Examining the Effectiveness of an Intensive Telemental Health Treatment for Pediatric Anxiety and OCD During the COVID-19 Pandemic and Pediatric Mental Health Crisis.

Despite research supporting the efficacy of weekly outpatient videoconferencing-based cognitive behavioral therapy (VCBT), limited evidence exists about the benefits of leveraging VCBT for brief intensive formats. We examined the effectiveness of an intensive outpatient VCBT targeting pediatric anxiety and OCD. Quasi-experimental design was used to compare outcomes of intensive, in-person, group-based cognitive-behavioral therapy with medication management and caregiver guidance pre-pandemic, to a similar VCBT peri-pandemic (n = 130). Pretreatment and posttreatment assessments included patient- and caregiver-report of anxiety and functional impairment. Analyses of covariance were conducted, examining changes in anxiety and impairment between treatment groups, controlling for admission levels. No significant differences in posttreatment anxiety or impairment were observed between conditions. This study illustrates that intensive, group-based treatment for pediatric anxiety and OCD using VCBT is associated with comparable reductions in anxiety and impairment. It marks a crucial step toward providing broader access to quality care for youth in need.

Associations between parental distress and pediatric anxiety and obsessive-compulsive disorder treatment outcomes.

This study investigated whether an intensive group-based cognitive-behavioral therapy program with family involvement for children with anxiety disorders and obsessive-compulsive disorder could help reduce parental distress by addressing the larger family system. This study also examined associations between parental distress and parent-reported child outcomes of treatment. Two hundred ninety-nine children and adolescents, ages 6-19, who were patients in the intensive treatment program and their caregivers participated in this intervention-based study. Parents reported significant reductions in their own distress from admission to discharge, and greater reductions in parent-reported distress predicted greater reductions in parents' reports of their children's anxiety symptoms and the degree of child functional impairment. Higher levels of parent-reported parent mental health symptoms at children's admission and at discharge were associated with poorer levels of functioning in children at discharge. Parents' mental health symptoms may play a critical role in children and adolescents' treatment outcomes and therefore may need to be a separate treatment target.

The impact of intensive treatment for pediatric anxiety and obsessive-compulsive disorder on daily functioning.

This study investigated whether intensive group-based cognitive-behavioral therapy (CBT) with family involvement for children with anxiety disorders and obsessive-compulsive disorder (OCD) would facilitate children's return to their daily routines. The focus shifted from the usual emphasis on remission to an improvement in functioning. The aim was to capture potentially missed gains when children pursue their fears and engage in more adaptive behaviors as these efforts may result in ongoing symptoms. Two hundred twelve children and adolescents aged 8-19 years old, who were patients in an intensive outpatient group-based treatment program at an academic hospital, participated in this study. Results indicated that both children and their parents endorsed significant improvement in children's functioning from admission to discharge. Symptom reduction was assessed for reference, and both children and parents reported significant decreases in child anxiety symptoms from admission to discharge, and children endorsed decreases in their comorbid depression symptoms. Short-term group-based intensive treatment in a clinical setting may help children return to their daily activities quickly.

Children's expressions of positive emotion are sustained by smiling, touching, and playing with parents and siblings: A naturalistic observational study of family life.

Research on family socialization of positive emotion has primarily focused on the infant and toddler stages of development, and relied on observations of parent-child interactions in highly structured laboratory environments. Little is known about how children's spontaneous expressions of positive emotion are maintained in the uncontrolled settings of daily life, particularly within the family and during the school-age years. This naturalistic observational study examines 3 family behaviors-mutual display of positive emotion, touch, and joint leisure-that surround 8- to 12-year-old children's spontaneous expressions of positive emotion, and tests whether these behaviors help to sustain children's expressions. Recordings taken of 31 families in their homes and communities over 2 days were screened for moments when children spontaneously expressed positive emotion in the presence of at least 1 parent. Children were more likely to sustain their expressions of positive emotion when mothers, fathers, or siblings showed positive emotion, touched, or participated in a leisure activity. There were few differences in the ways that mothers and fathers socialized their sons' and daughters' positive emotion expressions. This study takes a unique, ecologically valid approach to assess how family members connect to children's expressions of positive emotion in middle childhood. Future observational studies should continue to explore mechanisms of family socialization of positive emotion, in laboratory and naturalistic settings. (PsycINFO Database Record

A naturalistic observational study of children's expressions of anger in the family context.

Traditional approaches to the study of children's expressions of anger rely on tightly controlled study environments to test hypotheses about outcomes and correlates of expression characteristics. An unexplored area in the study of emotion expression is a naturalistic examination of school-age children's spontaneously occurring expressions of emotion in their real, uncontrolled family contexts. This observational study describes the naturally occurring characteristics and contexts of 8- to 12-year-old children's anger expressions with family members. Thirty-one families were videotaped for 2 days at home and in community settings. Children's expressions of anger were identified and coded for angry facial, vocal and physical behaviors, and for the expressions' instigating situational contexts. The majority of anger expressions were of mild intensity and brief duration, and most often contained vocal behavioral characteristics (e.g., loud voice, whining). The most common cause of an anger expression was a verbal disagreement; other frequently occurring situational causes included homework, requests for compliance, and reprimands. Patterns in the angry behaviors children exhibited in response to specific situational causes support a functionalist perspective on emotion expression in that children engaged in behaviors that appeared to be attempts to get their needs met. Few differences were observed between mothers' and fathers' rates of instigating children's anger expressions, and between boys' and girls' expression characteristics and contexts. This study offers an ecologically valid, uniquely naturalistic methodology to describe children's observable expressions of anger as they occur in family contexts.