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A Family and Developmentally based CBT Model for Treating Anxiety in Youth
Original Recording Date :
Course Format
Recorded webinar.
Anxiety disorders are the most common class of mental health problems in youth, with onset in early childhood and increasing prevalence building through to emerging adulthood. Youth with anxiety disorders evidence significant distress, impairments in functioning, and are at high risk for the development of secondary conditions such as depression and substance use by adolescence. Notable for parents of an anxious child is a phenomenon of "over-protection" and "over-control." Parenting occurs over a substrate of development where the child’s independent interactions with the environment shape to refine skills and cognitive-emotional abilities that propel the child towards greater independence and self-confidence. For youth with anxiety and related disorders however, everyday tasks often feel insurmountable and involve much upset and reliance on parent intervention in the form of over involvement. While the youth may be calmed in the moment by parent involvement, anxiety and avoidance behavior are reinforced.
Although cognitive behavioral therapy (CBT) and medication are effective treatments for anxiety in youth (Walkup, et al., 2008), traditionally the family has been of secondary focus or minimally involved in CBT, with developmental milestones and age-appropriate functioning also not a primary target of treatment. The unique features of the family environments and situations experienced by youth calls for therapists to assist youth and their caretakers to understanding and meet the tasks of development as well as address anxiety and other mental health conditions in the child. Central to treatment is for youth to take on age-related challenges of anxiety and daily living with appropriate parental guidance and support. This also means addressing directly the parents' history, beliefs, and expectations for their child, and the interactions and dynamics of the family system.
Dr. Albano will present a novel model integrating the core components of effective CBT for anxiety in youth with novel family-based and developmental components designed to address patient-caretaker dependency, role transitions, and attainment of behaviors necessary for greater independent functioning within the contexts that are unique to the child’s age and developmental stage. Adaptations of this model for younger children, adolescents, and emerging adults will be presented.
Learning Objectives:
- Recognize the tasks of development necessary to master independence on the way to adulthood
- Describe the way that child anxiety can interact with and shape overprotective parenting, and the consequences on continued anxiety and stalled development
- Identify Evidence-Based models for parental involvement in youth-focused cognitive behavioral treatment to address anxiety
- Apply strategies for addressing parental over involvement and youth dependency including family communication and problem solving
Research:
- Kiff, CJ, Ernestus, S., Gonzalez, A., Kendall, P.C., Albano, A.M., Compton, S.N., Birmaher, B., Ginsburg, G., Rynn, M., Walkup, J.T., McCracken, J., & Piacentini J. (2018). The interplay of familial and individual risk predicting clinical improvements in pediatric anxiety disorders. Journal of Clinical Child & Adolescent Psychology, 47, S542-S554. https://doi.org/10.1080/15374416.2018.1460848
- Kranzler, A., Elkins, M.R., & Albano, A.M. (2019). Anxiety in emerging adulthood: A developmentally informed treatment model. In S. Compton, M.A. Villabo, & H. Kristensen (Eds), Pediatric Anxiety Disorders, 499-519. Elsevier Press.
- Makover, H. B., Kendall, P. C., Olino, T., Carper, M. M., Albano, A. M., Piacentini, J., Peris, T., Langley, A. K., Gonzalez, A., Ginsburg, G. S., Compton, S., Birmaher, B., Sakolsky, D., Keeton, C., Walkup, J. (2020). Mediators of youth anxiety outcomes 3 to 12 years after treatment. Journal of Anxiety Disorders, 70, 102188. https://dx.doi.org/10.1016/j.janxdis.2020.102188
- Norris, Lesley A, Rifkin, Lara S, Olino, Thomas M, Piacentini, John, Albano, Anne Marie, Birmaher, Boris, et al. (2019). Multi-informant expectancies and treatment outcomes for anxiety in youth. Child Psychiatry and Human Development, 50, 1002-1010. https://doi.org/10.1007/s10578-019-00900-w
Target Audience: Social workers, mental health counselors, marriage and family therapists, addictions professionals, psychologists, and other interested parties.
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Anne Marie Albano, Ph.D., ABPP
Anne Marie Albano is the Columbia University Clinic for Anxiety and Related Disorders (CUCARD) Professor of Medical Psychology in Psychiatry. She received her Ph.D. in clinical psychology from the University of Mississippi. Dr. Albano is a Fellow of the American Psychological Association (APA), Association for Behavioral and Cognitive Therapies (ABCT), Founding Fellow of the Academy of Cognitive Therapy, and is Board Certified in Clinical Child and Adolescent Psychology. Dr. Albano was the recipient of the 2015 ABCT Award for Outstanding Contributions by an Individual for Clinical Activities. Dr. Albano served as President of the Society for Clinical Child and Adolescent Psychology of the American Psychological Association and also President of the Association for Behavioral and Cognitive Therapies (ABCT), editor of Cognitive and Behavioral Practice, founding editor of the journal Evidence-Based Practice in Child and Adolescent Mental Health, and associate editor of the Journal of Consulting and Clinical Psychology. She was a Principal Investigator for the NIMH-funded "Child/Adolescent Anxiety Multimodal Treatment Study" (CAMS) and the “Treatments for Adolescents with Depression Study” (TADS), as well as their follow-up studies. Presently, Dr. Albano and her team are developing and testing virtual environments that are developmentally and contextually valid for adolescents and young adults who suffer with anxiety and mood disorders, with the aim to extend the benefits of Evidence-Based therapies and make meaningful, lasting changes for emerging adults.
With her colleagues, Dr. Albano has published over 200 articles and chapters and she the co-author of several cognitive behavioral treatment manuals and of the Anxiety Disorders Interview Schedule for DSM-5, Child and Parent Versions, all published by Oxford University Press, where she is also the co-editor of the series “Programs that Work” with David H. Barlow. She is a mentor, teacher, and supervisor to child psychiatry fellows, clinical psychology students and fellows, and to audiences of clinicians from the range of mental health professions. Dr. Albano is a frequently sought-after presenter in the US and by international organizations interested in training and education of mental health professionals as well as consumer audiences. In addition to her clinical and teaching roles, Dr. Albano serves as a consultant to organizations and entities in developing clinical services or research methods to evaluate services, as well to non-profit boards focused on mental health, suicide prevention, and health education for youth.
