Skip to main content

Integrating Acceptance and Mindfulness into Treatments for Child and Adolescent Anxiety Disorders

Acceptance and Commitment Therapy as an Example

  • Chapter
Acceptance and Mindfulness-Based Approaches to Anxiety

Part of the book series: Series in Anxiety and Related Disorders ((SARD))

Abstract

In cognitive-behavioral therapy (CBT) for child and adolescent anxiety disorders, negatively evaluated thoughts and emotions are viewed as problematic responses to be managed via control-oriented strategies such as distraction, systematic desensitization, self-instruction, or cognitive restructuring. Within this framework, anxiety is conceptualized as “the problem,” and symptom reduction is a standard index of treatment success. Acceptance- and mindfulness-based therapies such as acceptance and commitment therapy (ACT; Hayes, Strosahl, & Wilson, 1999) differ from standard CBT primarily in their treatment of private events (e.g., thoughts, emotions, physical-bodily sensations, memories).

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 89.00
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 119.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 169.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  • American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders (4th ed. text Rev.). Washington, DC: Author.

    Google Scholar 

  • Barker, P. (1996). Psychotherapeutic metaphors: A guide to theory and practice. Philadelphia: Brunner/Mazel, Inc.

    Google Scholar 

  • Barlow, D. H. (2002). Anxiety and its disorders: The nature and treatment of anxiety and panic (2nd ed.). New York: Guilford Press.

    Google Scholar 

  • Barnes-Holmes, D., Hayes, S. C., & Dymond, S. (2001). Self and self-directed rules. In S. C. Hayes, D. Barnes-Holmes, S. C. Hayes, & B. Roche (Eds.), Relational frame theory; A post-Skinnerian account of human language and cognition (pp. 119–139). New York: Kluwer Academic/Plenum.

    Google Scholar 

  • Barrett, P. M., Dadds, M. R., & Rapee, R. M. (1996). Family treatment of childhood anxiety: A controlled trial. Journal of Consulting and Clinical Psychology, 64, 333–342.

    Article  PubMed  Google Scholar 

  • Barrett, P. M., Duffy, A. L., Dadds, M. R., & Rapee, R. M. (2001). Cognitive-behavioral treatment of anxiety disorders in children: Longer-term (6-year) follow-up. Journal of Consulting and Clinical Psychology, 69, 135–141.

    Article  PubMed  Google Scholar 

  • Barrett, P. M., Rapee, R. M., Dadds, M. R., & Ryan, S. (1996). Family enhancement of cognitive styles in anxious and aggressive children: The FEAR effect. Journal of Abnormal Child Psychology, 24, 187–203.

    Article  PubMed  Google Scholar 

  • Beidal, D. C., Christ, M. A., & Long, P. J. (1991). Somatic complaints in anxious children. Journal of Abnormal Child Psychology, 19, 659–670.

    Article  Google Scholar 

  • Blackledge, J. T. (2002). An introduction to Relational Frame Theory: Basics and applications. The Behavior Analyst Today, 3, 421–433.

    Google Scholar 

  • Blackledge, J. T. (2004). Using acceptance and commitment therapy to support parents of children diagnosed with autism. Unpublished doctoral dissertation, University of Nevada, Reno.

    Google Scholar 

  • Blechman, E. A., Prinz, R. J., & Dumas, J. E. (1995). Coping, competence, and aggression prevention: Developmental model. Applied & Preventive Psychology, 4, 211–232.

    Article  Google Scholar 

  • Boegels, S. M., & Zigterman, D. (2000). Dysfunctional cognitions in children with social phobia, separation anxiety disorder, and generalized anxiety disorder. Journal of Abnormal Child Psychology, 28, 205–211.

    Article  Google Scholar 

  • Chorpita, B. F. (2001). Control and the development of negative emotion. In M. W. Vasey & M. R. Dadds (Eds.), The developmental psychopathology of anxiety (pp. 112–142). Oxford: University Press.

    Google Scholar 

  • Chorpita, B. F., Tracey, S. A., Brown, T. A., Collica, T. J., & Barlow, D. H. (1997). Assessment of worry in children and adolescents: An adaptation of the Penn State Worry Questionnaire. Behaviour Research and Therapy, 35, 569–581.

    Article  PubMed  Google Scholar 

  • Cohen, L. L., Bernard, R. S., Greco, L. A., & C. McClellan. (2002). Using a childfocused intervention to manage procedural pain: Are parent and nurse coaches necessary? Journal of Pediatric Psychology, 27, 749–757.

    Article  PubMed  Google Scholar 

  • Costello, J. E., Mustillo, S., Erkanli, A., Keeler, G., & Angold, A. (2003). Prevalence and development of psychiatric disorders in childhood and adolescence. Archives of General Psychiatry, 60, 837–844.

    Article  PubMed  Google Scholar 

  • Coyne, L. W., & Wilson, K. W. (2004). The role of cognitive fusion in impaired parenting: An RFT analysis. International Journal of Psychology and Psychological Therapy, 4, 469–486.

    Google Scholar 

  • Dadds, M. R., & Barrett, P. M. (1996). Family processes in child and adolescent anxiety and depression. Behaviour Change, 13, 231–239.

    Google Scholar 

  • Dadds, M. R., & Barrett, P. M. (2001). Psychological management of anxiety disorders in childhood. Journal of Child Psychology and Psychiatry and Allied Disciplines, 42, 999–1011.

    Google Scholar 

  • Dadds, M. R., Barrett, P. M., Rapee, R. M., & Ryan, S. (1996). Family process and child anxiety and aggression: An observational analysis. Journal of Abnormal Child Psychology, 24, 715–734.

    Article  PubMed  Google Scholar 

  • Dempsey, M., Overstreet, S., & Moely, B. (2000). “Approach” and “avoidance” coping and PTSD symptoms in inner-city youth. Current Psychology: Developmental-Learning-Personality-Social, 19, 28–45.

    Google Scholar 

  • Durlak, J. A., Fuhrman, T., & Lampman, C. (1991). Effectiveness of cognitive-behavior therapy for maladapting children: Ameta-analysis. Psychological Bulletin, 110, 204–214.

    Article  PubMed  Google Scholar 

  • Fields, L., & Prinz, R. J. (1997). Coping and adjustment during childhood and adolescence. Clinical Psychology Review, 17, 937–976.

    Article  PubMed  Google Scholar 

  • Greco, L. A. (2002, November). Creating a context of acceptance in child clinical and pediatric settings. In G. H. Eifert (Chair), Balancing acceptance and change in the treatment of anxiety disorders. Symposium presented at the Association for the Advancement of Behavior Therapy, Reno, NV.

    Google Scholar 

  • Greco, L. A. (2003, August). Balancing acceptance and change in a family-based behavior therapy for teens. In L. A. Greco (Chair), Acceptance and change in adolescence: understanding and applying RFT/ACT through a developmental Lens. Symposium conducted at the World Conference on ACT, RFT, and the New Wave Behavioral Therapies, Linkoping, Sweden.

    Google Scholar 

  • Greco, L. A., & Eifert, G. H. (2004). Treating parent-adolescent conflict: Is acceptance the missing link for an integrative family therapy? Cognitive and Behavioral Practice, 11, 305–314.

    Article  Google Scholar 

  • Greco, L. A., & Morris, T. L. (2001). Treating childhood shyness and related behavior: Empirically investigated approaches used to promote positive social interactions. Clinical Child and Family Psychology Review, 4, 299–318.

    Article  PubMed  Google Scholar 

  • Greco, L. A., & Morris, T. L. (2002). Paternal child-rearing style and child social anxiety: Investigation of child perceptions and actual father behavior. Journal of Psychopathology and Behavioral Assessment, 24, 259–267.

    Article  Google Scholar 

  • Greco, L. A., Murrell, A. M., & Coyne, L.W. (2004). Willingness and acceptance measure for children and adolescents (WAM-C/A). Available from Laurie Greco, Division of Adolescent Medicine and Behavioral Science, Vanderbilt University Medical Center, Nashville, TN.

    Google Scholar 

  • Hayes, S. C., Barnes-Holmes, D., & Roche, B. (2001). Relational frame theory: Aprecis. In S. C. Hayes, D. Barnes-Holmes, S. C. Hayes, & B. Roche (Eds.), Relational frame theory: A post-Skinnerian account of human language and cognition (pp. 141–154). New York: Kluwer Academic/Plenum.

    Google Scholar 

  • Hayes, S. C., & Gifford, E. V. (1997). The trouble with language: Experiential avoidance, rules, and the nature of verbal events. Psychological Science, 8, 170–173.

    Article  Google Scholar 

  • Hayes, S. C., Masuda, A., Bissett, R., Luoma, J., & Guerrero, L. F. (2004). DBT, FAP, and ACT: How empirically oriented are the new behavior therapy technologies? Behavior Therapy, 35, 35–54.

    Article  Google Scholar 

  • Hayes, S. C., Strosahl, K. D., & Wilson, K. G. (1999). Acceptance and commitment therapy: An experiential approach to behavior change. New York: The Guilford Press.

    Google Scholar 

  • Hayes, S. C., Wilson, K. G., Gifford, E. V., Follette, V. M., & Strosahl, K. (1996). Experiential avoidance and behavioral disorders: A functional dimensional approach to diagnosis and treatment. Journal of Consulting and Clinical Psychology, 64, 1152–1168.

    Article  PubMed  Google Scholar 

  • Heffner, M., Greco, L. A., & Eifert, G. H. (2003). Pretend you are a turtle: Children’s responses to metaphorical and literal instructions during progressive muscle relaxation. Child and Family Behavior Therapy, 25, 19–33.

    Article  Google Scholar 

  • Kardum, I., & Krapic, N. (2001). Personality traits, stressful life events, and coping styles in early adolescence. Personality and Individual Differences, 30, 503–515.

    Article  Google Scholar 

  • Kendall, P. C. (1994). Treating anxiety disorders in children: Results of a randomized clinical trial. Journal of Consulting and Clinical Psychology, 62, 100–110.

    Article  PubMed  Google Scholar 

  • Kendall, P. C., Safford, S., Flannery-Schroeder, E., & Webb, A. (2004). Child anxiety treatment: Outcomes in adolescence and impact on substance use and depression at 7.4-year follow-up. Journal of Consulting and Clinical Psychology, 72, 276–287.

    Article  PubMed  Google Scholar 

  • Laugesen, N., Dugas, M. J., & Bukowski, W. M. (2003). Understanding adolescent worry: The application of a cognitive model. Journal of Abnormal Child Psychology, 31, 55–64.

    Article  PubMed  Google Scholar 

  • Luoma, J., & Hayes, S. C. (2003). Cognitive defusion. In W. T. Donohue, J. E. Fisher, & S. C. Hayes (Eds.), Empirically supported techniques for cognitive behavior therapy: A step by step guide for clinicians (pp. 71–78). New York: Wiley.

    Google Scholar 

  • Manassis, K., Mendlowitz, S. L., Scapillato, D., Avery, D., Fiksenbaum, L., Freire, M., et al. (2002). Group and individual cognitive-behavioral therapy for childhood anxiety disorders: A randomized trial. Journal of the American Academy of Child and Adolescent Psychiatry, 41, 1423–1430.

    Article  PubMed  Google Scholar 

  • Marx, B. P., & Sloan, D. M. (2002). The role of emotion in the psychological functioning of adult survivors of childhood sexual abuse. Behavior Therapy, 33, 563–577.

    Article  Google Scholar 

  • Medvedova, L. (1998). Personality dimensions-“Little Five”-and their relationship with coping strategies in early adolescence. Studia Psychologica, 40, 261–265.

    Google Scholar 

  • Moore, D., Wilson, K. G., Wilson, D. M., Murrell, A. R., Roberts, M., Merwin, R., et al. (2003, May). Treating at-risk youth with an in-school acceptance and commitment training program. Paper presented at the 2003 meeting of Association for Behavior Analysis, San Francisco.

    Google Scholar 

  • Morris, T. L., & Greco, L. A. (2002). Assessment and treatment of childhood anxiety disorders. In L. VandeCreek (Ed.), Innovations in clinical practice: A source book (Vol. 20, pp. 76–86). Sarasota, FL: Professional Resource Press.

    Google Scholar 

  • Muris, P., Kindt, M., Boegels, S., Merckelbach, H., Gadget, B., & Moulaert, V. (2000). Anxiety and threat perception abnormalities in normal children. Journal of Psychopathology and Behavioral Assessment, 22, 183–199.

    Article  Google Scholar 

  • Muris, P., Steerneman, P., Merckelbach, H., & Meesters, C. (1996). The role of parental fearfulness and modeling in children’s fear. Behavioural Research and Therapy, 34, 265–268.

    Article  Google Scholar 

  • Murrell, A. R., Coyne, L. W., & Wilson, K. G. (2004). Acceptance and commitment therapy with children, adolescents, and their parents. In S. C. Hayes & K. Strosahl (Eds.), A practical guide to acceptance and commitment therapy (pp. 249–273). New York: Springer.

    Google Scholar 

  • Peterson, A. C. (1993). Presidential address: Creating adolescents: The role of context and process in developmental trajectories. Journal of Research on Adolescence, 3, 1–18.

    Article  Google Scholar 

  • Rapee, R. M. (1997). Potential role of childrearing practices in the development of anxiety and depression. Clinical Psychology Review, 17, 47–67.

    Article  PubMed  Google Scholar 

  • Rapee, R. M., & Melville, L. F. (1997). Recall of family factors in social phobia and panic disorder: Comparison of mother and offspring reports. Depression and Anxiety, 5, 7–11.

    Article  PubMed  Google Scholar 

  • Schniering, C. A., Hudson, J. L., & Rapee, R. M. (2000). Issues in the diagnosis and assessment of anxiety disorders in children and adolescents. Clinical Psychology Review, 20, 453–478.

    Article  PubMed  Google Scholar 

  • Simons, L., Ducette, J., Kirby, K. C., Stahler, G., & Shipley, T. E. (2003). Childhood trauma, avoidance coping, and alcohol and other drug use among women in residential and outpatient treatment programs. Alcoholism Treatment Quarterly, 21, 37–54.

    Article  Google Scholar 

  • Spence, S. H., Rapee, R., McDonald, C., & Ingram, M. (2001). The structure of anxiety symptoms among preschoolers. Behavior Research and Therapy, 39, 1293–1316.

    Article  Google Scholar 

  • Steele, R. G., Forehand, R., & Armistead, L. (1997). The role of family processes and coping strategies in the relationship between parental chronic illness and childhood internalizing problems. Journal of Abnormal Child Psychology, 25, 83–94.

    Article  PubMed  Google Scholar 

  • Steiner, H., Erickson, S. J., Hernandez, N. L., & Pavelski, R. (2002). Coping styles as correlates of health in high school students. Journal of Adolescent Health, 30, 326–335.

    Article  PubMed  Google Scholar 

  • Titchener, E. B. (1916). A text-book of psychology. New York: MacMillan.

    Google Scholar 

  • Twohig, M. P., & Hayes, S. C. (in press). Implications of verbal processes for childhood disorders: Tourette’s disorder, attention deficit hyperactivity disorder, and autism. In D.W. Woods & J. Kantor (Eds.), Understanding behavior disorders: A contemporary behavioral perspective. Reno, NV: Context Press.

    Google Scholar 

  • Twohig, M. P., Masuda, A., Varra, A. A., & Hayes, S. C. (2005). Acceptance and commitment therapy as a treatment for anxiety disorders. In S. Orsillo & L. Roemer (Eds.), Acceptance-and mindfulness-based approaches to anxiety (pp. 101–129). New York: Springer.

    Google Scholar 

  • Vasey, M. W., & Daleiden, E. L. (1994). Worry in children. In G. Davey & F. Tallis (Eds.), Worrying: Perspectives on theory, assessment, and treatment (pp. 185–207). New York: Wiley.

    Google Scholar 

  • Vygotsky, L. S. (1991). Genesis of the higher mental functions. In P. Light & S. Sheldon (Eds.), Learning to think. Child development in social context (Vol. 2, pp. 32–41). Florence, KY: Taylor & Francis/Routledge.

    Google Scholar 

  • Wicksell, R. K., Olsson, G. L., Dahl, J., & Melin, L. (2004, November). Using ACT to promote rehabilitation among children and adolescents with chronic pain. In L. A. Greco & G. H. Eifert (Cochairs), Using acceptance and commitment therapy (ACT) with children and adolescents: Applications and empirical findings across school, family, and medical settings. Symposium to be conducted at the Association for Advancement of Behavior Therapy, New Orleans, LA.

    Google Scholar 

  • Wilson, K. G., & Blackledge, J. T. (2000). Recent developments in the behavioural analysis of language: Making sense of clinical phenomena. In M. J. Dougher (Ed.), Clinical behavior analysis (pp. 27–46). Reno, NV: Context Press.

    Google Scholar 

  • Wilson, K. G., and Coyne, L. W. (2003, May). Treatment of refractory school refusal using a values-centered ACT approach. Paper presented at the Applied Behavioral Analysis Conference, San Francisco, CA.

    Google Scholar 

  • Wilson, K. G., & Murrell, A. R. (2004). Values-centered interventions: Setting a course for behavioral treatment. In S. C. Hayes, V. M. Follette, & M. Linehan (Eds.), The new behavior therapies: Expanding the cognitive behavioral tradition. New York: Guilford.

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2005 Springer Science+Business Media, LLC

About this chapter

Cite this chapter

Greco, L.A., Blackledge, J.T., Coyne, L.W., Ehrenreich, J. (2005). Integrating Acceptance and Mindfulness into Treatments for Child and Adolescent Anxiety Disorders. In: Orsillo, S.M., Roemer, L. (eds) Acceptance and Mindfulness-Based Approaches to Anxiety. Series in Anxiety and Related Disorders. Springer, Boston, MA. https://doi.org/10.1007/0-387-25989-9_12

Download citation

Publish with us

Policies and ethics