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Eight-Day
Intensive Treatment Program for Adolescents with Panic Disorder with Agoraphobia
Parent
Child Interaction Therapy
Intensive
Treatment Program for Specific Phobias
Eight-Day
Intensive Treatment Program for Adolescents with Panic Disorder with Agoraphobia
at Boston University
Program
Description
This new treatment, which was featured recently on 48 Hours, is a highly specialized,
very intensive form of therapy for persons whose primary problem is panic
disorder with moderate to severe agoraphobia. This program has been administered
to adults since February, 1999, when it was first featured on ABC News 20/20.
The program has recently been adapted for treatment of adolescents. The therapy
is administered over a period of 8 days, with follow-up telephone contacts
1 week, 1 month, and 6 months later. Patients typically arrive in Boston on
a Sunday, begin treatment on Monday, and leave on the following Monday afternoon
or evening. All children/adolescents should be accompanied by at least one
parent or primary caregiver. While families are here in Boston, they devote
a significant amount of time to the treatment. During much of the time (on
the order of 15-20 hours) adolescents are working directly with a therapist,
and during the additional time, they are completing age- appropriate reading
assignments and therapy assignments, and spending time with their family.
It is crucial that adolescents are willing to work hard, are motivated to
get better, and are willing to experience anxiety during portions of the treatment
in order to overcome this disorder.
How can this program
help?
Treatment aims to help adolescents recognize the signs of anxiety and avoidance
and learn specific skills to cope with the sensations of panic, change their
anxious thoughts, and face anxiety-provoking situations. Treatment can be
successful in helping adolescents to overcome their fears and to increase
participation in everyday activities. Because of this, treatment can lead
to considerable improvement in the quality of adolescent's lives during this
important developmental period.
Is This Program Right
for your Child?
This program is right for only a small percentage of people with anxiety
problems. To benefit from it, your adolescent's principal problem must
be panic disorder and he/she must be avoiding multiple situations or activities
because of concerns about panic attacks. If you are unsure about the nature
of your adolescent's anxiety, it is best to receive a thorough assessment
to better understand his or her anxiety problems. This diagnostic anxiety
assessment is also available at the Center for Anxiety and is included
in the cost of the program.
Practical Concerns
To take part in this program you must be able to travel to Boston with your
child and stay here for a period of 8 days. This often is very difficult for
adolescents with agoraphobia. And as mentioned earlier, your child must be
willing to experience anxiety and panic symptoms during the course of treatment,
as it is essential for recovery.
Even if this program is
suitable for you, you should be aware that there are other effective, less
expensive treatments for panic disorder, including standard forms of cognitive
behavioral therapy that are typically conducted on a weekly basis over a period
of three or four months. Our program was designed specifically for adolescents
who do not have access to other forms of treatment, have not responded to
them, have time constraints, or prefer a very intensive form of therapy.
Cost
The cost of the treatment is $2,500 which includes all assessments, the complete
treatment, and the follow-up calls. That amount is payable on the first day.
In addition, you will need to pay any costs necessary for the out-of-office
work (for example, car rentals, transportation fares, other costs of travel
away from the clinic, or admission fees) for both yourself and, if the therapist
needs to come along, for the therapist. If you stay in a hotel while you are
in Boston (which we recommend that you do), we can assist you with reservations
and may be able to get you a slightly discounted rate. We do not provide accommodations.
We regret that we do not accept insurance and cannot guarantee that insurance
companies will reimburse you for the program. However, we will be glad to
provide a statement that can be submitted to insurance companies.
Screening Procedure
Because of the significant cost and effort the intensive program entails,
we want to be sure that the persons we accept are good candidates for this
form of treatment. To help us evaluate that, we do a careful assessment by
telephone and mail before we offer treatment. The assessments involve several
steps, beginning with a telephone screen by one of our staff. Persons who
are interested and appear appropriate after that screen are sent a set of
questionnaires to complete. These are standard questionnaires that we use
routinely with patients we see in our Center, and they will give us a clearer
picture of your child's anxiety problem. After we receive your completed questionnaires,
one of our staff (generally the person who would be your therapist) will call
you to conduct a diagnostic interview by phone, and will also call you to
discuss the results.
Interested
in Child/Adolescent Intensive Panic Program?
If you are interested in having your adolescent screened for the Adolescent
Intensive Panic Treatment Program, or would like more information, feel free
to call us at (617) 353-9610.
or contact Dr. Pincus at: dpincus@bu.edu
Parent Child Interaction Therapy: An Innovative
Parent Training Program for Families
Parent-Child
Interaction Therapy (PCIT) is a parent-training program developed by Dr. Sheila
Eyberg and colleagues to treat children with conduct problem behavior and
their families. The treatment is designed to help parents build a warm and
responsive relationship with their child and to help parents manage their
child's behavior more effectively. Parent Child Interaction Therapy is based
on the assumption that improving the parent child interaction will result
in improvement in both child and family functioning (Eyberg & Robinson, 1982;
Foote, Eyberg & Schuhmann, 1998).
During Parent-Child
Interaction Therapy, parents are taught specific skills to improve their interaction
with their children. These skills are taught by trained therapists, and parents
have the unique opportunity to practice these skills with their children in
session. Therapists "coach" parents in using new skills as parents play with
their children in a safe, therapeutic context that allows the child to experiment
with change. Parents are taught specific ways to praise children's appropriate
play and are taught to ignore undesirable child behaviors. Parents are also
taught ways to give clear, age-appropriate instructions to children. Parents
are taught to provide consistent, appropriate positive and negative consequences
following the child's obedience and disobedience. In addition, parents learn
how a child's behavior is shaped and maintained by his or her social environment
and how methods of behavior change learned throughout PCIT can be applied
to new problems as they arise.
There have
been numerous studies demonstrating the effectiveness of PCIT for reducing
child behavior problems (Eyberg & Robinson, 1982; Foote, Eyberg & Schuhmann,
1998). These studies have documented change in the interactional syle of parents
in play situations with the child, as well as significant improvements in
child compliance and decreases in disruptive behaviors, which have been shown
to generalize to the home and to the child's behavior at school (Boggs, Eyberg
& Reynolds, 1990). In addition, parent behaviors have been shown generalize
to interactions with other children in the family as reflected by improved
behavior of siblings (Brestan, Eyberg, Boggs & Algina, 1997). Because the
specific goals of PCIT are to teach parents to build a more positive relationship
with their child, to teach their child desirable, appropriate behaviors, and
to decrease their child's inappropriate behaviors, it is not surprising that
many parents have reported that PCIT can be extremely helpful in improving
the quality of life for their family.
In our recent
research at Boston University, we have begun testing PCIT for use with parents
and young children with Separation Anxiety Disorder. Although this research
is still underway, we have thus far found that parents have reported that
their children show decreases in their daily separation anxious behaviors
after PCIT training. Parents have also reported having improved relationships
with their children (Pincus & Choate, in press). It appears that the skills
taught through this innovative parent training program are helpful for improving
children's behavior problems as well as potentially decreasing the anxious
behaviors of young children.
References
Boggs, S.R.,
Eyberg, S.M., & Reynolds, L.A. (1990). Concurrent validity of the Eyberg Child
Behavior Inventory. Journal of Clinical Child Psychology, 19, 75-78.
Brestan,
E. V., Eyberg, S. M., Boggs, S. R., &Algina, J. (1997). Parent-child interaction
therapy: Parents' perceptions of untreated siblings. Child and Family Behavior
Therapy, 19(3), 13-28.
Eyberg, S.M.,
& Robinson, E.A. (1982). Parent-child interaction training: Effects on family
functioning. Journal of Clinical Child Psychology, 11, 130-137.
Foote, R.,
Eyberg, S.M., & Schuhmann, E. (1998). Parent-child interaction approaches
to the treatment of child behavior disorders. In T.H. Ollendick & R.J. Prinz
(Eds.) Advances in Clinical Child Psychology, 20, New York: Plenum Press.
Pincus, D.B.,
& Choate, M.L. (in press). Parent child interaction approaches to the treatment
of separation anxiety in young preschoolers. Cognitive and Behavioral Practice,
Special Series.
Intensive Treatment Program for Specific
Phobias
Introduction
Children and adolescents may experience specific phobias, which are intense,
irrational fears of certain things or situations, (e.g., dogs, bees, injections,
the dark, escalators, tunnels, flying, etc.) Children may not realize that
fear of such objects are unreasonable. Typically, children or adolescents
will become extremely distressed when confronted with the feared object or
situations. As children become increasingly fearful, they begin to avoid the
feared object, and this often results in significant disruption in the child
or adolescent's routine, school functioning, family functioning, or social
relationships. In children, the anxiety felt may be expressed by crying, tantrums,
freezing, or clinging. In addition, children or adolescents may experience
rapid heart rate, dizziness, sweaty palms, etc. when confronted with the feared
object or situation.
Specific
Phobia Intensive Treatment Program
The specific phobia intensive treatment program was designed to help children
and adolescents to gain the skills necessary to begin to overcome their specific
phobia in a time-intensive, 5 day treatment program. The program utilizes
a cognitive behavioral treatment approach, which is the most effective treatment
known to date for treatment of children's fears or phobias. Cognitive behavioral
treatment packages have been successfully employed in the treatment of specific
phobias such as fears of dogs, spiders, the dark, needles, etc. Techniques
commonly used include relaxation training, use of imagery techniques, token
reinforcements implemented by parents (e.g., praise, sticker charts), and
children’s and parent’s careful monitoring of the child’s positive behaviors.
Through this program, children and adolescents are taught to change their
anxious thoughts and replace them with positive, coping thoughts. Children
are also taught, through the process of exposure therapy, ways to gradually
enter situations that they formerly avoided due to fear.
The therapy
is administered over a period of 5 days, with follow-up telephone contacts
1 week, 1 month, and 6 months later. Patients typically arrive in Boston on
a Sunday, begin treatment on Monday, and leave on Friday afternoon. All children/adolescents
should be accompanied by at least one parent or primary caregiver. While families
are here in Boston, they devote a significant amount of time to the treatment.
During much of the time (on the order of 12-18 hours) adolescents are working
directly with a therapist, and during the additional time, they are completing
age-appropriate reading assignments and therapy assignments. It is crucial
that children and adolescents are motivated to overcome their fears, and are
willing to experience some anxiety during portions of the treatment in order
to overcome their phobia.
How can this program
help?
Treatment aims to help children and adolescents recognize the signs of anxiety
and avoidance and learn specific skills to cope with the situations or objects
that elicit fear. Children learn to change their anxious thoughts, and learn
to confront their fears with the guidance of a trained therapist. Treatment
can be successful in helping children and adolescents to overcome their fears
and to increase participation in everyday activities. Because of this, treatment
can lead to considerable improvement in the quality of children's and adolescent's
lives.
Is This Program Right
for your Child?
To benefit from this program, your child's or adolescent's principal problem
must be specific phobia. If you are unsure about the nature of your child
or adolescent's fear or anxiety, it is best to receive a thorough assessment
to better understand his or her anxiety problems.
Practical Concerns
To take part in this program you must be able to travel to Boston with your
child and stay here for a period of 5 days. And as mentioned earlier, your
child must be willing to experience some anxiety symptoms during the course
of treatment, as it is essential for recovery.
Even if this program is
suitable for your child, you should be aware that there are other effective,
less expensive treatments for specific phobia in children, including standard
forms of cognitive behavioral therapy that are typically conducted on a weekly
basis over a period of three or four months. Our program was designed specifically
for children or adolescents who do not have access to other forms of treatment,
have not responded to them, have time constraints, or prefer a very intensive
form of therapy.
Interested in Child/Adolescent
Specific Phobia Program?
If you are interested in having your child or adolescent screened for the
Intensive Treatment Program for Specific Phobia, or would like more information,
feel free to call us at (617) 353-9610, or contact
Dr. Donna Pincus at: dpincus@bu.edu
Copyright
© 2001 The Child Anxiety Network. All Rights Reserved.
Sponsored by Psychzone Inc. |
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