Joy Lian

According to the National Institute of Mental Health, nearly one in three American children will experience at least some kind of anxiety disorder before reaching adulthood — a number that continues to rise despite years of innovations in drugs and therapy techniques.

But in a recent study, a new technique developed by the Yale Child Study Center shows promising results for curing childhood anxiety disorders. The winning method? Ditch individual treatment for the child and focus on another source of support — the parents.

A team of Yale researchers randomly assigned 124 children with anxiety into a conventional, therapy-based group or a parent-only group. Those in the therapy group attended 12 weekly meetings to learn how to control their symptoms and to confront their fears through exposure therapy. But for the second group, none of the children spoke to a therapist about their anxiety at any point during the trial. Rather, their parents were encouraged to stop accommodating the child’s behavior and to be supportive of the child’s ability to cope with anxiety themselves, in a treatment called SPACE.

What they found was surprising: Not only did SPACE reduce anxiety symptoms just as well as the conventional therapy did, but parents in the SPACE therapy also reported a much better relationship with their children than those of children in the therapy-based group. The study was published in the Journal of the American Academy of Child & Adolescent Psychiatry on March 7.

According to first author and Associate Director of the Anxiety and Mood Disorders Program Eli Lebowitz, SPACE — which stands for Supportive Parenting for Anxious Childhood Emotions — is an alternative to the cognitive-behavioral therapy normally used to treat childhood anxiety.

“The results of the study were really quite remarkable,” he said. “Regardless of what measure we used to look at the outcomes, children whose parents received SPACE were as improved and as likely to be cured from their anxiety problem as children who had 12 sessions of some of the best CBT therapy available. And that is truly a remarkable outcome.”

It is natural for parents to seek to accommodate their children, Lebowitz said. For example, if a child gets anxious when there are guests in the house, parents may stop inviting people over. However, according to the study, children can grow accustomed to these accommodations over time, which can lead to greater difficulty with anxiety later in life. For the SPACE group, researchers worked with parents to replace accommodation with words of support and with expressions of confidence in their children’s abilities to deal with anxiety on their own.

In the first study written about SPACE — a 2013 explanatory study authored by Lebowitz — parents were encouraged to follow a script of supportive and reassuring phrases when they attempt to reduce accommodations for their child with anxiety.

“We understand it makes you feel really anxious or afraid,” the script said. “We want you to know that this is perfectly natural and everyone feels afraid some of the time. But we also want you to know that it is our job as your parents to help you get better at things that are hard for you, and we have decided to do exactly that. We are going to be working on this for a while and we know it will probably take time, but we love you too much not to help you when you need help.”

Lebowitz said this study was the first to test SPACE’s effectiveness as a standalone technique. The researchers’ success with SPACE will provide a new alternative for children with anxiety who may not respond well to traditional therapy or who refuse to participate.

However, Lebowitz said more research is still needed to figure out how the brain’s psychological pathways are altered in children whose parents participated in SPACE. Given the program’s success, co-author Yaara Shimshoni is currently adapting SPACE to work with children with Avoidant Restrictive Food Intake Disorder, whose picky eating habits have interfered with their wellbeing.

“The focus of the treatment that we developed based on the SPACE program is on identifying and reducing these accommodations in a supportive and loving way,” she said.

The Yale Child Study Center was founded in 1911.

Matt Kristoffersen | matthew.kristoffersen@yale.edu

  • Bigcheese

    It’s called growing pains…it’s a wonder how the human species ever survived without liberalism for millions of years

    • Avdhut

      Liberalism ??. What’s that got to do with this ? Yes, the article is about how to help children with their anxiety, it doesn’t mean their anxiety is un-justified or wrong. The most insecure people are also the most aggressive, antagonistic, hate-filled people. Who wants that? They turn up in both sides of the ”house”. When people stop allowing their anxieties to determine their behaviour all the side-taking, hate, and vindictiveness stops…and people can live in peace and harmony.

      • Syntax

        Bigcheese isn’t totally wrong, but he’s not completely right either. I think it is the liberal parent that over compensates, over attends to and gets children over focused on their emotions. They also adapt the environment to the child and seem to avoid helping the child (through the use of space as the article describes) to find their calm and even adapt to circumstances or limits the child would prefer didn’t exist.

        The SJW type is almost definitely highly anxious and also controlling to the point of near totalitarian and I’m comfortable saying it’s the mothers that just can’t stop themselves from over identifying with their children’s emotions and thus becoming fused with them psychologically. Just watch a playground, the mothers are rabid control freaks that can’t let children just be, get hurt and be there to support them when they do. It’s actually the liberals that need to restive anxiety and start seeing reality without it. I think that would quell the perception of racism or evil white men everywhere. It’s mostly based in anxiety induced hysteria that exacerbates people who were raised poorly.

        • swift_4

          Liberals want to control every aspect of their children’s lives.
          Conservatives want to control every aspect of everyone else’s lives.

    • Amy

      Dumb comment

  • Michael Allison

    Wow Yale just learned what family therapists have known for over a half century. Then they are going to evaluate the child’s brain pathways when they don’t even really know what happens in the brain to cause anxiety in the first place.

    Amazing.

    Mike

  • Naomi Aldort

    When an academic institution stands behind a discovery of the obvious – its news. When many of us parenting guides, authors, speakers (many with not academic credentials) offer exactly the same guidance for parents for years, it is no news. My mother often says to me, as she reads the news, “They have discovered what you have been teaching all along.” So yes, the title of my book shows it is about raising ourselves, not fixing out children. SPACE is wonderful but not new. What I and other parenting authors teach goes deeper into finding the source of anxiety in the parent and releasing it. Then, saying these supporting phrases come naturally because the parent is not anxious. In the opening of his book, The Little Prince, Antoine de Saint-Exupéry points out how a true planetary discovery is not accepted when the astronaut is not in the correct dress code, then it is accepted when he puts on a western suit. I applaud the new approach with joy, welcoming the academic world to what many have known for a while now.

    • Molly Martinez

      As a child psychologist, I 100% agree that the fundamentals of the SPACE program are not new or revolutionary. But I can’t emphasize enough that we as professionals depend on science to back up what we “know.” Yes, as clinicians we have observational evidence to support our continuing practices and a general sense that what we do works & is helpful (which is why we keep doing it)…But this is little more than anecdotal evidence until someone systematically collects the data and analyzes it objectively. We NEED science & it is difficult, tedious, resource & energy consuming long-term work. The rigor involved is exactly why it takes so long to go from what we “know” works to what research demonstrates is efficacious & effective. I give this study a standing g ovation and appreciate the time & commitment & effort of these authors in developing & testing the SPACE program!!

      • Joanie

        In the West, if someone in a white lab coat doesn’t approve of it, it has no value. Millennia of use of meditation in other cultures was treated as mere anecdotal evidence until Western researchers could prove its effectiveness.
        Meanwhile, how many people could have benefitted?
        What’s frustrating is that scientists often don’t look at their biases when designing research. Yes, some parents are overly anxious themselves, which exacerbates their child’s anxiety. Duh. But do they need parent training to teach them to sit on their hands because they’re incompetent? Or do they need help for their own anxiety and guidelines for supporting their kids so that if they can’t afford therapy (true of a huge number of people), they can support their kids and themselves? Is there a bias toward professionals fixing their kids and toward seeing parents as incompetent rather than in need of strategies for helping themselves?
        So Naomi, good for you for helping parents for the price of a book that’s probably in a genre that people ridicule because it’s not “backed by science.” It’s people like you who help real moms and dads who don’t have a lot of money.
        Do I sound bitter? Yes, because my kid had issues I recognized from day 1 and the “we don’t have scientific support for your observations” people blew me off when I could’ve gotten early intervention for him. I learned to listen to other parents.