Building Confidence: Family Cognitive Behavioral Therapy for Child Anxiety Disorders

Problem(s) Addressed by Treatment
Social Phobia
Generalized Anxiety Disorder
Separation Anxiety Disorder
Obsessive-Compulsive Disorder
Other: Simple Phobia


Program Summary
Building Confidence is a family-based cognitive behavioral therapy treatment (CBT) program for children ages 6 to 13 years with anxiety disorders, and their parents. Building Confidence emphasizes parent communication training, with the specific goal of reducing parental intrusiveness and increasing child autonomy in relation to parents.

Program Evaluation/Results
In a study undertaken between 2000 and 2003, the research team compared Building Confidence with a traditional, individual child-focused CBT treatment program (CCBT), with the aim of determining the impact of parent training on child anxiety.

Referred by school psychologists, principals, and a medical center-based child anxiety clinic, 40 children and their parents were randomly assigned to either Building Confidence or CCBT. All children were suffering from one of the following anxiety disorders: separation anxiety disorder (SAD), general anxiety disorder (GAD) or social phobia.

Both study conditions included 12 to 16 weekly therapy sessions. Sessions included coping skills and in vivo exposure. However, Building Confidence also included parenting education, communication skills, relaxation techniques, and, in optional modules, family therapy in setting up and hosting “playdates” (or get-togethers) with peers, problem solving, and exploring new roles for the child.

Participating children and parents completed assessment instruments at baseline, midtreatment (typically after session 7), and post-treatment. An independent evaluator, blind as to treatment condition, conducted semi-structured diagnostic interviews at pre- and posttreatment.

At posttreatment, both groups demonstrated improvement on all outcome measures. However, participation in Building Confidence was associated with greater improvement on independent evaluators’ ratings and parent reports compared to CCBT. Ratings of anxiety disorder severity were significantly lower in the Building Confidence condition than in CCBT. In addition, significantly more children in Building Confidence (79%) than in CCBT (21%) were rated as very much better or completely recovered by the independent evaluator at posttreatment assessment.


Age Range
6-10 years
11-14 years


Treatment Components
Adult/Family Involvement
Individual Therapy
Intersession Assignment (homework)
Other: Family Therapy

Treatment Participants
Child-parent dyad


Duration of Treatment
12-16 Weeks, 12-16 Sessions (60-80 minutes each)

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

Staffing Requirements/Training

Sessions can be conducted by: Clinical psychologists and clinical psychology doctoral students. Therapists need extensive previous CBT training and experience.

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 $335 and includes:

1 CEDETA User's Guide 1 Treatment manual for use with families (see Child Anxiety Disorders)
1 copy of How to Talk so Kids Will Listen and Listen So Kids Will Talk (Faber & Mazlish, 2004) 1 copy of Good Friends are Hard to Find (Frankel, 1996). Please note this book is currently out of print (the copy enclosed is a used book)
1 Therapist’s reference copy of Parent Manual 1 Photocopy master of the Parent Manual
Photocopy masters of the Children’s Illustrations Photocopy masters of the Children’s Challenges
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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