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Does Training Parents in Reinforcement Skills or Relationship Skills Enhance Individual Youths’ Cognitive Behavioral Therapy for Anxiety? Outcome, Specificity, and Mediation
Clinical Psychological Science ( IF 4.8 ) Pub Date : 2021-06-08 , DOI: 10.1177/21677026211016402
Wendy K Silverman 1 , Yasmin Rey 2 , Carla E Marin 1 , James Jaccard 3 , Jeremy W Pettit 2
Affiliation  

We conducted a dismantling design treatment study comparing individual cognitive behavioral therapy (CBT), CBT targeting parents’ reinforcement skills (CBT + Reinf), and CBT targeting parents’ relationship skills (CBT+ Relat) in 341 youths with primary anxiety diagnoses. At posttreatment, youths in CBT with parent involvement had lower anxiety than youths in CBT. At 12-month follow-up, youths in CBT + Relat maintained lower anxiety relative to CBT. At posttreatment, negative reinforcement was significantly lower in CBT + Reinf than CBT + Relat and CBT; negative reinforcement partially mediated anxiety reduction in youths. Reducing parental negative reinforcement in CBT + Reinf was associated with lower parental psychological control, which also partially mediated anxiety reduction in youths. Some of these mediational dynamics continued through follow-up. Targeting concrete behavioral parenting skills, especially negative reinforcement, produced treatment specificity and partial mediation relative to less concrete targeting and enhanced CBT. Findings highlight complexities in identifying mechanisms through which targeting of parenting skills produces anxiety reduction in youths and suggest avenues for future research.



中文翻译:

在强化技能或关系技能方面培训父母是否会增强个别青少年的焦虑认知行为疗法?结果、特异性和中介

我们对 341 名患有原发性焦虑症的青少年进行了一项拆解设计治疗研究,比较了个人认知行为疗法 (CBT)、针对父母强化技能的 CBT (CBT + Reinf) 和针对父母关系技能的 CBT (CBT+ Relat)。在治疗后,有父母参与的 CBT 青少年的焦虑程度低于 CBT 的青少年。在 12 个月的随访中,与 CBT 相比,CBT + Relat 的青少年保持较低的焦虑。在后处理中,CBT + Reinf 的负强化显着低于 CBT + Relat 和 CBT;负强化部分介导了青少年焦虑的减少。减少 CBT + Reinf 中的父母负强化与较低的父母心理控制有关,这也部分介导了青少年焦虑的减少。其中一些中介动力通过后续行动继续存在。针对具体的行为育儿技能,尤其是负强化,产生了治疗特异性和相对于较少具体的目标和增强的 CBT 的部分调解。研究结果突出了确定以育儿技能为目标的机制的复杂性,通过这些机制减少了青少年的焦虑,并为未来的研究提供了途径。

更新日期:2021-06-09
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