Parental Involvement in Cognitive-Behavioral Therapy for Children with Anxiety Disorders

Objective: A growing body of literature suggests that parents play a critical role in the development and/or maintenance of child anxiety. One of the main purposes of this article is to identify common parental involvement techniques and most common obstacles derived from parents in cognitive behavioral therapy (CBT) with anxious children. Another purpose of the present study is to revise empirical studies comparing child-focused CBT with and without parental involvement. Method: The PsycARTICLES, MEDLINE and PubMed databases were searched to identify articles in English that were published between the years of 1990 and 2012 (October) using the following keywords; (1) anxiety, (2) cognitive behavioral therapy, (3) parental involvement. Studies were only included in this review if they were comparing the treatment effect of child-only CBT and CBT with additional parental components. Results: Thirteen studies were introduced in the context of method (diagnosis of children, age range of children, follow-up, results, etc.) and therapy characteristics (number of sessions, frequency of sessions, treatment components both child focused CBT and CBT with parental involvement, etc.). Conclusion: The common techniques of therapy with parental involvement are psychoeducation, contingency management, cognitive restructuring, reducing parental anxiety, improving parent-child relationship, and relapse prevention. Parental psychopathology, parental inappropriate expectations and family dysfunctions are important difficulties derived from parents in CBT with anxious children. The results of the studies suggested that parental involvement have increased the efficacy of the treatment in CBT especially working with young children and having at least one anxious parent.