Topic: Anxiety, Parenting
Target Population: Adolescents, Middle Childhood, Parents
Sector: Community-Based
This program is for families with children who are 7 to 17 years old and have been diagnosed with an anxiety disorder or have reported symptoms of anxiety and their parents.
Cool Kids (Family Version), a family- and community-based, group-treatment program, is designed to help parents recognize and manage their child’s anxiety issues and help youth cope with their anxiety.
Results from an internal, randomized control trial found that children in the program reported lower levels of fear and anxiety, and mothers and fathers in the program reported lower levels of child internalizing behaviors. All effects were maintained at the 12-month follow-up except for child anxiety levels. However, results suggest that, with a larger sample, this effect may have reached significance. Results from an external evaluation of the Danish version of the program indicated that positive effects on anxiety diagnoses and anxiety symptoms were found at posttest and at the 3- and 12-month follow-ups.
Cool Kids follows basic principles of Cognitive Behavioral Therapy. In this program, parents and children learn how to identify emotion and anxiety, engage in realistic thinking, implement strategies to manage anxiety, identify cues that induce fear, and improve social skills. Families meet in groups, and parents and children receive information on anxiety and formal cognitive restructuring. To utilize the information, children complete homework activities that are monitored by parents, and parents are taught strategies to help them handle anxiety-related behaviors. Sessions cover the following topics:
At the beginning of each session, parents and children meet with program therapists to review and discuss the homework activity assigned during the previous session. Next, parents and children individually meet with therapists to review the topic for the current session. Then, the parents and children meet as a group to discuss the homework activity assigned for the next session. Adaptations of the Cool Kids program have been made for youth who have been diagnosed with social anxiety disorder, attention-deficit/hyperactivity disorder, and autism spectrum disorder.
Cool Kids was developed in Australia and has been implemented since 1993.
Facilitators should have a minimum of a 4-year undergraduate or 2-year postgraduate degree in health or education and should be trained in cognitive behavioral therapy. Training and accreditation are required to facilitate this program. A 5- to 6-hour, online training course costs $300 per person, completion of accreditation costs $300 per person, and materials cost $99.95. Please contact ceh.info@mq.edu.au to learn more.
Considerations for implementing this program include recruiting and retaining qualified facilitators and arranging for them to complete training and accreditation, acquiring parent and child buy-in, ensuring program sessions are delivered with fidelity, locating space to hold program sessions, and possibly providing child care during sessions for younger children.
The Clearinghouse can help address these considerations. Please call 1-877-382-9185 or email Clearinghouse@psu.edu
If you are interested in implementing Cool Kids (Family Version), the Clearinghouse is interested in helping you!
Please call 1-877-382-9185 or email Clearinghouse@psu.edu
Parents and children attend 10-weekly, 2-hour sessions.
To implement this program, the facilitator will need the Cool Kids Anxiety Program Kit, which includes a therapist manual and one copy each of the parent and child workbooks. Each participant will require his or her own workbook. Please use details in the Contact section for specific information on costs.
The Clearinghouse can help you develop an evaluation plan to ensure the program components are meeting your goals. Please call 1-877-382-9185 or email Clearinghouse@psu.edu
Contact the Clearinghouse with any questions regarding this program.
Phone: 1-877-382-9185 Email: Clearinghouse@psu.edu
You may also contact the Macquarie University Emotional Health Clinic by mail Australian Hearing Hub, Level 1, 16 University Ave., Wallumattagal Campus, North Ryde, phone +61 (2) 9850 8711, email ehc.admin@mq.edu.au, or visit https://www.mq.edu.au/research/research-centres-groups-and-facilities/centres/lifespan-health-and-wellbeing/emotional-health-clinic/treatment-programs-for-children-and-teens/cool-kids
Arendt, K., Thastum, M., & Hougaard, E. (2016). Efficacy of a Danish version of the Cool Kids program: A randomized wait-list controlled trial. Acta Psychiatrica Scandinavica, 133(2), 109-121. https://doi.org/10.1111/acps.12448
Hudson, J. L., Rapee, R. M., Deveney, C., Schniering, C. A., Lyneham, H. J., & Bovopoulos, N. (2009). Cognitive-behavioral treatment versus an active control for children and adolescents with anxiety disorders: A randomized trial. Journal of the American Academy of Child and Adolescent Psychiatry, 48(5), 533-544. https://doi.org/10.1097/CHI.0b013e31819c2401
Rapee, R. M. (2000). Group treatment of children with anxiety disorders: Outcome and predictors of treatment response. Australian Journal of Psychology, 52(3), 125-129. https://doi.org/10.1080/00049530008255379
Rapee, R. M. (2003). The influence of comorbidity on treatment outcome for children and adolescents with anxiety disorders. Behaviour Research and Therapy, 41(1), 105-112. https://doi.org/10.1016/S0005-7967(02)00049-9
Rapee, R. M., Abbott, M. J., & Lyneham, H. J. (2006). Bibliotherapy for children with anxiety disorders using written materials for parents: A randomized controlled trial. Journal of Consulting and Clinical Psychology, 74(3), 436-444. https://doi.org/10.1037/0022-006X.74.3.436
Zikopoulou, O., Rapee, R. M., & Simos, G. (2021). A randomized controlled trial of a cognitive behavior therapy program for children with clinical anxiety symptoms. Psychiatry International, 2(2), 211-223. https://doi.org/10.3390/psychiatryint2020016
Agersnap, T. N., Hougaard, E., Jensen, M. B., & Thastum, M. (2022). Diagnosis-specific group CBT treating social anxiety in adolescents: A feasibility study. Scandinavian Journal of Child and Adolescent Psychiatry and Psychology, 10(1), 89-101. https://doi.org/10.2478/sjcapp-2022-0010
Breinholst, S., Walczak, M., Christiansen, B., & Esbjørn, B. (2021). A therapist-guided parent-delivered self-help group for anxiety disorders in children: An effectiveness study. Journal of Behavioral and Cognitive Therapy, 31(2), 105-113. https://doi.org/10.1016/j.jbct.2020.11.008
Kilburn, T. R., Sørensen, M., Thastum, M., Rapee, R. M., Rask, C. U., Arendt, K., & Thomsen, P. H. (2019). Group-based cognitive behavioural therapy for anxiety disorder in children with autism spectrum disorder: A feasibility study. Nordic Journal of Psychiatry, 73(4-5), 273-280. https://doi.org/10.1080/08039488.2019.1622153
Kilburn, T. R., Sørensen, M. J., Thastum, M., Rapee, R. M., Rask, C. U., Arendt, K. B., … Thomsen, P. H. (2023). Group based cognitive behavioural therapy for anxiety in children with autism spectrum disorder: A randomised controlled trial in a general child psychiatric hospital setting. Journal of Autism and Developmental Disorders, 53(2), 525-538. https://doi.org/10.1007/s10803-020-04471-x
Lassen, N. F., Hougaard, E., Arendt, K. B., & Thastum, M. (2019). A disorder-specific group cognitive behavior therapy for social anxiety disorder in adolescents: Study protocol for a randomized controlled study. Current Controlled Trials in Cardiovascular Medicine, 20(1), 757-757. https://doi.org/10.1186/s13063-019-3885-3
Leigh, L. H., Doyle, F. L., & Hudson, J. L. (2022). Increasing the efficacy of treatment for socially anxious youth through theoretically derived improvements: A pilot study. Child Psychiatry and Human Development, https://doi.org/10.1007/s10578-022-01351-6
Rapee, R. M., McLellan, L. F., Carl, T., Trompeter, N., Hudson, J. L., Jones, M. P., & Wuthrich, V. M. (2022). Comparison of transdiagnostic treatment and specialized social anxiety treatment for children and adolescents with social anxiety disorder: A randomized controlled trial. Journal of the American Academy of Child & Adolescent Psychiatry. https://doi.org/10.1016/j.jaac.2022.08.003
Rapee, R. M., Shaw, T., Hunt, C., Bussey, K., Hudson, J. L., Mihalopoulos, C., … Cross, D. (2020). Combining whole‐school and targeted programs for the reduction of bullying victimization: A randomized, effectiveness trial. Aggressive Behavior, 46(3), 193-209. https://doi.org/10.1002/ab.21881
Sciberras, E., Efron, D., Patel, P., Mulraney, M., Lee, K. J., Mihalopoulos, C., … Hiscock, H. (2019). Does the treatment of anxiety in children with attention-deficit/hyperactivity disorder (ADHD) using cognitive behavioral therapy improve child and family outcomes? Protocol for a randomized controlled trial. BMC Psychiatry, 19(1), 359-359. https://doi.org/10.1186/s12888-019-2276-3
Sciberras, E., Mulraney, M., Anderson, V., Rapee, R. M., Nicholson, J. M., Efron, D., … Hiscock, H. (2018). Managing anxiety in children with ADHD using cognitive-behavioral therapy: A pilot randomized controlled trial. Journal of Attention Disorders, 22(5), 515-520. https://doi.org/10.1177/1087054715584054
Djurhuus, I. D., & Bikic, A. (2019). Is the Cool Kids programme working in outpatient psychiatric clinics? A Danish naturalistic effectiveness study. Nordic Journal of Psychiatry, 73(2), 141-148. https://doi.org/10.1080/08039488.2019.1574893
Hudson, J. L., McLellan, L. F., Eapen, V., Rapee, R. M., Wuthrich, V., & Lyneham, H. J. (2023). Combining CBT and sertraline does not enhance outcomes for anxious youth: A double-blind randomised controlled trial. Psychological Medicine, 53(5), 1741-1749. https://doi.org/10.1017/S0033291721003329
Johnsen, D. B., Arendt, K., & Thastum, M. (2019). The efficacy of manualized cognitive behavior therapy conducted by student-therapists treating Danish youths with anxiety using a benchmark comparison. *Scandinavian Journal of Child and Adolescent Psychiatry and Psychology, 7(*1), 68-80. https://doi.org/10.21307/sjcapp-2019-010
Rapee, R. M., Lyneham, H. J., Wuthrich, V., Chatterton, M. L., Hudson, J. L., Kangas, M., & Mihalopoulos, C. (2021). Low intensity treatment for clinically anxious youth: A randomised controlled comparison against face-to-face intervention. European Child & Adolescent Psychiatry, 30(7), 1071-1079. https://doi.org/10.1007/s00787-020-01596-3
Zetterlund, J., von Thiele Schwarz, U., Hasson, H., & Neher, M. (2022). A slippery slope when using an evidence-based intervention out of context. How professionals perceive and navigate the fidelity-adaptation dilemma-A qualitative study. Frontiers in Health Services, 2, 883072. https://doi.org/10.3389/frhs.2022.883072
