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J Anxiety Disord. 2012 Jan;26(1):40-9. doi: 10.1016/j.janxdis.2011.08.011. Epub 2011 Aug 25.

A pilot feasibility evaluation of the CALM Program for anxiety disorders in early childhood.

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Department of Psychology, Boston University, Center for Anxiety and Related Disorders, 648 Beacon Street, Boston, MA 02215, USA.


As many as 9% of preschoolers suffer from an anxiety disorder, and earlier onset of disorder is associated with more intractable forms of psychopathology in later life. At present there is a relative dearth of empirical work examining the development of evidence-based treatments for anxiety disorders presenting in early childhood. Building on previous work supporting extensions of PCIT for separation anxiety disorder, the present study examines the preliminary feasibility and efficacy of an anxiety-based modification of PCIT (The CALM Program; Coaching Approach behavior and Leading by Modeling) for the treatment of youth between the ages of three and eight presenting with separation anxiety disorder, social anxiety disorder, generalized anxiety disorder, and/or specific phobias (N=9; M(age)=5.4 years, ranging 4-8 years; 55.6% of families endorsing racial or ethnic minority status). Intent-to-treat (ITT; N=9) and treatment completer (N=7) analyses were conducted to evaluate diagnostic and functional response across participants. Pre- and posttreatment structured diagnostic interviews were conducted (ADIS-C/P), and clinical impression measures were completed (e.g., CGI, CGAS). Roughly 80% of the sample completed all treatment sessions. All treatment completers were categorized as global treatment responders by independent evaluators, with all but one showing full diagnostic improvements, and all but one showing meaningful functional improvements. These findings lend preliminary support for the promising role of live parent coaching for the treatment of a range of anxiety disorders that present in early childhood. Future work is needed to replicate the present findings in larger samples utilizing randomized controlled comparisons.

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