As a CBT practitioner since 2011, I've seen this movie before. CBT is cognitive behavioral therapy. It’s a treatment for a range of mental health concerns that flows from a solid scientific foundation of understanding human behavior and emotion. The movie begins when a new type of CBT treatment emerges, perhaps making claims that it is novel and in some way better. Upon closer examination, it's pretty similar, if not indistinguishable from the old CBT. It works well too! After all, CBT works well. And oftentimes, it's a further refinement or more sophisticated application to particular problems. But the novel treatments are not always as novel as one might think. The old adage "old wine in new bottles" comes to mind.
When I first heard about SPACE (Supportive Parenting for Anxious Child Emotions), a recently developed therapeutic approach for anxious children, I must admit I was a tad skeptical. It seemed to me like it might be just another repackaging of traditional cognitive-behavioral therapy (CBT), an approach that psychologists have long used to help individuals manage anxiety. SPACE focuses on helping parents reduce unhelpful accommodation of child anxiety, but this was already something psychologists were doing as part of pediatric CBT. However, as I delved deeper into the SPACE program, I realized that it offered something truly novel. Its most distinctive feature is its minimal - even complete lack of - direct involvement with the anxious child. Unlike CBT, which requires the child's active participation in treatment, SPACE focuses exclusively on guiding parents towards more supportive and adaptive behaviors. Through several clinical trials, the developer of SPACE, Dr. Eli Leibowitz, a professor at the Yale Child Study Center, demonstrated that this approach works as well as traditional CBT. It is possible to effectively address childhood anxiety by targeting parental behaviors, without requiring direct intervention with the child.
I was convinced. In fact, I was so thoroughly convinced that I became trained in delivering SPACE.
Moreover, SPACE extends beyond just the parents. The program also involves supporters, other adults close to the family, such as grandparents or trusted friends, and gives them specific roles in the process. By involving these individuals in the therapeutic process, SPACE can create a broader network of support for the child and their family. Furthermore, SPACE offers a structured and systematic approach to reducing parental accommodation. The program outlines specific steps and stages that parents and therapists can work through together, providing a clear roadmap for addressing anxiety-related behaviors. This methodical approach can be especially helpful for parents who may feel overwhelmed or unsure about how to support their child effectively.
Since SPACE focuses on reducing parental accommodation, it's important to note that sometimes children with anxiety may become aggressive or agitated when accommodation is withdrawn. This can be a challenging phase for families, and often disruptive to the family. Here too, SPACE introduces a unique way to deal with aggression that involves recruiting family supporters. By providing a supportive and understanding environment, SPACE can help parents and supporters navigate this difficult period and prevent the situation from escalating.
So, contrary to my skepticism it offers a truly novel approach to addressing childhood anxiety. By focusing exclusively on guiding parents towards more supportive and adaptive behaviors, SPACE demonstrates that effective treatment can be achieved without requiring direct intervention with the child. This approach, combined with the program's structured and systematic approach to reducing parental accommodation and the involvement of family supporters, makes SPACE a promising and valuable tool for addressing childhood anxiety.