Supportive Parenting for Anxious Childhood Emotions (SPACE)
A common misconception in therapy for children that centers on anxiety is that effective interventions/therapies should only be centered on changing the child’s behavior. Parents may think that they cannot be an integral part of the therapeutic journey for their child. While there are effective child-focused therapies, there are also therapies that are focused on parental involvement. One of these parent-based therapeutic interventions is SPACE, Supportive Parenting for Anxious Childhood Emotions. SPACE empowers parents to modify their own responses, which, in turn, helps reduce their child’s anxiety. With SPACE, parents play a meaningful, pivotal role in restructuring and organizing their child’s environment. This adjustment in focus emphasizes on changing a parent’s response to an anxiety-related behavior, leading to significant improvements in their child’s anxiety.
Supportive Parenting for Anxious Childhood Emotions (SPACE) in Round Rock and Austin, Texas
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Supportive Parenting for Anxious Childhood Emotions (SPACE) in Round Rock and Austin, Texas •
Understanding SPACE Therapy
The common parental response to anxiety often incorporates some level of reassurance. For example, if a child is fearful of going to a social event and the parent allows the child to stay home, the anxiety has been reinforced and the belief that social events are too intimidating or scary has been confirmed. SPACE understands and builds its treatment around recognizing how parental behaviors can often unintentionally reinforce a child’s anxiety. This desire to support and alleviate distress makes sense. Parents want to reduce discomfort and provide reassurance. In SPACE, parents will be empowered and taught how to identify the pitfalls of accommodation behaviors while learning how to decrease their frequency. What’s more, parents will be instructed on how to respond supportively to a child’s anxiety without accidentally reinforcing it. It is important to understand that SPACE is not about ignoring or dismissing a child’s fear but assisting their child to tackle fear-inducing situations head-on while knowing that their parents are confident and believe in their ability to effectively navigate the situation.
Who Benefits from SPACE?
SPACE is an effective modality to address a variety of anxiety disorders that can be present in children and adolescents. Anxiety Disorders, including: generalized anxiety disorder (GAD), separation anxiety, social anxiety, and panic disorder. Within our practice, in alignment with increasing research outcomes, SPACE has been discovered to be a useful therapy in treating obsessive-compulsive disorder (OCD) in children.
It is worth noting that SPACE is a great option for parents who are ready to tackle the challenges of a child with anxiety disorders, allowing them to be in the driver seat of learning strategies and implementing them at home and in other settings. For some children who have previously struggled with engagement in therapy whether it is due to their young age or have exhibited refusal as a result of anxiety disorders, SPACE can be a great option. SPACE puts the parents at the forefront, forgoing any attendance of children in therapy sessions.
Number of Sessions and Treatment Structure
SPACE sessions can range from about 8 to 12 weekly sessions. Sessions are attended solely by the parents, the child is not required to join. As with most therapeutic modalities, the exact number of sessions can range. A variety of factors can influence the number of sessions, including how the skills are being implemented in the home as well as the level of severity of the child’s anxiety.
One area of focus in recognizing the common response to the anxious statements made by children. These responses can be categorized into two areas. One, the parent feels their job is to protect, making statements such as, “She just goes to pieces” or “She just can’t handle it.” The other category of responses comes from the lens that a parent’s job is to promote independence. This category can include statements such as, “You should be able to do this!” or “It’s not that scary.” We use this understanding of the common responses to support parents in recognizing that it is important to acknowledge the child’s distress while also highlighting confidence in the child’s ability to more effectively manage their anxiety.
The goal to decrease accommodations comes in the first few sessions, where parents will learn the specific accommodations that are occurring in response to their child’s anxiety. Accommodations can look like allowing a child to avoid something that causes them anxiety, completing tasks for the child, or providing too much reassurance. Once aware of the accommodations, the goal will be to reduce the frequency of accommodation while increasing the use of supportive statements. Supportive statements can include, “It scared you but I am sure you’ll be OK,” or “It’s my job to prepare her for dealing with challenges in life”. These supportive statements are a key element of SPACE and help children feel understood without reinforcing avoidance behaviors.
As the sessions progress, the goal remains the same. Parents will maintain a routine of reducing accommodations and continuing to provide supportive statements. Therapists will provide guidance and feedback, helping parents navigate challenges and resistance they may encounter from their child. The hope is that by the end of therapy parents are able to more confidently and effectively handle their child’s anxiety, while their child has developed greater independence and resilience.
Important Considerations for Parents
If you are a parent that is considering SPACE for your child, it is important to review this and understand the way in which this intervention functions. It differs from how therapy is traditionally conducted with children and their parents. Historically, the child is the designated client while the parents receive information on the interventions used in a session and how to provide support when the child needs to use the skills at home. With SPACE, it is parent-based meaning that the parents are required to actively and jointly participate in sessions. It requires exploration of the parental behaviors, which can feel a little uncomfortable.
This discomfort can most often be found when parents are asked to modify and reduce the accommodations. The reduction in accommodations can make parents feel as if they are not helping their child, or even that they are abandoning their child. It is really emotionally challenging to stop giving reassurance, and it makes sense if that has been the way in which support has been provided for anxiety behaviors in the past. However, it is the job of a SPACE therapist to guide parents through the discomfort
as these changes start to take place. Patience and compassion is encouraged for parents as they navigate this period of time as it can take time for the new strategies to have a tangible effect. But remember, consistency is key to continuing the progress made during therapy.
Effectiveness of SPACE
To understand just how useful SPACE can be for the treatment of anxiety disorders in kids, research has shown that SPACE is highly effective in reducing anxiety in children. A study conducted by Dr. Lebowitz [founder of SPACE] and colleagues compared SPACE to traditional cognitive-behavioral therapy (CBT) for childhood anxiety disorders. The results showed that SPACE was just as effective as CBT in reducing anxiety symptoms, and in some cases, it was more effective in reducing parental accommodation, which is a major contributor to continuing anxiety (Lebowitz et al., 2019).
Conclusion
SPACE is an excellent therapeutic intervention for the parents of children and teens with anxiety disorders. It helps parents feel empowered to assist their kids in building autonomy and resilience when regularly confronted with anxiety. SPACE allows parents to step into the driver’s seat of therapy by making gradual changes and providing supportive, non-accommodating responses that encourage their children to face their fears.
If you are a parent looking for a more active role in changing the narrative and experience for your child and their challenges with anxiety disorders, please consider SPACE as an option for tackling the roles and behaviors that feel overwhelming to change.
References
- Lebowitz, E. R. (2021). Breaking free of child anxiety and OCD: A scientifically proven program for parents. Oxford University Press.
- Lebowitz, E. R., Marin, C., Martino, A., Shimshoni, Y., & Silverman, W. K. (2019). Parent-based treatment as efficacious as cognitive-behavioral therapy for childhood anxiety: A randomized noninferiority study of supportive parenting for anxious childhood emotions. Journal of the American Academy of Child and Adolescent Psychiatry, 58(10), 887-897.
- Lebowitz, E. R. (2013). Treating childhood and adolescent anxiety: A guide for caregivers and clinicians. New Haven: Yale University Press.
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