Parent Perceptions of an Anxiety Prevention Manual for Young Children
Abstract
1. Introduction
2. Materials and Methods
2.1. Instrumentation
2.2. Participants
2.3. Procedures
3. Results
3.1. Virtual Interviews with Parents
3.2. In-Person Interviews with Parents
4. Discussion
- Strategies Parents Would Use
- What Children Worry About
- Usefulness of the Manual
- Strategies Learned from the Manual
- Use of Strategies Not in the Manual
- Limitations
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
- Kodish, I.; Rockhill, C.; Ryan, S.; Varley, C. Pharmacotherapy for anxiety disorders in children and adolescents. Pediatr. Clin. North. Am. 2011, 58, 55–72. [Google Scholar] [CrossRef] [PubMed]
- Vallance, A.K.; Fernandez, V. Anxiety disorders in children and adolescents: Aetiology, diagnosis and treatment. BJPsych Adv. 2016, 22, 335–344. [Google Scholar] [CrossRef]
- Muris, P.; Merckelbach, H.; Gadet, B.; Moulaert, V. Fears, worries, and scary dreams in 4- to 12-year-old children:Their content, developmental pattern, and origins. J. Clin. Child. Psychol. 2000, 29, 43–52. [Google Scholar] [CrossRef] [PubMed]
- Muris, P.; Meesters, C.; Merckelbach, H.; Sermon, A.; Zwakhalen, S. Worry in normal children. J. Am. Acad. Child. Adolesc. Psychiatry. 1998, 37, 703–710. [Google Scholar] [CrossRef]
- Fonseca, A.C.; Perrin, S. The clinical phenomenology and classification of child and adolescent anxiety. In Anxiety Disorders in Children and Adolescents; Cambridge University Press: Cambridge, UK, 2011; pp. 25–55. [Google Scholar] [CrossRef]
- Wehry, A.M.; Beesdo-Baum, K.; Hennelly, M.M.; Connolly, S.D.; Strawn, J.R. Assessment and treatment of anxiety disorders in children and adolescents. Curr. Psychiatry Rep. 2015, 17, 52. [Google Scholar] [CrossRef]
- Merikangas, K.R.; Nakamura, E.F.; Kessler, R.C. Epidemiology of mental disorders in children and adolescents. Dialogues Clin. Neurosci. 2009, 11, 7–20. [Google Scholar] [CrossRef]
- Allan, N.P.; Capron, D.W.; Lejuez, C.W.; Reynolds, E.K.; MacPherson, L.; Schmidt, N.B. Developmental trajectories of anxiety symptoms in early adolescence: The influence of anxiety sensitivity. J. Abnorm. Child. Psychol. 2014, 42, 589–600. [Google Scholar] [CrossRef]
- Ginsburg, G.S.; Smith, I.C. School-Based Interventions for Students with Anxiety, 3rd ed.; Evans, S.W., Owens, J.S., Bradshaw, C.P., Weist, M.D., Eds.; Springer International Publishing: Cham, Switzerland, 2023. [Google Scholar] [CrossRef]
- McClure, E.B.; Brennan, P.A.; Hammen, C.; Le Brocque, R.M. Parental anxiety disorders, child anxiety disorders, and the perceived parent-child relationship in an Australian high-risk sample. J. Abnorm. Child. Psychol. 2001, 29, 1–10. [Google Scholar] [CrossRef]
- Kendall, P.C. Anxiety Disorders in Youth. In Child and Adolescent Therapy: Cognitive-Behavioral Procedures, 4th ed.; Kendall, P.C., Ed.; Guilford Press: New York, NY, USA, 2012. [Google Scholar]
- Rabner, J.; Mian, N.D.; Langer, D.A.; Comer, J.S.; Pincus, D. The relationship between worry and dimensions of anxiety symptoms in children and adolescents. Behav. Cogn. Psychother. 2017, 45, 124–138. [Google Scholar] [CrossRef]
- Nabors, L.; Odar Stough, C.; Combs, A.; Elkins, J. Implementing the coping positively with my worries manual: A pilot study. J. Child. Fam. Stud. 2019, 28, 2708–2717. [Google Scholar] [CrossRef]
- Comer, J.S.; Hong, N.; Poznanski, B.; Silva, K.; Wilson, M. Evidence base update on the treatment of early childhood anxiety and related problems. J. Clin. Child Adolesc. Psychol. 2019, 48, 1–15. [Google Scholar] [CrossRef] [PubMed]
- Scaini, S.; Rossi, F.; Rapee, R.M.; Bonomi, F.; Ruggiero, G.M.; Incerti, A. The cool kids as a school-based universal prevention and early intervention program for anxiety: Results of a pilot study. Int. J. Environ. Res. Public. Health. 2022, 19, 941. [Google Scholar] [CrossRef]
- Zhang, B. The implication of the COVID-19 lockdown and quarantine on child psychology. J. Educ. Humanit. Soc. Sci. 2023, 7, 168–174. [Google Scholar] [CrossRef]
- Cuijpers, P.; Cristea, I.A.; Karyotaki, E.; Reijnders, M.; Huibers, M.J.H. How effective are cognitive behavior therapies for major depression and anxiety disorders? A meta-analytic update of the evidence. World Psychiatry 2016, 15, 245–258. [Google Scholar] [CrossRef]
- Toussaint, L.; Nguyen, Q.A.; Roettger, C.; Dixon, K.; Offenbächer, M.; Kohls, N.; Hirsch, J.; Sirois, F. Effectiveness of progressive muscle relaxation, deep breathing, and guided imagery in promoting psychological and physiological states of relaxation. Evid.-Based Complement. Altern. Med. 2021, 2021, 5924040. [Google Scholar] [CrossRef] [PubMed]
- Obradović, J.; Sulik, M.J.; Armstrong-Carter, E. Taking a few deep breaths significantly reduces children’s physiological arousal in everyday settings: Results of a preregistered video intervention. Dev. Psychobiol. 2021, 63, e22214. [Google Scholar] [CrossRef]
- de Mooij, B.; Fekkes, M.; Miers, A.C.; van den Akker, A.L.; Scholte, R.H.J.; Overbeek, G. What works in preventing emerging social anxiety: Exposure, cognitive restructuring, or a combination? J. Child. Fam. Stud. 2023, 32, 498–515. [Google Scholar] [CrossRef]
- Zarra-Nezhad, M.; Pakdaman, F.; Moazami-Goodarzi, A. The effectiveness of child-centered group play therapy and narrative therapy on preschoolers’ separation anxiety disorder and social-emotional behaviours. Early Child. Dev. Care. 2023, 193, 841–853. [Google Scholar] [CrossRef]
- Rienks, K.; Salemink, E.; Laas Sigurðardóttir, L.B.; Melendez-Torres, G.J.; Staaks, J.P.C.; Leijten, P. Supporting parents to reduce children’s anxiety: A meta-analysis of interventions and their theoretical components. Behav. Res. Ther. 2025, 185, 104692. [Google Scholar] [CrossRef]
- Carpenter, A.L.; Puliafico, A.C.; Kurtz, S.M.S.; Pincus, D.B.; Comer, J.S. Extending parent–child interaction therapy for early childhood internalizing problems: New advances for an overlooked population. Clin. Child. Fam. Psychol. Rev. 2014, 17, 340–356. [Google Scholar] [CrossRef]
- Jewell, C.; Wittkowski, A.; Pratt, D. The impact of parent-only interventions on child anxiety: A systematic review and meta-analysis. J. Affect. Disord. 2022, 309, 324–349. [Google Scholar] [CrossRef] [PubMed]
- Nabors, L.; Bauer, A.; Addy, T.N.A. Development and implementation of an anxiety management intervention for young children. Evid. Based Pract. Child. Adolesc. Ment. Health. 2024, 9, 472–485. [Google Scholar] [CrossRef]
- Creswell, J.W. Research Design: Qualitative and Quantitative Approaches; Sage Publication: Thousand Oaks, CA, USA, 1994. [Google Scholar]
- Braun, V.; Clarke, V. Using thematic analysis in psychology. Qual. Res. Psychol. 2006, 3, 77–101. [Google Scholar] [CrossRef]
- Creswell, J.W.; Poth, C.N. Qualitative Inquiry and Research Design Choosing among Five Approaches, 5th ed.; Sage Publications: Thousand Oaks, CA, USA, 2023. [Google Scholar]
- Corbin, J.; Strauss, A. Basics of Qualitative Research. In Techniques and Procedures for Developing Grounded Theory, 3rd ed.; SAGE Publications, Inc.: Thousand Oaks, CA, USA, 2008. [Google Scholar] [CrossRef]
- Miles, M.B.; Huberman, A.M. Qualitative Data Analysis: An Expanded Sourcebook, 2nd ed.; Sage Publication: Thousand Oaks, CA, USA, 1994. [Google Scholar]
- Morse, J.M.; Barrett, M.; Mayan, M.; Olson, K.; Spiers, J. Verification strategies for establishing reliability and validity in qualitative research. Int. J. Qual. Methods. 2002, 1, 13–22. [Google Scholar] [CrossRef]
- Guba, E.G.; Lincoln, Y.S. Effective Evaluation: Improving the Usefulness of Evaluation Results through Responsive and Naturalistic Approach-Es. Jossey-Bass: Hoboken, NJ, USA, 1981. [Google Scholar]
- Saldana, J. The Coding Manual for Qualitative Researchers; Sage Publications: Thousand Oaks, CA, USA, 2021. [Google Scholar]
- Twenge, J.M.; Campbell, W.K. Associations between screen time and lower psychological well-being among children and adolescents: Evidence from a population-based study. Prev. Med. Rep. 2018, 12, 271–283. [Google Scholar] [CrossRef]
Subtheme | Number of Parents Endorsing Subtheme | Parent Perception of the Strategy (How Their Child Could Use It) |
---|---|---|
Imagination of happy place | 6 | “When he tells me something is bothering him before bed and tell him to think about our vacations” (Participant 1). “The imaginary thought or a cool place (going to your favorite place, like a party” (Participant 4). |
Beach ball breathing | 9 | “A good one because you have to blow the air out. It can’t be like this it’s gotta be kind of a longer exhalation” (Participant 3). “I think the belly breath- the deep breathing is very important for the kids to learn how to calm themselves down” (Participant 12). |
Rock and sponge | 3 | “They understand that sponges can soak and expel water so like there’s something about that visual I think that worked really well” (Participant 3). |
Talking to someone | 3 | “He was able to identify two people that he could talk to that he has access to” (Participant 9). |
Positive thinking | 4 | “Thinking happy thoughts or using imagination helps redirect anxiety. Imagining a happy place is a new technique I’ll try with my child” (Participant 11). |
Distraction | 2 | “I know she’s always inclined towards reading books and playing with toys, she does pretend plays a lot... she can just come up with different characters and then start playing with it and that gets her to calm down” (Participant 7). “There is also watching TV or a movie or doing something fun. It is nice when it is just about something that you already know they like. It is not like a new thing entirely” (Participant 7). |
Subtheme | Number of Parents Who Endorsed Subtheme | Representative Quotes |
---|---|---|
Social media | 8 | “She wants to also have access to social media like her friends, that everyone has social media, everyone has Instagram. This social media is also affecting kids of this age” (Participant 7). “Like fitting in trends like social media and technology is really big... Meeting those trends and norms can cause a sense of worry in children” (Participant 9). |
Are mom and dad mad at me | 5 | “So those are some things that makes her worried...Mommy is upset with me because of my behavior” (Participant 7). |
Safety and environmental concerns | 3 | “She gave me this hug and said I have to hug you now because the earth is gonna break soon” (Participant 2). “Kids worry about gun violence” (Participant 4). “You can’t sugarcoat the fact that no matter what language you use, you’re having children do a drill in case someone tries to come in and put a bullet in their head” (Participant 2). |
Parental stresses | 3 | “Parents struggling financially makes children anxious about meals and home stability” (Participant 14). “Mostly, I think he’s worried about not going to the swimming pool. I don’t swim. I think they are worried about me not being able to swim” (Participant 6). “They are worried about their parents. If they have parents who are drug addicts, they could get taken away from their parents” (Participant 7). |
Friends/social concerns/bullying | 8 | “Worried that his friends won’t like him....friendship pressure people will be friends with them one day and then not friends with him the next” (Participant 3). “She worried about making friends are her new school when we moved and bullying it happened the first few weeks in her new school” (Participant 5). |
School/academic achievement concerns | 8 | “When they are in school, and they are given schoolwork to do, and they are having difficulties in getting it done”. (Participant 10) “They worry about grades a lot. My 3rd grader worries about workload and keeping track of schoolwork, it causes him a lot of stress” (Participant 4). “He’s already anxious about the sounds that he makes the way that he misuses the language or the way that he’s learning to use it” (Participant 3). |
Reason | Number of Parent Endorsements | Representative Quotes |
---|---|---|
Relatable for children | 5 | “I thought the strategies were good ideas that kids could relate to” (Participant 1). |
Toolbox for parents | 4 | “I didn’t know this type of book exists. I feel I have a good start and I feel assured... I have learned some new things that I can add to what I already know to help my child” (Participant 6). |
Good resource: Simple and manageable | 6 | “I thought it was really nice. It was a very simple and manageable group of skills” (Participant 4). |
Variety of strategies | 3 | “It provides multiple strategies, allowing children to choose what works best”. “That’s what I like about the booklet; it gives you a handful of practices, and you can figure out which is most successful” (Participant 3). |
Encourages emotional regulation | 3 | “The booklet helps children understand and regulate their emotions” (Participant 11). “Having the opportunity to teach and reinforce these skills helps the whole classroom” (Participant 4). |
Can be used at school and at home | 3 | “The strategies are applicable both at home and in the classroom. It is very good for kids to talk about their worries in the classroom” (Participant 12) |
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Sanyaolu, O.; Robertson, A.; Addy, T.N.A.; Nabors, L.A. Parent Perceptions of an Anxiety Prevention Manual for Young Children. Int. J. Environ. Res. Public Health 2025, 22, 833. https://doi.org/10.3390/ijerph22060833
Sanyaolu O, Robertson A, Addy TNA, Nabors LA. Parent Perceptions of an Anxiety Prevention Manual for Young Children. International Journal of Environmental Research and Public Health. 2025; 22(6):833. https://doi.org/10.3390/ijerph22060833
Chicago/Turabian StyleSanyaolu, Olutosin, Ava Robertson, Tabitha Naa Akuyea Addy, and Laura Anne Nabors. 2025. "Parent Perceptions of an Anxiety Prevention Manual for Young Children" International Journal of Environmental Research and Public Health 22, no. 6: 833. https://doi.org/10.3390/ijerph22060833
APA StyleSanyaolu, O., Robertson, A., Addy, T. N. A., & Nabors, L. A. (2025). Parent Perceptions of an Anxiety Prevention Manual for Young Children. International Journal of Environmental Research and Public Health, 22(6), 833. https://doi.org/10.3390/ijerph22060833