Percepciones De La Gestión De La Movilidad

This study has provided support for the association between parental and child anxiety, and therefore highlights the importance of a family-based approach to treating child anxiety from preschool age. Involving parents more actively in treatment from an early age may help to prevent maladaptive patterns being established, and brief parent-child interventions at an early age may be more effective than attempting to treat more entrenched patterns of interaction. The advantages of early intervention include the young child’s responsiveness to learning, both behaviourally and neurodevelopmentally (Hirshfeld-Becker & Biederman, 2002).

Past research has shown that the inclusion of parents in treatment of anxious children improves the efficacy of interventions (Barrett et al., 1996b; Cobham et al., 1998). Regardless of causality, parents of more anxious children tend to have higher levels of anxiety themselves. Interventions incorporating a focus on parental anxiety, may lead to improved outcomes for anxious children as well as for their parents. Recently, researchers have developed early interventions for preschool children, and have proposed some basic principles for parent involvement in the treatment of young

children with anxiety problems, as the result of ongoing pilot studies (Hirshfeld- Becker & Biederman, 2002; Rapee, 2002).

The early results from one selective intervention programmes highlights that risk factors for the development of child anxiety can be targeted for modification with success (Rapee, (2002). A large sample of inhibited children were identified in preschool using maternal questionnaires, and were randomly allocated to an

intervention or monitoring control group. A brief group intervention educated parents about child anxiety and provided techniques to help them enable their child to

become more confident and outgoing. The results showed that children’s inhibited temperament decreased over 12 months in both groups, but there was a significantly greater decrease in the intervention group. In addition, structured clinical interviews indicated a greater reduction in anxiety diagnoses in the children of parents who received the intervention. Therefore, by identifying those children at risk for becoming more anxious, early interventions may help to interrupt the cycle of anxious interaction between parents and children. It is possible that selective interventions could also identify parents with higher levels of anxiety and anxious cognitions, as the children of these parents may be higher risk for the development of anxiety problems.

Addressing parental cognitions in treatment regarding the cause of their child’s anxiety, and their beliefs about how they react to ambiguous situations, may help to address factors that may be maintaining their children’s difficulties. This will help to mitigate the effect of anxious parental cognitions on the maintenance of childhood anxiety.

In the current study, the cognitions of more anxious parents appeared to centre on a common theme of a lack of control of their child’s anxious responses. It is possible that this derives from a deficit in parental knowledge of ways of managing child anxiety. By providing information for parents about the nature of anxiety and giving the basic skills to manage this, it may help to enhance parental ability to cope with their child’s anxiety.

The findings of the current study suggest that some parental cognitions were related either to parental or child anxiety. However two cognitions, parent control of child anxious mood and of child anxious behaviour, were related to both parental anxiety and child anxiety. These may be the most important ones to focus on in parent-child treatment. However, the roles of parental and child anxiety in each of these

cognitions was different, when assessing child anxiety as measured by parent ratings of child anxious behaviours. Child anxiety was uniquely related to parents’

perception of their ability to change their child’s upset mood in ambiguous situations,

whereas parental anxiety was uniquely related to parents’ perception of their ability

to change their child’s avoidant behaviour. Therefore, any attempt to modify these

parental cognitions about their anxious child, need to consider whether the cognitions are based on parental anxiety or child anxiety. It appears that parent control of

anxious behaviour is more related to parental anxiety, and this may be due to the lack of alternative appraisals to avoidance in anxiety-provoking situations. Thus parental involvement in treatment needs to focus on providing alternatives to facilitating avoidance, and increasing parental efficacy about how to manage anxious behaviour. This may help to modify parent views of their child as vulnerable and in need of protection or control.

A more interactional approach to understanding child anxiety may also be more palatable to parents who are seeking treatment for their anxious child. A context highlighting that parents may be reacting to an anxious vulnerability in their children, may provide a less blaming foundation for engaging parents in treatment. Targeting parental cognitions may also have implications for the engagement of parents in treatment. In their review, Morris se y-Kane and Prinz (1999) highlighted the importance of parental cognitions and attributions on three aspects of the child treatment process: help seeking, engagement and retention, and outcome. In particular, their review suggests that parents’ beliefs about the cause of their children’s problems, perceptions about their ability to handle such problems, and expectations about the ability of therapy to help them, all influence parent

engagement. The current study has highlighted that parental cognitions about the ability to handle child anxious mood and behaviour, are uniquely related to child anxiety and parental anxiety.