Family Cognitive-behavioral Therapy Research Articles

Cultural Adaptation and Implementation of Cognitive-Behavioral Psychosocial Interventions for Anxiety and Depression in Japanese Youth.

The present article reviews the current status of cognitive-behavioral therapy (CBT) interventions for anxiety and depression in Japanese youth. First, a literature review of youth CBT programs for anxiety and depression is provided. Through this process, we identify which program/protocol has been most researched within Japan. Second, through a systematic interview to the authors, the development process of four predominant programs is outlined. The programs included were a family CBT program for anxiety disorders (the Japanese Anxiety Children/Adolescents Cognitive Behavior Therapy program), two school-based prevention programs for anxiety and depression (Journey of the Brave and Phoenix Time), and a transdiagnostic protocol for anxiety and depression (Unified Protocol for Transdiagnostic Treatment of Emotional Disorders in Children and the Unified Protocol for Transdiagnostic Treatment of Emotional Disorders in Adolescents). Third, cultural adaptation and modification of the programs are discussed from the scope of user-centered design principles as described by Lyon and Koerner (Sci Pract 23:180-200, 2016). As a result, changes in program content and material, as represented by the use of culture-friendly program names, acronyms, illustrations, and characters were endorsed in all of the programs. Structured but flexible session formats helped increase learnability and efficiency while keeping the cognitive load of providers and consumers low. A careful selection of providers, as well as quality training and consultation are important factors to maximize competency and ensure appropriate implementation. Application of existing time frames and staff who work in each setting were effective ways to increase scalability. Overall, it was shown that many of the modifications adopted overlap among successful programs; these represent the most basic and essential requirements for a program to be applicable to a wide range of contexts. Implications and further directions are explored.

Do Parents Enhance Cognitive Behavior Therapy for Youth Anxiety? An Overview of Systematic Reviews Over Time.

The last 20years has seen debate regarding the merits of involving parents in cognitive behavior therapy (CBT) for youth anxiety played out across systematic reviews which have high impact. These reviews examined varying treatment formats in relation to parent involvement, including youth only CBT (Y-CBT), parent only CBT (P-CBT) and family CBT (youth and parent; F-CBT). This is a novel overview of systematic reviews examining evidence for parental involvement in CBT for youth anxiety over the period this was studied. Two independent coders systematically searched for studies in medical and psychological databases using the categories"Review", "Youth", "Anxiety", "Cognitive Behavior Therapy" and "Parent/Family". Of the 2,189 unique articles identified, there were 25 systematic reviews since 2005 which compared the effects of CBT for youth anxiety with varying parent involvement. Despite systematically studying the same phenomenon, the reviews were heterogeneous in outcome, design, inclusion criteria and often had methodological limitations. Of the 25 reviews, 21 found no difference between formats and 22 reviews were considered inconclusive. Yet while there were typically no statistical differences, consistent patterns in the direction of effects were detectedover time. P-CBT was less effective than other formats, suggesting the importance of directly treating anxious youths. Early reviews favored F-CBT over Y-CBT, however, later reviews did not show this trend. We consider the effects of moderators including exposure therapy, long-term outcomes and the child's age. We consider how to manage heterogeneity in primary studies and reviews to better detect treatment differences where they exist.Trial registration This protocol is registered with the Open Science Framework: osf.io/2u58t.

Bilişsel-Davranışçı Aile Terapisinin Etkililiği: Randomize Kontrollü Çalışmaların Sistematik Bir İncelemesi

Cognitive–behavioral family therapy (CBFT) is used for a wide range of psychological and physical problems in integration with different treatment protocols. Effectiveness of CBFT research studies on the control group are limited in literature, even though this treatment is used frequently. Although various studies highlighted the effectiveness of CBFT, no systematic reviews were conducted. The study aims to review randomized controlled trials on CBFT. The study used keywords to identify 402 related articles in commonly used psychology databases (ULAKBİM, American Psychological Association, Psychology Database, Web of Science, Medline, and Scopus). The PRISMA diagram was used for analysis. Studies assessed with control groups were included without a historical limitation. The articles were screened according to inclusion and exclusion criteria. Fourteen articles were evaluated in terms of sample characteristics, content, application methods, characteristics of control and comparison groups, assessment tools, and findings. The results indicated that CBFT is especially more effective than individual CBT, psychoeducation or waitlist for various issues, such as anxiety disorders, obsessive compulsive disorders, pediatric bipolar disorder, substance use disorder, anorexia nervosa and chronic physical problems. The study inferred that CBFT can be used to improve mutual interaction between mental or physical problems with family. In other words, CBFT can be used to improve the effect of disorders experienced by one member on the family and the effect of the family on the disorders. In this manner, the risk of relapse can be reduced in the treatment of certain disorders. Therefore, the study suggests that CBFT should be used increasingly and that this field warrants further research.

A Cognitive Behavioral Family Therapy Approach: The Impact of Divorce on a Hispanic Adolescent with an Eating Disorder

Each year, millions of marriages end up in divorce which can cause teenagers to experience multiple physiological and psychological issues. Cognitive Behavioral Family Therapy (CBFT) has become increasingly popular among family therapists in recent decades, who utilize it either as a stand-alone technique within a system perspective or integrated into other approaches with couples and family therapy. There is a gap in the literature regarding the utilization of CBFT to a divorced family of Hispanic/Latinx descent with an adolescent who developed an eating disorder. The overall aim of this article is to provide insight for marriage and family therapists (MFTs), other mental health professionals, professors/teachers, researchers, and virtually everyone. The researchers hope to provide the ability to conceptualize eating disorders in a way that promotes empathy, compassion, and awareness. Barriers unique to Hispanic/Latinx families, clinical implications, and future directions will be discussed.

Comparison of Efficacy of Child Cognitive – Behavioral Therapy (CCBT) Versus Family Cognitive – Behavioral Therapy (FCBT) and Mother - Child Attachment Intervention in Reduction of Separation Anxiety Disorder in Children between 7-12 Years Old

Objective: The purpose of this study was to compare and evaluate the effectiveness of child-based cognitive-behavioral therapy (CCBT), family-based cognitive-behavioral therapy (FCBT) and mother-child attachment intervention in reducing separation anxiety in children aged 7 to 12 years. Methods and Materials: The method of this semi-experimental study was pre-test-post-test with a control group and a three-month follow-up. For this purpose, 48 children with separation anxiety disorder were selected by purposive sampling and were divided into four groups of 12 people. The first group received child-based cognitive behavioral therapy, the second group received family-based cognitive behavioral therapy, the third group received mother-child attachment intervention, and the control group did not receive any intervention. The measurement tools of this research include the semi-structured diagnostic interview of mood disorders and schizophrenia for children and adolescents (K-SADS-PL) and Separation Anxiety Scale (Parental Form). The data were analyzed using mixed variance analysis with repeated measurement and Bonferroni's post hoc test. Findings: The findings show that child-centered cognitive-behavioral therapy has been more successful in reducing separation anxiety compared to family-centered cognitive-behavioral therapy and mother-child attachment-centered intervention. Also, family-centered cognitive-behavioral therapy has been more effective in reducing children's separation anxiety compared to mother-child attachment-centered intervention (P<0.05). Conclusion: The results of the present study show that the therapeutic methods used can be effective in the treatment of separation anxiety disorder by psychologists and psychiatrists.

Značaj telepsihijatrije u lečenju patološkog kockanja za vreme pandemije kovid-19

Pathological gambling is a serious mental disorder and is the only behavioral addiction currently recognized by the American Psychiatric Association. Due to the increase in the frequency of disorders caused by gambling around the world, the need for treatment not only for pathological gamblers but also for their families has increased. The COVID-19 pandemic has greatly affected the social life of the world's population, and it has also been reflected through changes in the world of commercial gambling, changes in the characteristics of disorders caused by gambling as well as in the therapy of already diagnosed patients. Group family cognitive-behavioral therapy is one of the therapies of choice in the pathology of pathological gambling. The COVID-19 pandemic has led to changes in the provision of psychiatric services due to changes in working conditions, at a time of increased need for them. Telepsychiatry found its place in a given situation that adversely affected the mental health of the population around the world and thus opened up questions about the importance of its further application in the future.

Treatment of preschool children with obsessive compulsive disorder.

The aim was to examine the clinical features of Obsessive-Compulsive Disorder (OCD) in preschool and the effectiveness of aripiprazole with a standardized Cognitive-Behavioral Family Therapy (CBFT) in the treatment of preschoolers with OCD. Twelve preschool children, 36-72months of age were diagnosed with OCD according to the Diagnostic and Statistical Manual of Mental Disorders, the Fifth Edition criteria by a fellowship-trained child and adolescent psychiatrist. They were evaluated with Kiddie Schedule for Affective Disorders and Schizophrenia for School-Age Children Present and Lifetime version and Childhood Yale-Brown Obsessive Compulsive Scale (CY-BOCS) at baseline, at the end of the 12th and 24th weeks of treatment. The baseline mean of total CY-BOCS score decreased from 33.67 to 13.83 at the 12th week and 5.58 at the end of the 24th week of treatment. Also, 66.7% of them had at least one psychiatric comorbidity. Overall, this study revealed the effect of aripiprazole with CBFT in preschool-aged children with OCD. Also, the presence of comorbidity that is seen frequently in preschoolers with OCD may complicate the treatment. Therefore, there is a need to increase awareness of OCD and its comorbidities in preschoolers to supply treatment at an early age.

فاعليّة برنامج جمعيّ يستند إلى نظرية العلاج المعرفيّ السلوكيّ في تحسين تمايز الذات وخفض ‏غموض الهرميّة لدى النساء العاملات في الحقل الطبيّ

This study aimed at investigating the effectiveness of a group ‎program based on the theory of family cognitive behavioral ‎therapy in improving self-differentiation and reducing ‎hierarchical ambiguity among women working in the medical ‎field. In order to achieve the study objectives, the researcher ‎selected a sample of females working in the medical fiele in ‎Amman with a total of (18) women who were divided into two ‎groups ;the experimental group (n=9) and the control group ‎‎(n=9). Two scales were developed; one for self-differentiation ‎and the other for hierarchical ambiguity, in addition to a ‎psychological intervention program based on cognitive ‎behavioral therapy. After applying the program on the ‎individuals of the experimental group, the results showed that ‎the experimental group improved in self-differentiation and ‎witnessed a statistically significant decline in hierarchical ‎ambiguity in comparison with the control group. Improvement ‎continued among the individuals of the experimental group after ‎one month of follow-up. Based on the results, the study ‎recommended the necessity of taking care of women in the mid-‎life period as well as designing guidance programs for them, ‎particularly those working in the medical field.‎ ‎(Keywords: Family cognitive behavioral therapy, Self-‎differentiation, Hierarchical ambiguity, Women in the medical ‎fields)‎

Examination of Telemental Health Practices in Caregivers of Children and Adolescents with Mental Illnesses: A Systematic Review

In this systematic review, effects of telemental health (TMH) practices’ on caregivers of children/adolescents with mental illnesses were investigated. The literature review included databases, and reference lists of published studies. All studies published until September 2021 were reviewed. Eleven studies were included. Several services were provided via TMH: education, cognitive behavioral therapy (CBT), parent training, caregiver behavior training, family CBT. The effectiveness of TMH interventions on caregivers varied from low to high. Most reproducible findings were on caregivers’ satisfaction, stress, therapeutic alliance and caregiver burden. Studies had a low to high bias risk. Most studies had small samples. Results built on the small but growing literature support TMH interventions’ promising role in caregivers of children with mental illness. Future studies should estimate outcomes with medium to low effect size. Other caregiver groups, rarely considered in previous studies, should be included. Bias risk should be minimized. Larger, more methodologically rigorous studies should be conducted.

Couple- or family-oriented interventions and outcomes for preventing mental health problems and promoting mental health: a scoping review protocol.

The objective of this scoping review is to map the literature describing couple- and family-oriented interventions and outcomes to prevent mental health problems and promote mental health. Literature involving couple- and family-focused mental health interventions has gained increased attention over the past two decades, yet little is known about the efficacy of these interventions for promoting mental health and preventing mental disorders. Despite recognition that the most sustainable method for reducing the increasing burden of mental disorders is primary prevention, there has been no systematic investigation of relevant couple- and family-focused interventions. This scoping review will consider studies that include couples or multiple family members who have participated in couple- and family-focused interventions aimed at primary prevention of mental disorders and promotion of mental health. This study will include experimental, quasi-experimental, and observational study designs, as well as qualitative studies. Conference abstracts, posters, editorials, commentaries, and opinion papers will be excluded. Multiple databases will be searched, including PubMed (MEDLINE), CINAHL, ERIC, PsycINFO (via EBSCO), Web of Science, Scopus, and Research Information Sharing Service (RISS). Trial registers and gray literature will also be searched. Two independent reviewers will screen the abstract/title of retrieved citations using inclusion and exclusion criteria. After screening titles and abstracts of identified citations, relevant studies will be retrieved in full. Using a data extraction instrument developed specifically for this review, eligible studies will be extracted and presented in diagrammatic or tabular form, accompanied by a narrative summary.

Cognitive-behavioral family therapy as psychoeducation for adolescents with high-functioning autism spectrum disorders: Aware and Care for my Autistic Traits (ACAT) program study protocol for a pragmatic multisite randomized controlled trial

BackgroundOne aim of an autism spectrum disorder (ASD) diagnosis is to obtain special support for the disorder, though this does not guarantee practical support. We developed a psychoeducational program using cognitive-behavioral therapy (CBT) and Aware and Care for my Autistic Traits (ACAT) for Japanese adolescents with high-functioning ASD and their parents.MethodsThis multisite study is a randomized controlled trial. In total, 24 participants will be assigned to the ACAT group and 24 to the treatment-as-usual (TAU) group. The ACAT group will receive a weekly 100-min session for 6 weeks, regular medical care, and one follow-up session. In this ongoing clinical trial, we will compare the scores of the measures recorded in the pre- and post-intervention stages between the ACAT and TAU groups. A total of 41 patients out of a target of 48 have participated in the trial to date. The primary outcome measure is the Autism Knowledge Questionnaire. Secondary outcome measures include Barriers to Access to Care Evaluation 3rd Edition, the Strengths and Difficulties Questionnaire, the Vineland Adaptive Behavior Scales second edition, the Parenting Resilience Elements Questionnaire, the General Health Questionnaire 12, and the Depression Self-Rating Scale for Children assessments, as well as an electroencephalographic recording.DiscussionIt is expected that participants in the ACAT group will significantly increase their self-understanding and awareness of ASD symptoms compared to those in the TAU group. Additionally, the ACAT group is expected to exhibit improved social adaptation and mental health if children and parents are able to better understand the ASD characteristics through sessions. This intervention will contribute to the establishment of an effective evidence-based treatment strategy for adolescents with ASD.Trial registrationUMIN Register 000029851. Registered on January 06, 2018

The challenges of engaging individuals at high-risk of developing psychosis: reflections from research assistants within a randomised control trial

ABSTRACT Background Individuals at risk of psychosis typically underutilise mental health services and disengage from clinical trials. Their family context, culture and beliefs about service involvement may influence their motivation and likelihood to engage. Method Reflections and quotes collected from research assistants (RAs) on the Individual and Family Cognitive Behavioural Therapy (IFCBT) trial were examined. Results Individuals and family members experienced stressful life events. RAs developed strategies to further engage service users, including flexible, after-hours appointments and liaising with family members. Discussion Service users’ disengagement may be linked to prior service dissatisfaction, busy lifestyles and positive perceptions of their health. Involving families could help improve and facilitate long-term engagement.

"I don't think I took her fears seriously": Exploring the experiences of family members of individuals at-risk of developing psychosis over 12 months.

Individuals with an at-risk mental state (ARMS) of psychosis experience high levels of distress, anxiety, low mood, and suicidal ideation. Families of ARMS individuals provide significant support but are often neglected by services. This study is the first of its kind to use a novel longitudinal qualitative methodology to directly compare family/carers' earlier experiences supporting ARMS individuals to 12 months later. This provides a more ecologically valid insight into how perceptions change over time and how family/carers adapt. Semistructured interviews were conducted with 10 family/carers at two points within a 12-month period. This study was embedded within a randomized control trial, the Individual and Family Cognitive Behavioural Therapy trial. Interview transcripts were analysed using thematic analysis, with a focus on how experiences and reactions for family/carers changed over time. Over 12 months, four factors were important for family/carers to facilitate their caring role. These were summarized in the thematic map (LACE model): Looking after your own well-being; Accessing additional support from family intervention; Communicating openly with the individual; and Engaging with services for the individual. All four aspects of the model were important in improving family communication, meeting family/carers' unmet needs, and helping them to feel more confident and less isolated in their carer role. Novel implications suggest that when feasible, services should involve family/carers of ARMS individuals in sessions and explore family/carer support strategies in managing their own distress. The most significant insight was the need to develop family/carer resources to educate, normalize, and validate their own experiences.

Spiritually-Oriented Cognitive-Behavioral Family Therapy

A great many factors influence human life. Among these are individuals’ religious and spiritual orientations, whose importance cannot be understated as they not only affect how individuals perceive and interpret themselves, events in their everyday lives, and the greater world but also shape their thoughts, feelings, and behaviors. Consequently, religious and spiritual orientations constitute an integral part of clients’ lives and are an important element that needs to be thoroughly investigated. In addition to having been integrated into individual psychological counseling approaches, religious/spiritual orientation has become as a highly supportive element in family therapy. Spiritually-oriented applications are quite helpful when addressing problems dealt with by individuals and families. In the current study, spiritually-oriented cognitive-behavioral family therapy is addressed in light of the relevant literature. We first present a general overview of cognitive-behavioral therapy and cognitive-behavioral family therapy, after which we frame the assessment steps followed in spiritually-oriented cognitive-behavioral family therapy within a paradigm based on religion and spirituality. After that, we reveal the religious/spiritual-based cognitive-behavioral applications that may be used during family therapy. We then discuss several exercises and applications employed during spiritually-oriented cognitive-behavioral family therapy. Finally, this study seeks to fill in gaps in the relevant literature on this topic in Turkey and offer a novel perspective to practitioners and researchers.

Combined individual and family therapy in comparison to treatment as usual for people at-risk of psychosis: A feasibility study (IF CBT): Trial rationale, methodology and baseline characteristics.

Current National Institute for Health and Care Excellence (NICE) guidelines for psychosis recommend psychological therapy with or without family intervention for individuals at-risk of developing psychosis. NICE guidelines have a specific research recommendation to investigate the clinical and cost effectiveness of combined individual and family intervention. We report the rationale, design and baseline characteristics of a feasibility study which aimed to investigate combined Individual and Family Cognitive Behavioural Therapy (IFCBT) for those at-risk of developing psychosis. The IFCBT study was a single blind, pilot randomized controlled trial (RCT) to compare a combined individual and family Cognitive Behavioural Therapy (CBT) intervention to treatment as usual. Participants were assessed using the Comprehensive Assessment of the At-risk Mental State (CAARMS) and randomly allocated to either therapy or enhanced treatment as usual (ETAU). All participants were followed up at 6 and 12 months. Primary feasibility outcomes were recruitment and retention of participants. Secondary outcomes included transition to psychosis and assessment of mood, anxiety and the relationship of the individual and nominated family member. We report data showing entry into the study from initial enquiry to randomization. We report the characteristics of the recruited sample of individuals (n = 70) and family members (n = 70) at baseline. The study recruited to 92% of target demonstrating it is feasible to identify and recruit participants. Our study aimed to add to the current evidence base regarding the utility of family interventions for people at-risk of psychosis.

Measurement training and feedback system for implementation of evidence-based treatment for adolescent externalizing problems: protocol for a randomized trial of pragmatic clinician training

BackgroundInnovations in clinical training and support that enhance fidelity to evidence-based treatment (EBT) for adolescent behavior problems are sorely needed. This study will develop an online training system to address this gap: Measurement Training and Feedback System for Implementation (MTFS-I). Using procedures intended to be practical and sustainable, MTFS-I is designed to increase two aspects of therapist behavior that are fundamental to boosting EBT fidelity: therapist self-monitoring of EBT delivery, and therapist utilization of core techniques of EBTs in treatment sessions. This version of MTFS-I focuses on two empirically supported treatment approaches for adolescent conduct and substance use problems: family therapy and cognitive behavioral therapy (CBT).Methods/designMTFS-I expands on conventional measurement feedback systems for client outcomes by adding training in observational coding to promote EBT self-monitoring and focusing on implementation of EBT treatment techniques. It has two primary components. (1) The training component, delivered weekly in two connected parts, involves self-monitored learning modules containing brief clinical descriptions of core EBT techniques and mock session coding exercises based on 5–8 min video segments that illustrate delivery of core techniques. (2) The feedback component summarizes aggregated therapist-reported data on EBT techniques used with their active caseloads. MTFS-I is hosted online and requires approximately 20 min per week to complete for each treatment approach. This randomized trial will first collect data on existing delivery of family therapy and CBT techniques for youth in outpatient behavioral health sites (Baseline phase). It will then randomize site clinicians to two study conditions (Implementation phase): Training Only versus Training + Feedback + Consultation. Therapists will choose whether to train in family therapy, CBT, or both. Study aims will compare clinician performance across study phase and between study conditions on MTFS-I uptake, reliability and accuracy in EBT self-monitoring, and utilization of EBT techniques in treatment sessions (based on observer coding of audiotapes).DiscussionStudy contributions to implementation science and considerations of MTFS-I sustainability are discussed.Trial registrationClinicalTrials.gov, NCT03722654. Registered on 29 October 2018.

“I don’t know how to fix it and sometimes it’s so overwhelming” Identifying the barriers and facilitators for family caregivers supporting someone at high-risk of psychosis: A qualitative study

ABSTRACTProviding care can be demanding and is associated with increased financial, emotional and psychological distress. Relatives of individuals with At-Risk Mental State (ARMS) of psychosis provide significant emotional, practical and economic support but are often a neglected group. The current study aimed to investigate the barriers and facilitators for those supporting ARMS individuals. Semi-structured interviews with fourteen family members from the Individual and Family Cognitive Behavioural Therapy (IFCBT) trial were conducted. Key barriers included relatives’ unmet needs and limited confidence accessing and providing support. Facilitating factors included open communication with the individual, flexible, understanding employers and feeling that they themselves were supported. Those who identify multiple barriers may have increased levels of worry and distress that negatively impact their own health and wellbeing. Services in contact with ARMS individuals should provide families support to sustain an adequate level of care, including psychoeducation around the individual’s experiences and behaviours, discussions around talking to employers and help exploring more adaptive coping strategies including accessing support from social networks. Clinical teams and/or family peer-support workers that look to support relatives early in their caregiving journey could help improve outcomes in relative’s quality of life and consequently benefit the ARMS individual.

Multi-family therapy for bulimia nervosa in adolescence: a pilot study in a community eating disorder service

ABSTRACT Multi-family therapy for Bulimia Nervosa (MFT-BN) was developed in response to the modest outcomes following both Family Therapy and Cognitive Behavior Therapy for adolescents with BN. BN impacts individuals and their family members with high levels of carer stress. MFT-BN targets barriers to treatment including low motivation to change, hostility and criticism, negative affect alongside emotion dysregulation and common comorbidities. MFT-BN enhances treatment, providing a community of support and acquisition of emotional regulation and interpersonal skills. The study describes the clinical characteristics of the group of participants to whom MFT-BN is offered and presents the outcomes of families who have participated in it. Prior to MFT-BN, adolescents who received it were more likely to have self-harmed and had elevated levels of eating disordered cognitions than those who did not receive MFT-BN. Following MFT-BN, parents report decreases in the negative experiences of caregiving and in their own symptoms of anxiety. Adolescents report reductions in anxiety and depression alongside improvement in emotion regulation. Improvements in symptoms of eating disorders include reductions in eating disorder cognitions and modest reductions in binge and purge symptoms after 14 weeks of treatment. Adolescents who participated in MFT-BN were less likely to drop out of outpatient treatment.

Changes in rejection and psychological control during parent-child interactions following CBT for children's anxiety disorder.

This study examined changes in mothers' and fathers' rejection and psychological control during parent-child interactions after cognitive-behavioral therapy (CBT) for children's anxiety disorders. We studied whether family CBT reduced rejection (vs. warmth) and psychological control (vs. autonomy-granting) more than child CBT, and whether parents own anxiety disorders resulted in smaller decreases in these parenting behaviors. Participants were 128 clinically referred children and adolescents (52 boys; Mage = 12.4, SDage = 2.7) with anxiety disorders and their parents, randomly assigned to either family CBT (n = 64) or child CBT (n = 64). The Anxiety Disorders Interview Schedule was used to assess children's and parents' anxiety disorders. Before and after treatment, parents' rejection and psychological control toward their child was rated during conflict and anxiety discussions of mother-child dyads, father-child dyads, and mother-father-child triads. As expected, during dyadic and triadic interactions, mothers' and fathers' rejection toward their child decreased after child and family CBT. Unexpectedly, during triadic conflict interactions, mothers, after child CBT and family CBT, as well as fathers, after child CBT, displayed increased psychological control. During triadic anxiety interactions, only mothers, after child CBT, showed increased psychological control. Changes in parenting did not depend on whether or not parents had anxiety disorders themselves. Thus, CBT for anxiety-disordered children can successfully reduce parents' rejection. The unexpected findings of increased psychological control after treatment, particularly by mothers in the presence of the father, suggests potential benefits of mothers' psychological control with anxious children. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Trajectories and predictors of response in youth anxiety CBT: Integrative data analysis.

Integrative data analysis was used to combine existing data from nine trials of cognitive-behavioral therapy (CBT) for anxious youth (N = 832) and identify trajectories of symptom change and predictors of trajectories. Youth- and parent-reported anxiety symptoms were combined using item-response theory models. Growth mixture modeling assessed for trajectories of treatment response across pre-, mid-, and posttreatment and 1-year follow-up. Pretreatment client demographic and clinical traits and treatment modality (individual- and family-based CBT) were examined as predictors of trajectory classes. Growth mixture modeling supported three trajectory classes based on parent-reported symptoms: steady responders, rapid responders, and delayed improvement. A 4-class model was supported for youth-reported symptoms: steady responders, rapid responders, delayed improvement, and low-symptom responders. Delayed improvement classes were predicted by higher number of diagnoses (parent and youth report). Receiving family CBT predicted membership in the delayed improvement class compared to all other classes and membership in the steady responder class compared with rapid responders (youth report). Rapid responders were predicted by older age (parent report) and higher number of diagnoses (parent report). Low-symptom responders were more likely to be male (youth report). Integrative data analysis identified distinct patterns of symptom change. Diagnostic complexity, age, gender, and treatment modality differentiated response classes. (PsycINFO Database Record (c) 2019 APA, all rights reserved).