To Parents of Anxious Children: You May Hold a Key

We have all seen the headlines: rates of anxiety among children and adolescents are at an all-time high, while the availability of effective, qualified therapists to treat them is at an all-time low. Overscheduled, stressed-out, social media-saturated lives tax already vulnerable nervous systems and can wreak havoc on developing brains and bodies. As I learned at the Anxiety and Depression Association of America’s conference earlier this year, the parents are also not alright. In 2024 the U.S. surgeon general warned that parenting stress is a serious health issue. What’s more, because anxiety disorders have a moderate to strong heritability rate, that means many families with anxious kids also have anxious parents. It’s no wonder parents of anxious kids find themselves at wits’ end.

While the gold standard in therapy for anxiety and OCD has long been cognitive behavioral therapy (CBT), there’s another empirically supported yet still relatively lesser known treatment on the scene, which not only lowers anxiety in kids but also lowers anxiety in parents. The treatment, called Supportive Parenting of Anxious Childhood Emotions, or SPACE, is a treatment for child and adolescent anxiety and OCD…with a twist. Instead of the child attending sessions, the therapy is delivered through the parents. Yet, even though a child may never attend a single session of SPACE, reductions in anxiety and OCD symptoms have shown to be equal to what we see through CBT where the child is in the patient’s seat.

This standalone treatment, developed by Dr. Eli Lebowitz at the Yale Child Study Center, focuses on changing parent–not child–behavior by teaching parents how to disrupt unhelpful responses to child symptoms of anxiety while maintaining a loving and supportive stance toward their child. Data show that 97-99% of parents of children diagnosed with an anxiety disorder or OCD participate in their child’s symptoms and/or modify family routines in order to accommodate their child’s anxiety. While perfectly natural and well-meaning, this kind of parent response is associated with worse outcomes for the anxious child and a higher burden experienced by the family. In other words, well-meaning efforts by parents of anxious kids often translates to worse anxiety for kids and more exhaustion for parents. The result of SPACE treatment is a child who feels less anxious and more confident, and parents who know how to support their child better while ultimately doing less work. 

I find the SPACE protocol to be particularly rewarding in my work with families because it combines my experience in treating child anxiety and OCD with my love for working with parents who are doing the best they can but feeling exasperated by parenting an anxious child. One of my favorite things about SPACE is that I can confidently tell parents at the outset of treatment that I will not ask them to make their child do anything (or to stop doing anything). It’s a huge relief to parents who know all too well how impossible it is to make an anxious child stop acting anxious. I love seeing parents watch their children become better able to cope with anxiety while at the same time becoming more confident in their own ability to parent an anxious child. It is a parallel process with so many payoffs. As one parent recently said when I explained her child’s anxiety and her anxiety should be lower after treatment, “it’s a twofer!” It is. And I’ll take anything that can help kids and parents both get relief. 

Emily Berner, LMFT, is a pediatric anxiety and OCD specialist and is certified in SPACE treatment. She is a partner at the San Francisco Bay Area Center for Cognitive Therapy and works as a consultant with the Yale Child Study Center’s Anxiety and Mood Disorders Program to help train other therapists pursuing their certification in SPACE. Find her at www.sfbacct.com. 

Emily Berner, MFT (she/her/hers)
Licensed Marriage and Family Therapist MFT81533
San Francisco Bay Area Center for Cognitive Therapy
5464 College Ave Suite C
510-652-4455 Ext. 5
eb@sfbacct.com
sfbacct.com