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Attachment-based family intervention for childhood anxiety and depression: A mixed methods evaluation

Kho, Kim Lee (2020) Attachment-based family intervention for childhood anxiety and depression: A mixed methods evaluation. Professional Doctorate thesis, Murdoch University.

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Parent-child attachment and family relationships significantly contribute to the development of childhood depression and anxiety disorders. However, clinical applications of such findings are currently limited. The overarching objective of this dissertation was to conduct a pilot trial and examine the feasibility of a novel attachment-based family intervention, Behaviour Exchange Systems Therapy- Foundations (BEST-F) in treating internalising symptoms of depression and anxiety disorders in children aged between 3 and 11 years. The first study systematically reviewed studies to describe core features of existing psychological interventions referring to themselves as ‘attachment-based’, which revealed that there were limited attachment-based interventions primarily aimed at improving child and adolescent mental health outcomes. Empirical study two reported quantitative outcomes of an uncontrolled study of 17 families who undertook BEST-F based on parent-report CBCL measures completed at four-timepoints (baseline, pre-, post-intervention, and follow-up). Empirical study three explored qualitative outcomes reported by participants. Results suggested that BEST-F reduced child internalising symptoms by 1 to 1.2 standard deviations, and moved children from the borderline clinical to normal range. Notably, additional reduction in symptoms were reported two months after cessation of treatment. Furthermore, there were reductions in child externalising symptoms and other problems, parental mental health symptoms and disorganised caregiving behaviours. Qualitative reports suggested that participants derived considerable benefits at both dyadic and systemic levels. Finally, translational study four evaluated a BEST training program to ensure effective dissemination of the intervention model to clinical practice. Results revealed that the training was well-received and trainees reported further development in clinical skills including family systems approach, risk assessment and management, and facilitation skills. The findings add to the limited body of literature on attachment-based family interventions designed to treat childhood depression and anxiety disorders.

Item Type: Thesis (Professional Doctorate)
Murdoch Affiliation(s): Psychology, Counselling, Exercise Science and Chiropractic
United Nations SDGs: Goal 3: Good Health and Well-Being
Supervisor(s): Lewis, Andrew, Almeida, Renita and Lewis, Raylene
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