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Parent-Assisted Cognitive-Behavioural Therapy for Children's Nighttime Fear

Published online by Cambridge University Press:  20 November 2014

Sandra E. Stewart  and
Jocelynne E. Gordon
Sandra E. Stewart*
Affiliation:
Monash University, Melbourne, Victoria, Australia
Jocelynne E. Gordon
Affiliation:
Monash University, Melbourne, Victoria, Australia
*
Address for correspondence: Sandra E. Stewart, Lecturer, Faculty of Education, Monash University, PO Box 6, Clayton VIC Australia, 3800. E-mail: [email protected]
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Abstract

Nighttime fear, including fear of monsters and the dark, is common. For most children and adolescents, nighttime fears are transient. However, approximately 10% experience severe nighttime fear that negatively impacts sleep, adjustment, and family life. Research conducted in the 1980s indicates that cognitive-behavioural therapy can reduce nighttime fear in as few as three sessions. The aims of the present study were to replicate and extend earlier research by evaluating a cognitive-behavioural treatment package for children's severe nighttime fear, and address methodological issues in previous studies. A manualised, multi-component treatment package was developed, based on current evidence-based practice for the treatment of children's anxiety. Interventions included graded exposure, muscle relaxation, cognitive restructuring, and social and material reinforcement. Treatment was individually tailored and delivered via weekly modules. A multiple baseline across-subjects design was utilised. Four ‘families’ — one parent and one child — participated; children's ages ranged from 6 to 10 years. Families attended five weekly intervention sessions and a 1-month follow-up. Multiple outcome measures were administered pre- and post-treatment. All children displayed changes consistent with reduced nighttime fear following treatment, including fewer phobic symptoms, reduced general fear, and improved nighttime and general behaviour. These changes were maintained at follow-up. Parents reported a high degree of satisfaction with the program and would recommend it to other families. The results support the effectiveness of manualised, parent-assisted treatment for nighttime fear in as few as three sessions. In cases of severe nighttime fear, therapist support is recommended. Treatment implications for children with complex presentations are discussed.

Keywords

nighttime feartreatment manualcognitive-behavioural therapychildanxietysleep
Type
Standard Papers
Information
Behaviour Change , Volume 31 , Issue 4 , December 2014 , pp. 243 - 257
Copyright
Copyright © The Author(s) 2014 

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References

Achenbach, T.M., & Rescorla, L.A. (2001). Manual for the ASEBA school-age forms and profiles. Burlington, VT: University of Vermont, Research Center for Children, Youth, and Families.Google Scholar
American Psychiatric Association (APA). (2000). Diagnostic and statistical manual of mental disorders (4th ed.). Washington, DC: Author.Google Scholar
Bandura, A. (1977). Social learning theory. Engelwood Cliffs, NJ: Prentice Hall.Google Scholar
Bauer, D.H. (1976). An exploratory study of the developmental changes in children's fears. Journal of Child Psychology & Psychiatry, 17, 69–74.Google Scholar
Carillo, X.M., Amoros, M.O., & Alacazar, A.I.R. (2005). Los tratamientos psicologicos en la fobia a la ascuridad: Una revision cuantitativa. Anales de Psicologia, 21 (1), 73–82.Google Scholar
Chorpita, B.F. (2007). Modular cognitive-behavioral therapy for childhood anxiety disorders. New York: Guilford.Google Scholar
Cortesi, F., Giannotti, F., Sebastiani, T., Vagnoni, C., & Marioni, P. (2008). Cosleeping versus solitary sleeping in children with bedtime problems: Child emotional problems and parental distress. Behavioral Sleep Medicine, 6 (2), 89–105. doi: http://dx.doi.org/10.1080/15402000801952922Google Scholar
Ferrari, M. (1986). Fears and phobias in childhood: Some clinical and developmental considerations. Child Psychiatry and Human Development, 17 (2), 75–87.CrossRefGoogle ScholarPubMed
Friedman, A.G., & Ollendick, T.H. (1989). Treatment programs for severe nighttime fears: A methodological note. Journal of Behavior Therapy and Experimental Psychiatry, 20 (2), 171–178.CrossRefGoogle Scholar
Gates, L., Lineberger, M.R., Crockett, J., & Hubbard, J. (1988). Birth order and its relationship to depression, anxiety, and self-concept test scores in children. Journal of Genetic Psychology, 149 (1), 29–34.Google Scholar
Giebenhain, J.E., & O’Dell, S.L. (1984). Evaluation of a parent-training manual for reducing children's fear of the dark. Journal of Applied Behavior Analysis, 17 (1), 121–125.Google Scholar
Gordon, J., & King, N. (2002). Children's night-time fears: An overview. Counselling Psychology Quarterly, 15 (2), 121–132.Google Scholar
Gordon, J., King, N., Gullone, E., Muris, P., & Ollendick, T. (2007a). Nighttime fears of children and adolescents: Frequency, content, severity, harm, expectations, disclosure, and coping behaviours. Behaviour Research and Therapy, 45, 2464–2472.Google Scholar
Gordon, J., King, N., Gullone, E., Muris, P., & Ollendick, T. (2007b). Treatment of children's nighttime fears: The need for a modern randomised control trial. Clinical Psychology Review, 27 (1), 98–113.Google Scholar
Gravetter, F.J., & Wallnau, L.B. (2004). Statistics for the behavioural sciences. Belmont, CA: Wadsworth.Google Scholar
Graziano, A., & Mooney, K. (1980). Family self-control instruction for children's nighttime fear reduction. Journal of Consulting and Clinical Psychology, 48 (2), 206–213.Google Scholar
Graziano, A.M., & Mooney, K.C. (1982). Behavioral treatment of nightfears in children: Maintenance of improvement at 2 1/2 to 3 year follow-up. Journal of Consulting and Clinical Psychology, 50 (4), 598–599.Google Scholar
Graziano, A., Mooney, K., Huber, C., & Ignasiak, D. (1979). Self-control instruction for children's fear-reduction. Journal of Behavior Therapy and Experimental Psychiatry, 10, 221–227.Google Scholar
Gullone, E., & King, N. (1992). Psychometric evaluation of a Revised Fear Survey Schedule for Children and Adolescents. Journal of Child Psychology & Psychiatry, 33 (6), 918–998.Google Scholar
Gullone, E., & King, N. (1993). The fears of youth in the 1990s: Contemporary normative data. Journal of Genetic Psychology, 154 (2), 137–153.Google Scholar
Gullone, E., King, N., Tonge, B., & Heyne, D. (2000). The Fear Survey Schedule for Children-II (FSSC-II): Validity data as a treatment outcome measure. Australian Psychologist, 35 (3), 238–243.Google Scholar
Herson, M., & Bellack, A.S. (Eds.). (2002). Dictionary of behavioral assessment techniques. New York: Pergamon Press.Google Scholar
Kanfer, F.H., Karoly, P., & Newman, A. (1975). Reduction of children's fear of the dark by competence-related verbal cues. Journal of Consulting and Clinical Psychology, 43 (2), 251–258.Google Scholar
Kazdin, A.E. (1982). Single-case research designs: Methods for clinical and applied settings. New York: Oxford University Press.Google Scholar
Kazdin, A.E. (2001). Behaviour modification in applied settings. Belmont, CA: Wadsworth.Google Scholar
Kendall, P. (1992). Anxiety disorders in youth. Needham Heights, MA: Allyn and Bacon.Google Scholar
King, N., Cranstoun, F., & Josephs, A. (1989). Emotive imagery and children's nighttime fears: A multiple baseline evaluation. Journal of Behavior Therapy and Experimental Psychiatry, 20 (2), 125–135.CrossRefGoogle Scholar
King, N., Heyne, D., & Ollendick, T.H. (2005). Cognitive-behavioral treatments for anxiety and phobic disorders in children and adolescents: A review. Behavioral Disorders, 30 (3), 241–257.Google Scholar
King, N., Ollendick, T.H., & Tonge, B. (1997). Children's nighttime fears. Clinical Psychology Review, 17 (4), 431–443.Google Scholar
Kushnir, J., & Sadeh, A. (2010). Childhood fears, neurobehavioral functioning and behavior problems in school-age children. Child Psychiatry and Human Development, 41 (1), 88–97. doi:http://dx.doi.org/10.1007/s10578-009-0154-9Google Scholar
Kushnir, J., & Sadeh, A. (2011). Sleep of preschool children with night-time fears. Sleep Medicine, 12 (9), 870–874.Google Scholar
Lyneham, H.J., Abbott, M.J., Wignall, A., & Rapee, R.M. (2003a). The Cool Kids Program — Children's workbook. Sydney, Australia: Macquarie University Anxiety Research Unit.Google Scholar
Lyneham, H.J., Abbott, M.J., Wignall, A., & Rapee, R.M. (2003b). The Cool Kids Program — Parent's workbook. Sydney, Australia: Macquarie University Anxiety Research Unit.Google Scholar
Lyneham, H.J., Abbott, M.J., Wignall, A., & Rapee, R.M. (2003c). The Cool Kids Program-Therapist Manual. Sydney, Australia: Macquarie University Anxiety Research Unit.Google Scholar
Manassis, K., Mendlowitz, S., Scapillato, D., Avery, D., Fiksenbaum, L., Freire, M., . . . Owens, M. (2002). Group and individual cognitive-behavioral therapy for childhood anxiety disorders: A randomized trial. Journal of the American Academy of Child and Adolescent Psychiatry, 41 (12), 1423–1430.Google Scholar
McMenamy, C., & Katz, R.C. (1989). Brief parent-assisted treatment for children's nighttime fears. Journal of Developmental and Behavioral Pediatrics, 10, 145–148.Google Scholar
Muris, P., & Merckelbach, H. (2000). How serious are common childhood fears? II. The parents’ point of view. Behaviour and Research Therapy, 38, 813–818.Google Scholar
Muris, P., Mercklebach, H., Ollendick, T. H., King, N.J., & Bogie, N. (2001). Children's nighttime fears: Parent-child ratings of frequency, content, origins, coping behaviors and severity. Behavior Research and Therapy, 39 (1), 13–28.Google Scholar
Ollendick, T.H. (1983). Reliability and validity of the Revised Fear Survey for Children (FSSC-R). Behavior Research and Therapy, 21 (6), 685–692.Google Scholar
Ollendick, T.H., Hagopian, L.P., & Huntzinger, R.M. (1991). Cognitive-behavior therapy with nighttime fearful children. Journal of Behavior Therapy and Experimental Psychiatry, 22, 113–121.Google Scholar
Ollendick, T.H., & Hersen, M. (1993). Handbook of child and adolescent assessment. Boston: Allyn & Bacon.Google Scholar
Rapee, R.M., Wignall, A., Hudson, J.L., & Schniering, C.A. (2000). Treating anxious children and adolescents: An evidence-based approach. Oakland, CA: New Harbinger Publications.Google Scholar
Sadeh, A. (2005). Cognitive-behavioral treatment for childhood sleep disorders. Clinical Psychology Review, 25 (5), 612–628.Google Scholar
Silverman, W.K., & Treffers, P.D.A. (Eds.). (2001). Anxiety disorders in children and adolescents: Research, assessment and intervention. Cambridge, UK: Cambridge University Press.Google Scholar
Wood, J., Piacentini, J., Southam-Gerow, M., Chu, B., & Sigman, M. (2006). Family cognitive behavioral therapy for child anxiety disorders. Journal of the American Academy of Child and Adolescent Psychiatry, 45 (3), 314–321.Google Scholar