Shaping Bravery in Children and Adolescents with Anxiety and OCD

Epidemiological studies have estimated a lifetime prevalence rate of 28.8% for anxiety disorders (Kessler et al, 2005), and a recent meta-analysis of 87 studies across 44 countries estimated the global current prevalence of anxiety disorders at 7.3% (4.8–10.9%, adjusted for methodological differences across studies; Baxter, Scott, Vos, & Whiteford, 2012).

While exposure-based treatment for anxiety and OCD in youth and adult populations has robust empirical support, there is room for improvement. In terms of outcomes, intent-to-treat analyses suggest that approximately 1 in 5 individuals drop out of exposure treatment (Hofmann and Smits, 2008; Ong et al. 2016), and a significant of proportion of youth either do not improve or relapse (eg Ginsburg et al., 2013; 2018).  Moreover, clinicians are unlikely to use exposure-based treatment even when it is needed (Freihart et al, 2004; Deacon et al., 2013; Sars & Van Minnen, 2015), due to their own experiential avoidance (Meyer et al., 2014; Scher, Herbert & Forman 2015). To complicate matters, simply adding ACT to ERP does not lead to demonstrably improved outcomes (Twohig et al., 2018). So, while exposure works, it could work better, and clinicians could get much more skilled and flexible in its use. Very likely, this will take a patient-centered “microanalytic approach” (Twohig et al., 2018) to improve outcomes of exposure-based approaches for individual clients in their specific contexts.

This workshop for clinicians with some experience with either Acceptance and Commitment Therapy (ACT) or Exposure and Response Prevention (ERP) will explore how to use ACT to enhance exposure-based treatment with children and adolescents through supporting curiosity, willingness, flexibility, and values-guided action.

Specifically, the presenter will discuss how to incorporate specific ACT strategies into exposure to strengthen inhibitory learning in exposure-based treatment. Clinical examples will be used to illustrate therapeutic techniques, in addition to the workshop’s didactic content. 

Learning objectives

After this presentation, participants will be able to:

1. Describe how an approach to exposure based on ACT differs from exposure conducted from a traditional habituation rationale
2. Engage child and adolescent clients clients using valuing as action and direction to “contextualize” exposure and place exposure-based tasks under appetitive control
3. Describe the DNA-V model and the three functional classes of behavior it addresses

Method of use

On-demand courses consist of recorded video lessons. Once purchased, you will find it available in your Reserved Area and you can follow it as many times as you like for 12 months from the date of purchase. From desktop, tablet, smartphone.