Changes in Rejection and Psychological Control During Parent–Child Interactions Following CBT for Children’s Anxiety Disorder

This study examined changes in mothers' and fathers' rejection and psychological control during parent-child interactions after cognitive-behavioral therapy (CBT) for children's anxiety disorders. We studied whether family CBT reduced rejection (vs. warmth) and psychological control (vs. autonomy-granting) more than child CBT, and whether parents own anxiety disorders resulted in smaller decreases in these parenting behaviors. Participants were 128 clinically referred children and adolescents (52 boys; Mage = 12.4, SDage = 2.7) with anxiety disorders and their parents, randomly assigned to either family CBT (n = 64) or child CBT (n = 64). The Anxiety Disorders Interview Schedule was used to assess children's and parents' anxiety disorders. Before and after treatment, parents' rejection and psychological control toward their child was rated during conflict and anxiety discussions of mother-child dyads, father-child dyads, and mother-father-child triads. As expected, during dyadic and triadic interactions, mothers' and fathers' rejection toward their child decreased after child and family CBT. Unexpectedly, during triadic conflict interactions, mothers, after child CBT and family CBT, as well as fathers, after child CBT, displayed increased psychological control. During triadic anxiety interactions, only mothers, after child CBT, showed increased psychological control. Changes in parenting did not depend on whether or not parents had anxiety disorders themselves. Thus, CBT for anxiety-disordered children can successfully reduce parents' rejection. The unexpected findings of increased psychological control after treatment, particularly by mothers in the presence of the father, suggests potential benefits of mothers' psychological control with anxious children. (PsycINFO Database Record (c) 2019 APA, all rights reserved)