The proposed research project will experimentally test the effectiveness of parent-child Dyadic Cognitive Behavioral Therapy (DCBT) for children with anxiety and phobic disorders. DCBT is designed to enhance effectiveness relative to """"""""standard"""""""" individual child treatment in both producing and maintaining treatment gains. DCBT is based on a """"""""transfer of control"""""""" model for use in treating a broad spectrum of anxiety and phobic disorders in children. Briefly, this model is based on the premise that treatment effectiveness is maximized by the use of clear and direct pathways of transfer of control (in this case, from the therapist to the parent to the child). To render the pathways more clear and direct, this intervention systematically targets parent-child relational processes and parental anxiety and/or phobic disorders and/or symptoms (as necessary) in a dyadic format. A total of 120 children (ages 8-12) will be admitted to the study over the three years of the study. This study uses a clinical trials design with two conditions: 1) DCBT-Dyadic Cognitive Behavioral Treatment and 2) ICBT-Individual Cognitive Behavioral Treatment. The primary outcome analyses will evaluate the relative effectiveness of DCBT in terms of both producing and maintaining child treatment gains. Effectiveness will be evaluated on three levels: global child functioning, specific anxiety/phobic symptomatology, and parent-child relations. First, the relative effectiveness of DCBT in reducing specific children's global level of distress as it interferes with their overall individual functioning and positive end-state functioning will be evaluated. Second, the relative effectiveness of DCBT in reducing specific children's anxious/phobic symptomatology will be evaluated. Third, the relative effectiveness of DCBT in improving parent-child relations will be evaluated. Supplemental analyses will investigate the role of parent symptomatology, and therapist/client expectancies as predictors/moderators of treatment outcome. The data analytic strategies will include repeated multivariate analysis of variance, and multivariate multiple regression analysis. A treatment manual for the conditions has been developed and will be further refined during the course of the study, thereby rendering the intervention replicable by other researchers and accessible to clinicians. This treatment outcome study utilizes rigorous experimental controls and systemic follow-up procedures.

National Institute of Health (NIH)
National Institute of Mental Health (NIMH)
Exploratory/Developmental Grants (R21)
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Child Psychopathology and Treatment Review Committee (CPT)
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Florida International University
Schools of Arts and Sciences
United States
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Silverman, Wendy K; Kurtines, William M; Jaccard, James et al. (2009) Directionality of change in youth anxiety treatment involving parents: an initial examination. J Consult Clin Psychol 77:474-85
Carter, Rona; Silverman, Wendy K; Allen, Andrea et al. (2008) Measures matter: the relative contribution of anxiety and depression to suicidal ideation in clinically referred anxious youth using brief versus full length questionnaires. Depress Anxiety 25:E27-35