Helping Your Anxious Child: Bibliotherapy for Children with Anxiety Disorders Using Written Materials for Parents

Problem(s) Addressed by Treatment
Specific Phobia
Social Phobia
Generaized Anxiety Disorder
Separation Anxiety Disorder
Obsessive-Compulsive Disorder
Other: Panic Disorder

Program Summary
Helping Your Anxious Child (HYAC) is a bibliotherapy outreach program based on a group cognitive-behavioral treatment program, the Cool Kids Child and Adolescent Anxiety Management Program. HYAC uses a parent-as-therapist model to assist children between 6 and 12 years of age in learning to manage their anxiety; including phobias, generalized anxiety, separation anxiety, social anxiety, obsessive-compulsive disorder, and panic attacks.

HYAC materials (book for parent and workbook for child) contain a structured course of readings and activities to help parents better understand child anxiety and teach their child to manage his or her anxiety. Children’s activities and practice tasks cover skills such as cognitive restructuring, gradual exposure, problem solving, social skills, assertiveness, and dealing with teasing. The program also covers more effective parenting strategies. Over 10-12 sessions, the parent and child work on the program in tandem over a 3 to 4 month period (some families require more time to master the skills). It is recommended that therapists monitor and assist with implementation of the program via telephone, email, or personal consultation.

Program Evaluation/Results
HYAC has been evaluated in two published randomized controlled trials. In the first study use of the bibliotherapy materials with no additional support was evaluated in a randomized comparison of bibliotherapy, standard face-to-face group treatment and a no treatment control. Findings indicated that bibliotherapy (26% anxiety diagnosis free) was better than no treatment (7% anxiety diagnosis free), however, bibliotherapy was not as efficacious as face-to-face treatment (61% anxiety diagnosis free).

The most recent study (and the focus of this replication kit) investigated the additional benefit of therapist contact with a family during bibliotherapy. The study was conducted with 100 anxiety disordered children, ages 6-12, and their parents from rural and remote communities. Families were randomized into one of four conditions: telephone contact, email contact, client-initiated contact, and waitlist control. Treatment conditions and waitlist lasted for a 12-week period. Assessments were conducted at baseline, post-treatment, and 12 months after the post-treatment assessment.

At post-treatment, compared to waitlist children, a significant reduction in symptoms was shown for children in all three of the study conditions, with the telephone sessions resulting in a greater reduction in symptom severity rating. Post-treatment comparisons also found that 79% of children in the telephone condition were free of an anxiety disorder compared with children in the email (33%) and client initiated (31%) conditions; and the percentage of children who returned to normal range of scores was greater for treatment groups compared to waitlist groups.

The study authors concluded that bibliotherapy with therapist contact is effective in the treatment of anxiety disorders in primary school children and provides a realistic service option for rural families who would normally not be able to access services without significant time and resource commitment.

It should be noted that the descriptions and instructions below have been updated to reflect the second edition of the treatment materials released in 2008. The treatment authors have advised that the second edition reflects minor changes to the original program that were based on therapist experiences in the two studies described above. Changes included increased number of examples, increased detail on applying anxiety management skills to complex presentations and one additional session of therapist time.

Age Range
6-10 years
11-14 years

Treatment Components
Adult/Family Involvement


Treatment Participants


Duration of Treatment
Home: 12 Weeks, 10 Sessions (up to 2 hours each)
Phone: 12 Weeks, 10 Sessions (up to 30 minutes each)

Treatment Providers
Licensed Professionals
Trainees (Graduate Student, Intern, Post-Doc)
Others (Parents)

Staffing Requirements/Training

Helping Your Anxious Child is administered by the parents of anxious children.

Therapeutic support can be provided by: Licensed professionals or clinical trainees under direct supervision of licensed professionals. There is no specific training required to implement this treatment program, but it is strongly recommended that therapists be trained in cognitive behavioral procedures and experienced in working with children and families.

It is intended that this program be implemented by mental health professionals with appropriate education, training, credentialing, and experience treating the target population.

Availability of Treatment Program Materials
Replication kit including all treatment program materials available for purchase from Sociometrics.



The CEDETA Treatment Package for this program costs $315 and includes:

1 CEDETA User's Guide 1 copy of the book Helping Your Anxious Child: A Step-by-Step Guide for Parents
1 Child workbook 1 Therapist manual
1 Reference copy of the age-appropriate PedsQL™ instruments

Sociometrics CEDETA materials are restricted to qualified purchasers in accordance with the ethical and professional standards of the American Psychological Association. CEDETA materials are therefore, only available for purchase by mail, phone or fax. For further details, see the purchaser requirements, or click below to download a qualification/order form.

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