Quantifying Session Content in the Delivery of Parent Coached Exposure Therapy

Despite exposure therapy having been identified as the active ingredient in the treatment of childhood anxiety disorders (CADs), available protocols deliver a variety of anxiety management strategies (AMS) in addition to exposure. To increase the effectiveness and efficiency of treatment, Parent Coached Exposure Therapy (PCET): 1) begins exposure early (e.g., session 2 or 3) to increase session time spent on exposure, 2) does not include other AMS, and 3) involves parents at all times. The current manuscript uses audio recordings from a previous pilot study to descriptively quantify the manner in which these key components of PCET are implemented by therapists closely involved in the development of the protocol. Results indicate that implementation of PCET accurately reflected the protocol in that the majority of session time was devoted to exposure activities (.60, s.d. = 0.2), AMS were effectively excluded from treatment (.01, s.d. =.03), and that parents and youth attended almost the entirety of session time together (.98, s.d. = 0.1). These findings suggest that PCET differs meaningfully from traditional CBT for CADs and provides preliminary guidelines for how much time per session to dedicate to in-session exposure work while delivering PCET.