An Attachment-Based Family Therapy for Anxiety and Depression in Children: A Mixed-Methods Evaluation of BEST-Foundations

Background/Objectives: Parent–child attachment and family relationships have been identified as risk factors for childhood internalising symptoms such as anxiety and depressive symptoms. This mixed-methods evaluation examined the feasibility of a recently developed attachment-based family interventi...

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Main Authors: Kim Lee Kho, Andrew J. Lewis, Renita A. Almeida
Format: Article
Language:English
Published: MDPI AG 2024-12-01
Series:Children
Subjects:
Online Access:https://www.mdpi.com/2227-9067/11/12/1552
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author Kim Lee Kho
Andrew J. Lewis
Renita A. Almeida
author_facet Kim Lee Kho
Andrew J. Lewis
Renita A. Almeida
author_sort Kim Lee Kho
collection DOAJ
description Background/Objectives: Parent–child attachment and family relationships have been identified as risk factors for childhood internalising symptoms such as anxiety and depressive symptoms. This mixed-methods evaluation examined the feasibility of a recently developed attachment-based family intervention, Behaviour Exchange Systems Therapy-Foundations (BEST-F), delivering 16 h of therapy over 8 weeks to treat internalising symptoms in children aged between 3 and 11 years. Methods: The quantitative outcomes of this uncontrolled study of 17 families were based on the parent-reported Child Behaviour Checklist (CBCL) measure, completed at four-timepoints (baseline, pre-, post-intervention, and follow-up), while qualitative data were collected from interviews with participants at follow-up. Results: Pre- and post-BEST-F intervention results demonstrated a significant change in internalising symptoms from the borderline and clinical range to the normal range, with a large effect size (<i>d</i> = 0.85). Notably, additional reductions in internalising symptoms were reported two months after cessation of treatment, with a very large effect size (<i>d</i> = 1.85). Furthermore, there were substantial reductions in child externalising symptoms and parental mental health symptoms, with large effect sizes ranging from <i>d</i> = 0.80 to 1.12. Qualitative reports were consistent with these quantitative findings. Conclusions: These pilot results suggest that children presenting with clinical-range internalising symptoms may benefit from family-based approaches where the parent–child relationship is a focus.
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spelling doaj-art-2923d179935d41d0ab7ea11dbe8db6682025-08-20T02:55:49ZengMDPI AGChildren2227-90672024-12-011112155210.3390/children11121552An Attachment-Based Family Therapy for Anxiety and Depression in Children: A Mixed-Methods Evaluation of BEST-FoundationsKim Lee Kho0Andrew J. Lewis1Renita A. Almeida2School of Psychology, Murdoch University, Perth, WA 6150, AustraliaInstitute of Health and Wellbeing, Federation University Australia, Berwick, Melbourne, VIC 3805, AustraliaSchool of Psychology, Murdoch University, Perth, WA 6150, AustraliaBackground/Objectives: Parent–child attachment and family relationships have been identified as risk factors for childhood internalising symptoms such as anxiety and depressive symptoms. This mixed-methods evaluation examined the feasibility of a recently developed attachment-based family intervention, Behaviour Exchange Systems Therapy-Foundations (BEST-F), delivering 16 h of therapy over 8 weeks to treat internalising symptoms in children aged between 3 and 11 years. Methods: The quantitative outcomes of this uncontrolled study of 17 families were based on the parent-reported Child Behaviour Checklist (CBCL) measure, completed at four-timepoints (baseline, pre-, post-intervention, and follow-up), while qualitative data were collected from interviews with participants at follow-up. Results: Pre- and post-BEST-F intervention results demonstrated a significant change in internalising symptoms from the borderline and clinical range to the normal range, with a large effect size (<i>d</i> = 0.85). Notably, additional reductions in internalising symptoms were reported two months after cessation of treatment, with a very large effect size (<i>d</i> = 1.85). Furthermore, there were substantial reductions in child externalising symptoms and parental mental health symptoms, with large effect sizes ranging from <i>d</i> = 0.80 to 1.12. Qualitative reports were consistent with these quantitative findings. Conclusions: These pilot results suggest that children presenting with clinical-range internalising symptoms may benefit from family-based approaches where the parent–child relationship is a focus.https://www.mdpi.com/2227-9067/11/12/1552attachmentattachment-based family interventionfamily therapyattachment-based interventioninternalising symptomschildhood depressive symptoms
spellingShingle Kim Lee Kho
Andrew J. Lewis
Renita A. Almeida
An Attachment-Based Family Therapy for Anxiety and Depression in Children: A Mixed-Methods Evaluation of BEST-Foundations
Children
attachment
attachment-based family intervention
family therapy
attachment-based intervention
internalising symptoms
childhood depressive symptoms
title An Attachment-Based Family Therapy for Anxiety and Depression in Children: A Mixed-Methods Evaluation of BEST-Foundations
title_full An Attachment-Based Family Therapy for Anxiety and Depression in Children: A Mixed-Methods Evaluation of BEST-Foundations
title_fullStr An Attachment-Based Family Therapy for Anxiety and Depression in Children: A Mixed-Methods Evaluation of BEST-Foundations
title_full_unstemmed An Attachment-Based Family Therapy for Anxiety and Depression in Children: A Mixed-Methods Evaluation of BEST-Foundations
title_short An Attachment-Based Family Therapy for Anxiety and Depression in Children: A Mixed-Methods Evaluation of BEST-Foundations
title_sort attachment based family therapy for anxiety and depression in children a mixed methods evaluation of best foundations
topic attachment
attachment-based family intervention
family therapy
attachment-based intervention
internalising symptoms
childhood depressive symptoms
url https://www.mdpi.com/2227-9067/11/12/1552
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