Hostname: page-component-cd9895bd7-jn8rn Total loading time: 0 Render date: 2024-12-25T18:06:45.995Z Has data issue: false hasContentIssue false
  • English
  • Français

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

Published online by Cambridge University Press:  17 February 2021

Gary Byrne
Gary Byrne*
Affiliation:
Psychology Department, Primary Care Services, Churchtown Primary Care Centre, Dublin 14, Ireland
*
Corresponding author. Email: [email protected]
Get access Rights & Permissions [Opens in a new window]

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. (1) To understand how FA impacts on child anxiety.

  2. (2) To help provide an overview of how ACT may be a relevant treatment in addressing FA.

  3. (3) To look at how each of the six core processes may address specific components of FA.

Keywords

acceptance and commitment therapychild anxietyfamily accommodationparental accommodationparenting
Type
Original Research
Information
the Cognitive Behaviour Therapist , Volume 14 , 2021 , e9
Copyright
© British Association for Behavioural and Cognitive Psychotherapies 2021

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Further reading

Byrne, et al. (2020) provide an up-to-date review of ACT treatments for anxious children which include various parental components.Google Scholar
Lebowitz, et al. (2020) show how a parent-led programme focused on reducing FA is an effective treatment.Google Scholar
Storch, et al. (2015a, 2015b) provide an excellent overview of research related to clinical correlates and behaviour treatments of FA.Google Scholar

References

Ale, C. M., McCarthy, D. M., Rothschild, L. M., & Whiteside, S. P. H. (2015). Components of cognitive behaviour therapy related outcome in childhood anxiety disorders. Clinical Child and Family Psychology Review, 18, 240–251. http://doi.org/10.1007/s10567-015-0184-0 CrossRefGoogle ScholarPubMed
ATjak, J. G., Davis, M. L., Morina, N., Powers, M. B., Smits, J. A., & Emmelkamp, P. M. (2015). A meta-analysis of the efficacy of acceptance and commitment therapy for clinically relevant mental and physical health problems. Psychotherapy and Psychosomatics, 84, 30–36. http://doi.org/10.1159/000365764 CrossRefGoogle Scholar
Benito, K. G., Caporino, N. E., Frank, H. E., Ramanujam, K., Garcia, A., Freeman, J., … & Storch, E. A. (2015). Development of the paediatric accommodation scale: reliability and validity of clinician- and parent-report measures. Journal of Anxiety Disorders, 29, 14–24. http://doi.org/10.1016/j.janxdis.2014.10.004 CrossRefGoogle ScholarPubMed
Blackledge, J.T., Ciarrochi, J., & Deane, F. (2009). Acceptance and Commitment Therapy: Contempory Theory, Research, and Practice. Australian Academic Press.Google Scholar
Blakey, S. M., Abramowitz, J. S., Buchholz, J. L., Jessup, S. C., Jacoby, R. J., Reuman, L., & Pentel, K. Z. (2019). A randomized controlled trial of the judicious use of safety behaviours during exposure therapy. Behaviour Research and Therapy, 112, 28–35. http://doi.org/10.1016/j.brat.2018.11.010 CrossRefGoogle ScholarPubMed
Bögels, S. M., Hellemans, J., van Deursen, S., Römer, M., & van der Meulen, R. (2014). Mindful parenting in mental health care: effects on parental and child psychopathology, parental stress, parenting, coparenting, and marital functioning. Mindfulness, 5, 536–551. http://doi.org/10.1007/s12671-013-0209-7 CrossRefGoogle Scholar
Brassell, A. A., Rosenberg, E., Parent, J., Rough, J. N., Fondacaro, K., & Seehuus, M. (2016). Parent’s psychological flexibility: associations with parenting and child psychosocial well-being. Journal of Contextual Behavioural Science, 5, 111–120. http://doi.org/10.1016/j.jcbs.2016.03.001 CrossRefGoogle Scholar
Breinholst, S., Walczak, M. A., & Esbjørn, B. H. (2019). Do parental behaviours predict anxiety symptom levels? A 3 year follow-up. Journal of Child and Family Studies, 28, 3425–3432. http://doi.org/10.1007/s10826-019-01524-3 CrossRefGoogle Scholar
Burgdorf, V. L., Szabo, M., & Abbott, M. (2019). The effect of mindful interventions for parents on parenting stress and youth psychological outcomes: a systematic review and meta-analysis. Frontiers in Psychology, 10, 1336. http://doi.org/10.3389/fpsyg.2019.01336 CrossRefGoogle ScholarPubMed
Burstein, M., Ginsburg, G. S., & Tein, J. Y. (2010). Parental anxiety and child symptomatology: an examination of additive and interactive effects of parent psychopathology. Journal of Abnormal Child Psychology, 38, 897–909. http://doi.org/10.1007/s10802-010-9415-0 CrossRefGoogle ScholarPubMed
Byrne, G., Ní Ghráda, A., O’Mahony, T., & Brennan, E. (2020). A systematic review of the use of acceptance and commitment therapy in supporting parents. Psychology and Psychotherapy. Advance online publication. http://doi.org/10.1111/papt.12282 CrossRefGoogle ScholarPubMed
Caporino, N., Morgan, J., Beckstead, J., Phares, V., Murphy, T., & Storch, E. (2012). A structural equation analysis of family accommodation in paediatric obsessive- compulsive disorder. Journal of Abnormal Child Psychology, 40, 133–143. http://doi.org/10.1007/s10802-011-9549-8 CrossRefGoogle Scholar
Clauss, J. A., & Blackford, J. U. (2012). Behavioural inhibition and risk for developing social anxiety disorder: a meta-analytical study. Journal of the American Academy of Child and Adolescent Psychiatry, 51, 1066–1075. http://doi.org/10.1016/j.jaac.2012.08.002 CrossRefGoogle Scholar
Copeland, W. E., Wolke, D., Shanahan, L., & Costello, E. J. (2015). Adult functional outcomes of common childhood psychiatric problems: a prospective, longitudinal study. JAMA Psychiatry, 72, 892–899. http://doi.org/10.1001/jamapsychiatry.2015.0730 CrossRefGoogle ScholarPubMed
Coyne, L. W., McHugh, L., & Martinez, E. R. (2011). Acceptance and commitment therapy (ACT): advances and applications with children, adolescents, and families. Child and Adolescent Psychiatric Clinics, 20, 379–399. http://doi.org/10.1016/j.chc.2011.01.010 CrossRefGoogle Scholar
Coyne, L. W., & Murrell, A. R. (2009). The Joy of Parenting. New Harbinger Publications.Google Scholar
Coyne, L. W., & Wilson, K. G. (2004). The role of cognitive fusion in impaired parenting: an RFT analysis. International Journal of Psychology and Psychological Therapy, 4, 469–486.Google Scholar
Creswell, C., Parkinson, M., Thirlwall, K., & Willetts, L. (2019). Parent-Led CBT for Child Anxiety: Helping Parents Help Their Kids. Guilford Publications.Google Scholar
Creswell, C., Waite, P., & Hudson, J. (2020). Practitioner review: anxiety disorders in children and young people- assessment and treatment. Journal of Child Psychology and Psychiatry. Advance online publication. http://doi.org/10.1111/jcpp.13186 CrossRefGoogle Scholar
Cummings, C. M., Caporino, N. E., & Kendall, P. C. (2014). Comorbidity of anxiety and depression in children and adolescents: 20 years after. Psychological Bulletin, 140, 816–854. http://doi.org/10.1037/a0034733 CrossRefGoogle Scholar
Duncan, L. G., Coastworth, J. D., & Greenberg, M. T. (2009). A model of mindful parenting: implications for parent-child relationships and prevention research. Clinical Child and Family Psychology Review, 12, 255–270. http://doi.org/10.1007/s10567-009-0046-3 CrossRefGoogle Scholar
Eley, T. C., McAdams, T. A., Rijsdijk, F. V., Lichtenstein, P., Narusyte, J., Reiss, D., Spotts, E. L., Ganiban, J. M., & Neiderhiser, J. M. (2015). The intergenerational transmission of anxiety: a children-of-twins study. American Journal of Psychiatry, 172, 630–637. http://doi.org/10.1176/appi.ajp.2015.14070818 Google ScholarPubMed
Emerson, L. M., Ogielda, C., & Rowse, G. (2019). The role of experiential avoidance and parental control in the association between parent and child anxiety. Frontiers in Psychology, 10, 262. http://doi.org/10.3389/fpsyg.2019.00262 CrossRefGoogle ScholarPubMed
Evans, T., Whittingham, K., & Boyd, R. (2012). What helps the mother of a preterm infant become securely attached, responsive and well-adjusted? Infant Behaviour & Development, 35, 1–11. http://doi.org/10.1016/j.infbeh.2011.10.002 CrossRefGoogle ScholarPubMed
Freeman, J., Sapyta, J., Garcia, A., Compton, S., Khanna, M., Flessner, C., … & Harrison, J. (2014). Family-based treatment of early childhood obsessive-compulsive disorder: the Pediatric Obsessive-Compulsive Disorder Treatment Study for Young Children (POTS Jr) – a randomized clinical trial. JAMA Psychiatry, 71, 689–698. http://doi.org/10.1001/jamapsychiatry.2014.170 CrossRefGoogle ScholarPubMed
Garcia, A. M., Sapyta, J. J., Moore, P. S., Freeman, J. B., Franklin, M. E., March, J. S., & Foa, E. B. (2010). Predictors and moderators of treatment outcome in the Paediatric Obsessive Compulsive Treatment Study (POTS I). Journal of the American Academy of Child & Adolescent Psychiatry, 49, 1024–1033. http://doi.org/10.1016/j.jaac.2010.06.013 CrossRefGoogle Scholar
Ginsburg, G. S., Becker, E. M., Keeton, C. P., Sakolsky, D., Piacentini, J., Albano, A. M., … & Kendall, P. C. (2014). Naturalistic follow-up of youths treated for pediatric anxiety disorders. JAMA Psychiatry, 71, 310–318. http://doi.org/10.1001/jamapsychiatry.2013.4186 CrossRefGoogle ScholarPubMed
Ginsburg, G. S., Kendall, P. C., Sakolsky, D., Compton, S. N., Piacentini, J., Albano, A. M., … & Rynn, M. A. (2011). Remission after acute treatment in children and adolescents with anxiety disorders: findings from the CAMS. Journal of Consulting and Clinical Psychology, 79, 806–813. http://doi.org/10.1037/a0025933 CrossRefGoogle ScholarPubMed
Graham, C. D., Gouick, J., Krahe, C., & Gillanders, D. (2016). A systematic review of the use of acceptance and commitment therapy (ACT) in chronic disease and long-term conditions. Clinical Psychology Review, 46, 46–58. http://doi.org/10.1016./j.cpr.2016.04.009 CrossRefGoogle ScholarPubMed
Hancock, K. M., Swain, J., Hainsworth, C. J., Dixon, A. L., Koo, S., & Munro, K. (2018). Acceptance and commitment therapy versus cognitive behaviour therapy for children with anxiety: outcomes of a randomized controlled trial. Journal of Clinical Child & Adolescent Psychology, 47, 296–311. http://doi.org/10.1080/15374416.2015.1110822 CrossRefGoogle ScholarPubMed
Harley, J. (2015). Bridging the gap between cognitive therapy and acceptance and commitment therapy (ACT). Procedia-Social and Behavioral Sciences, 193, 131–140.CrossRefGoogle Scholar
Hayes, S. C. (2004). Acceptance and commitment therapy, Relational Frame Theory and the third wave of behavioural and cognitive therapies. Behaviour Therapy, 35, 639–665. http://doi.org/10.1016/j.beth.2016.11.006 CrossRefGoogle Scholar
Hayes, S. C. (2019). A Liberated Mind. The Essential Guide to ACT. Vermilion.Google Scholar
Hayes, S. C., Barnes-Holmes, D., & Roche, B. (2001). Relational Frame Theory: A Post- Skinnerian Account of Human Language and Cognition. Springer.CrossRefGoogle Scholar
Hayes, S. C., & Strosahl, K. D. (2004). A Practical Guide to Acceptance and Commitment Therapy. Springer.CrossRefGoogle Scholar
Hayes, S. C., Strosahl, K. D., & Wilson, K. G. (2011). Acceptance and Commitment Therapy: The Process and Practice of Mindful Change (2nd edn). Guilford Press.Google Scholar
Iniesta-Sepúlveda, M., Rodriguez-Jimenez, T., Lebowitz, E. R., Goodman, W. K., & Storch, E. A. (2020). The relationship of family accommodation with paediatric anxiety severity: meta-analytic findings and child, family and methodological moderators. Child Psychiatry and Human Development. Advance online publications. http://doi.org/10.1007/s10578-020-00987-6 Google Scholar
Kagan, E. R., Peterman, J. S., Carper, M. M., & Kendall, P. C. (2016). Accommodation and treatment of anxious youth. Depression and Anxiety, 33, 840–847. http://doi.org/10.1002/da.22520 Google ScholarPubMed
Kendall, P. C., & Peterman, J. S. (2015). CBT for adolescents with anxiety: mature yet still developing. American Journal of Psychiatry, 172, 519–530. http://doi.org/10.1176/appi.ajp.2015.14081061 CrossRefGoogle ScholarPubMed
Kendall, P. C., Cummings, C. M., Villabo, M. A., Narayanan, M. K., Treadwell, K., Birmaher, B., Compton, S., Piacentini, J., Sherill, J., Walkup, J., Gosch, E., Keeton, C., Ginsburg, G., Suvey, C., & Albano, A. M. (2016). Mediators of change in the Child/Adolescent Anxiety Multimodal Treatment Study. Journal of Consulting and Clinical Psychology, 84, 1–14. http://doi.org/10.1037/a0039773 CrossRefGoogle ScholarPubMed
Lebowitz, E., Panza, K., Su, J., & Bloch, M. (2012). Family accommodation in obsessive- compulsive disorder. Expert Review of Neurotherapeutics, 12, 229–238. http://doi.org/10.1586/ern.11.200 CrossRefGoogle ScholarPubMed
Lebowitz, E. R., Woolston, J., Bar-Haim, Y., Calvocoressi, L., Dauser, C., Warnick, E., … & Vitulano, L. A. (2013). Family accommodation in paediatric anxiety disorders. Depression and Anxiety, 30, 47–54. http://doi.org/10.1002/da.21998 Google Scholar
Lebowitz, E. R., & Omer, H. (2013). Treating Childhood Adolescent Anxiety: A Guide for Caregivers. Wiley.CrossRefGoogle Scholar
Lebowitz, E. R., Omer, H., Hermes, H., & Scahill, L. (2014). Parent training for childhood anxiety disorders: the SPACE program. Cognitive and Behavioural Practice, 21, 456–469. http://doi.org/10.1016/j.cbpra.2013.10.004 CrossRefGoogle Scholar
Lebowitz, E. R., Marin, C., Martino, A., Shimshoni, Y., & Silverman, W. K. (2020). Parent-based treatment as efficacious as cognitive-behavioural therapy for childhood anxiety: a randomized non-inferiority study of supportive parenting for anxious childhood emotions. Journal of the American Academy of Child & Adolescent Psychiatry, 59, 362–372. http://doi.org/10.1016/j.jaac.2019.02.014 CrossRefGoogle Scholar
Losada, A. S., Marquez-Gonzalez, M. A., Romero-Moreno, R., Mausbach, B. T., Lopez, J., Fernandez-Fernandez, V., & Nogales-Gonzalez, C. (2015). Cognitive-behavioural therapy (CBT) versus acceptance and commitment therapy (ACT) for dementia family caregivers with significant depressive symptoms: results of a randomized clinical trial. Journal of Consulting and Clinical Psychology, 83, 760–772. http://doi.org/10.1037/ccp0000028 Google ScholarPubMed
Luoma, J. B., Hayes, S. C., & Walser, R. D. (2007). Learning ACT: An Acceptance & Commitment Therapy Skills-Training Manual for Therapists. New Harbinger Publications.Google Scholar
Manimala, M. R., Blount, R. L., & Cohen, L. L. (2000). The effects of parental reassurance versus distraction on child distress and coping during immunizations. Children’s Health Care, 29, 161–177.CrossRefGoogle Scholar
McCurry, C. (2015). Working with Parents of Anxious Children. Therapeutic Strategies for Encouraging Communication, Coping, & Change. W. W. Norton & Company.Google Scholar
McKinnon, A., Keers, R., Coleman, J. R., Lester, K. J., Roberts, S., Arendt, K., … & Hudson, J. L. (2018). The impact of treatment delivery format on response to cognitive behaviour therapy for preadolescent children with anxiety disorders. Journal of Child Psychology and Psychiatry, 59, 763–772. http://doi.org/10.1111/jcpp.12872 CrossRefGoogle ScholarPubMed
Merlo, L., Lehmkuhl, H., Geffen, G., & Storch, E. (2009). Decreased family accommodation associated with improved therapy outcome in paediatric obsessive-compulsive disorder. Journal of Consulting and Clinical Psychology, 77, 355–360. http://doi.org/10.1037/a0012652 CrossRefGoogle Scholar
Meyer, J. M., Clapp, J. D., Whiteside, S. P., Dammann, J., Kriegshauser, K. D., Hale, L. R., Jacobi, D. M., Riemann, B. C., & Deacon, B. J. (2018). Predictive relationship between parental beliefs and accommodation of paediatric anxiety. Behaviour Therapy, 49, 580–593. http://doi.org/10.1016/j.beth.2017.11.004 CrossRefGoogle Scholar
O’Connor, E. E., Holly, L. E., Chevalier, L. L., Pincus, D. B., & Langer, D. A. (2020). Parent and child emotion and distress responses associated with parental accommodation of child anxiety symptoms. Journal of Clinical Psychology. Advance online publication. http://doi.org/10.1002/jclp.22941 CrossRefGoogle ScholarPubMed
Peterman, J. S., Read, K. L., Wei, C., & Kendall, P. C. (2015). The art of exposure: putting science into practice. Cognitive and Behavioural Practice, 22, 379–392. http://doi.org/10.1016/j.cbpra.2014.02.003 CrossRefGoogle Scholar
Polanczyk, G. V., Salum, G.A., Sugaya, L. S., Caye, A., & Rohde, L. A. (2015). Annual research review: a meta-analysis of the worldwide prevalence of mental disorders in children and adolescents. Journal of Child Psychology and Psychiatry, 56, 345–365. http://doi.org/10.1111/jcpp.12381 CrossRefGoogle ScholarPubMed
Rapee, R. M., Lyneham, H. J., Hudson, J. L., Kangas, M., Wuthrich, V. M., & Schniering, C. A. (2013). Effect of comorbidity on treatment of anxious children and adolescents: results from a large, combined sample. Journal of the American Academy of Child and Adolescent Psychiatry, 52, 47–56. http://doi.org/10.1016/j.jaac.2012.10.002 CrossRefGoogle ScholarPubMed
Reuman, L., & Abramowitz, J. S. (2018). Predictors of accommodation among families affected by fear-based disorders. Child Psychiatry and Human Development, 49, 53–62. http://doi.org/10.1007/s10578-0170728-x CrossRefGoogle ScholarPubMed
Roemer, L., & Orsillo, S. M. (2005). An acceptance-based behaviour therapy for generalized anxiety disorder. In Orsillo, S. M. & Roemer, L. (eds), Acceptance and Mindfulness-Based Approaches to Anxiety: Conceptualization and Treatment (pp. 213–240). Springer.CrossRefGoogle Scholar
Storch, E. A., Salloum, A., Johnco, C., Dane, B. F., Crawford, E. A., King, M. A., McBride, N. M., & Lewin, A. B. (2015a). Phenomenology and clinical correlates of family accommodation in paediatric anxiety disorders. Journal of Anxiety Disorders, 35, 75–81. http://doi.org/10.1016/j.janxdis.2015.09.001 Google Scholar
Storch, E. A., Zavrou, S., Collier, A. B., Ung, D., Arnold, E. B., Mutch, P. J., Lewin, A. B., & Murphy, T. K. (2015b). Preliminary study of family accommodation in youth with autism spectrum disorders and anxiety: incidence, clinical correlates, and behavioural treatment response. Journal of Anxiety Disorders, 34, 94–99. http://doi.org/10.1016/j.janxdis.2015.06.007 Google ScholarPubMed
Swain, J., Hancock, K., Hainsworth, C., & Bowman, J. (2013). Acceptance and commitment therapy in the treatment of anxiety: a systematic review. Clinical Psychology Review, 33, 965–978. http://doi.org/10.1016/j.cpr.2013.07.002 Google ScholarPubMed
Swain, J., Hancock, K., Dixon, A., & Bowman, J. (2015). Acceptance and commitment therapy for children: a systematic review of intervention studies. Journal of Contextual Behavioural Science, 4, 73–85. http://doi.org/10.1016/j.jcbs.2015.02.001 CrossRefGoogle Scholar
Thompson-Hollands, J., Kerns, C. E., Pincus, D. B., & Comer, J. S. (2014). Parental accommodation of child anxiety and related symptoms: range, impact, and correlates. Journal of Anxiety Disorders, 28, 765–773. http://doi.org/10.1016/j.janxdis.2014.09.007 CrossRefGoogle ScholarPubMed
Townshend, K., Jordan, Z., Stephenson, M., & Tsey, K. (2016). The effectiveness of mindful parenting programs in promoting parents’ and children’s wellbeing: a systematic review. JBI Database of Systematic Reviews and Implementation Reports, 14, 139–180.CrossRefGoogle ScholarPubMed
Twohig, M. P., Abramowitz, J. S., Bluett, E. J., Fabricant, L. E., Jacoby, R. J., Morrison, K. L., Lillian, R., & Smith, B. M. (2015). Exposure therapy for OCD from an acceptance and commitment therapy (ACT) framework. Journal of Obsessive-Compulsive and Related Disorders, 6, 167–173. http://doi.org/10.1016/j.jocrd.2014.12.007 CrossRefGoogle Scholar
Twohig, M. P., & Levin, M. E. (2017). Acceptance and commitment therapy as a treatment for anxiety and depression: a review. Psychiatric Clinics, 40, 751–770. http://doi.org/10.1016/j.jocrd.2014.12.007 Google ScholarPubMed
Walser, R. D. (2019). The Heart of ACT: Developing a Flexible, Process-Based, and Client- Centered Practice Using Acceptance and Commitment Therapy. New Harbinger Publications.Google Scholar
Whittingham, K., & Coyne, L. (2019). Acceptance and Commitment Therapy: The Clinician’s Guide for Supporting Parents. Academic Press.Google Scholar
Wilson, K. G., & Sandoz, E. K. (2008). Mindfulness, values, and the therapeutic relationship in acceptance and commitment therapy. In Hick, S. & Bein, T. (eds), Mindfulness and the Therapeutic Relationship (pp. 89–106). Guilford Press.Google Scholar
Submit a response

Comments

No Comments have been published for this article.