Clinical Round Table 7 - Brave Beginnings: Parent Child Interaction Therapy (PCIT) Innovations for Childhood Anxiety

Anxiety disorders are among the most common and impairing mental health problems affecting young children today (Comer et al., 2019). Such early-onset (i.e., those presenting younger than 8 years of age) anxiety disorders and traumatic stress disorders, are associated with considerable functional impairment, and problems with emotion regulation, family functioning, sleep hygiene, and social development (e.g., Chou, DeSerisy, Garcia, Freeman, & Comer, 2017). Earlier onset of anxiety and related problems is associated with more intractable symptom trajectories and worse outcomes across time (Carpenter, Puliafico, Kurtz, Pincus, & Comer, 2014), highlighting their serious public health concern. Accordingly, effective treatment for early-onset anxiety and related problems is critical. Supported treatments for children over the age of seven are well-established and are cognitive-behavioral in nature, followed by graded exposure tasks in which children confront feared situations and objects using their newly acquired coping repertoire. Recent advances in treatments for younger children with anxiety have adapted the model of Parent-Child Interaction Therapy (PCIT; Eyberg, Boggs, & Algina, 1995; McNeil & Hembree-Kigin, 2010), originally developed to treat disruptive and non-compliant behavior in young children. PCIT focuses on teaching parents behavioral skills and coaching them during live in-session interactions with their children. This clinical round table will focus on several of these adaptations for addressing separation anxiety, social anxiety, selective mutism (SM), and trauma in early childhood, including PCIT-CALM (Coaching Approach behavior and Leading by Modeling) Program, PCIT-SM, PCIT for Trauma, and PCIT for Separation Anxiety. Discussion will identify several common features of these exposure-based treatments, while also highlighting the unique contribution each of these programs makes in addressing specific challenges of the anxiety disorder it targets. Presenters will review how the PCIT model of intervention for very young children best suits the developmental compatibility by focusing on parent-child interactions. Future directions for the treatment of early anxiety will be discussed.