CBT for anxious children focuses on dysfunctional cognitions (misperceptions of environmental threats and/or one's ability to cope) and how these affect the child's subsequent emotions and behavior. ICBT aims to help children develop new skills to cope with their specific circumstances, facilitates new experiences to test dysfunctional as well as adaptive beliefs, and assists in the processing of such experiences. Modeling and direct reinforcement are used to facilitate the child's learning of new approach behaviors, and cognitive strategies address processes such as information processing style, attributions, and self-talk. Although ICBT has been found effective in helping children to build emotional resilience, children also learn by observing and helping others. As such, group-based CBT (GCBT) programs have been developed based on peer and experiential learning models. Learning in a group context provides a safe and familiar environment in which participants can gain peer support, work in partnership, and practice newly learned skills in fun ways.
In addition to a child's social network, the family is considered to be a favorable environment for effecting change in the child's dysfunctional cognition. Therefore, CBT-based family anxiety management (FAM) training programs have also been developed to incorporate family-directed problemsolving strategies. In addition to helping parents recognize and effectively manage their own emotional distress, and identify behaviors that may advance or sustain their child's anxiety, parents are taught to utilize their own strengths as care-providers by assisting their children to practice newly developed coping skills, facilitate new experiences for children to test dysfunctional beliefs, and provide positive reinforcement. While parents typically participate in FAM training as a supplement to their child's ICBT or GCBT involvement, FAM can also be conducted without child participation (parents only) or with the family unit as a whole (parents and children participating as a collaborative "team").
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