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Family Accommodation of Child and Adolescent Anxiety: Mechanisms, Assessment, and Treatment

Kaila R. Norman · Wendy K. Silverman · Eli R. Lebowitz

75 citations0/0 files storedJournal of Child and Adolescent Psychiatric Nursing

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Child and Adolescent Psychosocial and Emotional Development Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes Family Caregiving in Mental Illness

Abstract

TOPIC: Anxiety disorders are the most common mental health concern for youth. Unfortunately, a substantial number of children and adolescents do not respond positively to current evidence-based interventions and/or relapse. As pediatric anxiety disorders are fundamentally a systemic phenomenon, focusing on the ways in which parents become involved in their children's anxiety symptoms may be a promising alternative approach to treatment. PURPOSE: To inform psychiatric mental health nurse practitioners (PMHNPs) about the phenomenology, associated neurobiology, and assessment of family accommodation (FA) as well as clinical interventions targeting FA. FA refers to ways that parents adapt their own behaviors to reduce their children's anxiety-related distress. SOURCES USED: A literature search was performed using Psyc-INFO and PubMed. CONCLUSIONS: Current findings indicate a high prevalence of FA associated with pediatric anxiety disorders. FA has a potentially deleterious impact on course of illness and treatment response and is associated with greater caregiver burden. Potential neurobiological underpinnings of FA include dysregulation of parent cortico-limbic circuitry and the oxytocinergic system. PMHNPs are in a unique position to identify families engaged in problematic FA, educate their clientele, provide psychotherapy services with the goal of reducing FA, and consult with multidisciplinary team members.

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References

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2019Measuring Family Accommodation of Childhood Anxiety: Confirmatory Factor Analysis, Validity, and Reliability of the Parent and Child Family Accommodation Scale – Anxiety 2022Modifiable Parent Factors Associated with Child and Adolescent School Refusal: A Systematic Review 2020The Relationship of Family Accommodation with Pediatric Anxiety Severity: Meta-analytic Findings and Child, Family and Methodological Moderators

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