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The Turtle Program: PCIT for Young Children Displaying Behavioral Inhibition

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Abstract

Stable behavioral inhibition (BI), a temperamental predisposition present in 15–20% of infants and toddlers, is associated with increased risk of developing anxiety disorders in adolescence and adulthood. Within a transactional framework, parent–child interactions and peer relationships have been shown to moderate the developmental progression from elevated, stable BI to social withdrawal to later psychopathology, presenting important targets for prevention and intervention programs. The Turtle Program: PCIT for Young Children Displaying Behavioral Inhibition (Turtle Program) is a multicomponent early intervention program for behaviorally inhibited preschoolers that targets both parent–child and child–peer interactions. The 8-session Turtle Program consists of a group-based adaptation of PCIT and a child social and emotional skills group (Social Skills Facilitated Play). Within the parent PCIT-based component, parents learn skills to increase parental responsiveness and facilitate child approach behaviors within the peer context. In this chapter, the authors describe modifications made to the PCIT protocol to target child BI/anxiety, and provide a case example to illustrate how the intervention works.

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References

  • Barstead, M., Danko, C. M., Coplan, R., O’Brien, K., Chronis-Tuscano, C., & Rubin, K. (2018). Generalization of an early intervention for inhibited preschoolers to the classroom setting. Journal of Child and Family Studies, 27(9), 2943–2953.

    Article  Google Scholar 

  • Booth-LaForce, C., Oh, W., Kennedy, A. E., Rubin, K. H., Rose-Krasnor, L., & Laursen, B. (2012). Parent and peer links to trajectories of anxious withdrawal from grades 5 to 8. Journal of Clinical Child & Adolescent Psychology, 41(2), 138–149.

    Article  Google Scholar 

  • Burgess, K. B., Rubin, K. H., Cheah, C. S., & Nelson, L. J. (2005). Behavioral inhibition, social withdrawal, and parenting. In W. R. Crozier & L. E. Alden (Eds.), The Essential Handbook of Social Anxiety for Clinicians (pp. 99–120). Hoboken, NJ: John Wiley & Sons.

    Google Scholar 

  • Chronis-Tuscano, A., Degnan, K. A., Pine, D. S., Perez-Edgar, K., Henderson, H. A., Diaz, Y., … Fox, N. A. (2009). Stable early maternal report of behavioral inhibition predicts lifetime social anxiety disorder in adolescence. Journal of the American Academy of Child & Adolescent Psychiatry, 48, 928–935.

    Article  Google Scholar 

  • Chronis-Tuscano, A., Rubin, K. H., O’Brien, K. A., Coplan, R. J., Thomas, S. R., Dougherty, L. R., … Wimsatt, M. (2015). Preliminary evaluation of a multimodal early intervention program for behaviorally inhibited preschoolers. Journal of Consulting and Clinical Psychology, 83, 534–540.

    Article  Google Scholar 

  • Coplan, R. J., Arbeau, K. A., & Armer, M. (2008). Don’t fret, be supportive! maternal characteristics linking child shyness to psychosocial and school adjustment in kindergarten. Journal of Abnormal Child Psychology, 36, 359–371.

    Article  Google Scholar 

  • Coplan, R. J., Reichel, M., & Rowan, K. (2009). Exploring the associations between maternal personality, child temperament, and parenting: A focus on emotions. Personality and Individual Differences, 46(2), 241–246.

    Article  Google Scholar 

  • Coplan, R. J., Schneider, B. H., Matheson, A., & Graham, A. (2010). ‘Play skills’ for shy children: Development of a social skills facilitated play early intervention program for extremely inhibited preschoolers. Infant and Child Development, 19, 223–237.

    Google Scholar 

  • Degnan, K. A., Henderson, H. A., Fox, N. A., & Rubin, K. H. (2008). Predicting social wariness in middle childhood: The moderating roles of childcare history, maternal personality and maternal behavior. Social Development, 17(3), 471–487.

    Article  Google Scholar 

  • Degnan, K. A., & Fox, N. A. (2007). Behavioral inhibition and anxiety disorders: Multiple levels of a resilience process. Development and Psychopathology, 19, 729–746.

    Article  Google Scholar 

  • Fox, N. A., Henderson, H. A., Marshall, P. J., Nichols, K. E., & Ghera, M. M. (2005). Behavioral inhibition: Linking biology and behavior within a developmental framework. Annual Review of Psychology, 56, 235–262.

    Article  Google Scholar 

  • Gazelle, H., & Ladd, G. W. (2003). Anxious solitude and peer exclusion: A diathesis-stress model of internalizing trajectories in childhood. Child Development, 74, 257–278.

    Article  Google Scholar 

  • Hastings, P. D., Nuselovici, J. N., Rubin, K. H., & Cheah, C. S. L. (2010). Shyness, parenting, and parent-child relationships. In K. H. Rubin & R. J. Coplan (Eds.), The development of shyness and social withdrawal in childhood and adolescence. New York, NY: Guilford.

    Google Scholar 

  • Hirshfeld-Becker, D. R., & Biederman, J. (2002). Rationale and principles for early intervention with young children at risk for anxiety disorders. Clinical Child and Family Psychology Review, 5(3), 161–172.

    Article  Google Scholar 

  • Hirshfeld-Becker, D. R., Biederman, J., Henin, A., Faraone, S. V., Davis, S., Harrington, K., & Rosenbaum, J. F. (2007). Behavioral inhibition in preschool children at risk is a specific predictor of middle childhood social anxiety: A five-year follow-up. Journal of Developmental & Behavioral Pediatrics, 28, 225–233.

    Article  Google Scholar 

  • Hirshfeld-Becker, D. R., Masek, B., Henin, A., Blakely, L. R., Pollock-Wurman, R. A., McQuade, J., … Biederman, J. (2010). Cognitive behavioral therapy for 4- to 7-year-old children with anxiety disorders: A randomized clinical trial. Journal of Consulting and Clinical Psychology, 78, 498–510.

    Article  Google Scholar 

  • Hudson, J. L., & Rapee, R. M. (2000). The origins of social phobia. Behavior Modification, 24(1), 102–129.

    Article  Google Scholar 

  • Hymel, S., Rubin, K. H., Rowden, L., & LeMare, L. (1990). Children’s peer relationships: Longitudinal prediction of internalizing and externalizing problems from middle to late childhood. Child Development, 61, 2004–2021.

    Google Scholar 

  • Kaminski, J. W., Valle, L. A., Filene, J. H., & Boyle, C. L. (2008). A meta-analytic review of components associated with parent training program effectiveness. Journal of Abnormal Child Psychology, 36(4), 567–589.

    Article  Google Scholar 

  • Lewis-Morrarty, E., Degnan, K. A., Chronis-Tuscano, A., Rubin, K. H., Cheah, C. S. L., Pine, D. S., … Fox, N. A. (2012). Maternal over-control moderates the association between early childhood behavioral inhibition and adolescent social anxiety symptoms. Journal of Abnormal Child Psychology, 40, 1363–1373.

    Article  Google Scholar 

  • McLeod, B. D., Wood, J. J., & Weisz, J. R. (2007). Examining the association between parenting and childhood anxiety: A meta-analysis. Clinical Psychology Review, 27(2), 155–172.

    Article  Google Scholar 

  • Mills, R. S. L., & Rubin, K. H. (1993). Socialization factors in the development of social withdrawal. In K. H. Rubin & J. Asendorpf (Eds.), Social withdrawal, inhibition, and shyness in childhood. Hillsdale, NJ: Erlbaum.

    Google Scholar 

  • Murray, L., Lau, P. Y., Arteche, A., Creswell, C., Russ, S., Zoppa, L. D., … Cooper, P. (2012). Parenting by anxious mothers: Effects of disorder subtype, context and child characteristics. Journal of Child Psychology and Psychiatry, 53(2), 188–196.

    Article  Google Scholar 

  • Nelson, L. J., Rubin, K. H., & Fox, N. A. (2005). Social withdrawal, observed peer acceptance, and the development of self-perceptions in children ages 4 to 7 years. Early Childhood Research Quarterly, 20(2), 185–200.

    Article  Google Scholar 

  • Niec, L. N., Barnett, M. L., Prewett, M. S., & Shanley Chatham, J. R. (2016). Group parent–child interaction therapy: A randomized control trial for the treatment of conduct problems in young children. Journal of Consulting and Clinical Psychology, 84(8), 682.

    Article  Google Scholar 

  • Oh, W., Rubin, K. H., Bowker, J. C., Booth-LaForce, C. L., Rose-Krasnor, L., & Laursen, B. (2008). Trajectories of social withdrawal middle childhood to early adolescence. Journal of Abnormal Child Psychology, 36, 553–556.

    Article  Google Scholar 

  • Pincus, D. B. (2005). Adapting parent-child interaction therapy for young children with separation anxiety disorder. Education Treatment of Children, 28, 163–181.

    Google Scholar 

  • Puliafico, A. C., Comer, J. S., & Pincus, D. B. (2012). Adapting parent-child interaction therapy to treat anxiety disorders in young children. Child and Adolescent Psychiatric Clinics of North America, 21(3), 607–619.

    Article  Google Scholar 

  • Rapee, R. M., & Jacobs, D. (2002). The reduction of temperamental risk for anxiety in withdrawn preschoolers: A pilot study. Behavioural and Cognitive Psychotherapy, 30, 211–215.

    Article  Google Scholar 

  • Rapee, R. M., Kennedy, S., Ingram, M., Edwards, S. L., & Sweeney, L. (2010). Altering the trajectory of anxiety in at-risk young children. American Journal of Psychiatry, 167, 1518–1525.

    Article  Google Scholar 

  • Rosenbaum, J. F., Biederman, J., Bolduc, E. A., Hirshfeld, D. R., Faraone, S. V., & Kagan, J. (1992). Comorbidity of parental anxiety disorders as risk for childhood-onset anxiety in inhibited children. American Journal of Psychiatry, 149(4), 475–481.

    Article  Google Scholar 

  • Rubin, K. H. (1985). Socially withdrawn children: An “at risk” population? In B. Schneider, K. H. Rubin, & J. Ledingham (Eds.), Children’s peer relations: Issues in assessment and intervention (pp. 125–139). New York, NY: Springer-Verlag.

    Chapter  Google Scholar 

  • Rubin, K. H., Burgess, K. B., & Hastings, P. D. (2002). Stability and social-behavioral consequences of toddlers’ inhibited temperament and parenting. Child Development, 73, 483–495.

    Article  Google Scholar 

  • Rubin, K. H., Chen, X., McDougall, P., Bowker, A., & McKinnon, J. (1995). The Waterloo Longitudinal Project: Predicting adolescent internalizing and externalizing problems from early and mid-childhood. Development and Psychopathology, 7, 751–764.

    Article  Google Scholar 

  • Rubin, K. H., Coplan, R. J., & Bowker, J. C. (2009). Social withdrawal in childhood. Annual Review of Psychology, 60, 141–171.

    Article  Google Scholar 

  • Rubin, K. H., Nelson, L. J., Hastings, P. D., & Asendorpf, J. (1999). The transaction between parents’ perceptions of their children’s shyness and their parenting styles. International Journal of Behavioral Development, 23, 937–958.

    Article  Google Scholar 

  • Stewart, S. L., & Rubin, K. H. (1995). The social problem-solving skills of anxious-withdrawn children. Development and Psychopathology, 7(2), 323–336.

    Article  Google Scholar 

  • Van Der Bruggen, C. O., Stams, G. J. J., & Bögels, S. M. (2008). Research review: The relation between child and parent anxiety and parental control: A meta-analytic review. Journal of Child Psychology and Psychiatry, 49(12), 1257–1269.

    Article  Google Scholar 

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Acknowledgement

This research was funded by NIH R34 MH083832-01 and NIH R01 MH103253-01 awarded to Drs. Chronis-Tuscano and Rubin.

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Authors and Affiliations

  1. University of Maryland, College Park, MD, USA

    Christina M. Danko, Kelly A. O’Brien, Kenneth H. Rubin & Andrea Chronis-Tuscano

Authors
  1. Christina M. Danko
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  2. Kelly A. O’Brien
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  3. Kenneth H. Rubin
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  4. Andrea Chronis-Tuscano
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Corresponding author

Correspondence to Christina M. Danko .

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Editors and Affiliations

  1. Center for Children, Families, and Communities, Department of Psychology, Central Michigan University, Mount Pleasant, MI, USA

    Larissa N. Niec

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Danko, C.M., O’Brien, K.A., Rubin, K.H., Chronis-Tuscano, A. (2018). The Turtle Program: PCIT for Young Children Displaying Behavioral Inhibition. In: Niec, L. (eds) Handbook of Parent-Child Interaction Therapy. Springer, Cham. https://doi.org/10.1007/978-3-319-97698-3_6

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