subjective Distress ◽  
Mediation Analyses ◽  
Maternal Report ◽  
Negative Reactivity

It is not known whether alterations to temperamental characteristics associated with prenatal maternal stress (PNMS) exposure account for the development of childhood anxiety symptomatology (internalizing behaviors and anxiety symptoms). The QF2011 Queensland flood study examined whether (1) toddler temperamental characteristics explained the association between PNMS exposure and childhood anxiety symptomatology; and (2) whether effects were dependent upon child sex or the timing of gestational exposure to PNMS. We investigated the effects of various aspects of flood-related stress in pregnancy (objective hardship, cognitive appraisal, subjective distress) on maternal report of 16-month toddler temperament (attentional control, shy-inhibition, negative reactivity), 4-year maternal-reported childhood anxiety symptomatology (internalizing and anxiety symptoms; N = 104), and teacher reports of internalizing behaviors (N = 77). Severity of maternal objective hardship during pregnancy and shy-inhibited behaviors were uniquely associated with 4-year child anxiety symptoms. Mediation analyses found that higher levels of 16-month negative reactivity accounted, in part, for the relationship between increased maternal objective flood-related hardship and greater internalizing behaviors (maternal but not teacher report). Neither child sex nor gestational timing of exposure moderated the hypothesized mediations. Our findings highlight several pathways through which varying aspects of disaster-related PNMS may influence early childhood anxiety symptomatology.

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