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 childrenís and parentís careful monitoring of the childís 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



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Last Updated
May 5, 2015