Integrating attachment-based and neurobiological approaches with cognitive behaviour therapy: a mixed methods exploration of a novel intervention for childhood anxiety

Introduction: The current study aimed to explore the feasibility of a novel integrative intervention for childhood anxiety, known as the Opposite of Worry (OOW) intervention. This approach incorporates attachment-based and neurobiological approaches, with Cognitive Behavioural Therapy (CBT). It consists of parent sessions and child sessions delivered in parallel. Method: Seven parent-child pairs consented to take part in the study. The experiences of both parents and children were explored using a mixed methods approach. Semi-structured interviews were carried out with all parents and children. Quantitative data was gathered at three time points, using measures of anxiety, attachment, and emotion regulation. Results: Qualitative analysis was carried out using Thematic Analysis. Seven parent themes were generated (‘A family affair’, ‘We’re all in the same boat’ ‘Attunement’, ‘Facing and feeling anxiety’, ‘Connection’, ‘Parent’s emotions’, and ‘Child’s expression of feelings’). Five child themes were also produced (‘Awareness of emotions’, ‘Fun’, ‘Coping strategies’, ‘Discomfort contemplating emotions’, and ‘Facing fears’). Quantitative analysis was completed using descriptive statistics. Trends were observed in terms of anxiety reduction and enhanced attachment. Discussion: The current study generated preliminary findings in support of the OOW intervention; however, further research is required to establish the efficacy of this approach. The findings are discussed in the context of previous literature, and implications for clinical practice and future research are outlined.