Independence Focused Therapy (IFT): A Randomized Controlled Trial of a Novel, Low Cost, and Scalable Intervention for Child and Adolescent Anxiety

Overview:

Helicopter parenting undermines children's sense of agency and resilience, contributing to rising anxiety levels, while daily independence-building experiences can powerfully shift their perception of themselves and the world. Independence-Focused Therapy (IFT) offers a scalable, strengths-based solution, showing promising results in reducing anxiety in children, and this project will support a rigorous randomized controlled trial to further validate its effectiveness.

Abstract:

Child and adolescent anxiety has increased markedly over the past decade (Haidt & Twenge 2023). Evidence that over-involved ("helicopter") parenting is a contributing cause to this increase in anxiety has grown. Exposure-based therapy is the gold standard in the treatment of anxious children. Few clinicians use it, however. This leaves us with a vexing public health dilemma. How do we treat anxiety in a manner that is as (or more) effective as exposure therapy, is appealing to children, parents, and mental-health providers, and addresses the changing societal context for child development (helicopter parenting) that is contributing to rising rates of anxiety? Independence-Focused Therapy (IFT) is a novel treatment approach for child and adolescent anxiety that is considerably simpler to administer than exposure. This new approach comprises independence activities (IAs), defined as child-directed, fun, unstructured, developmentally challenging tasks performed without any help from parents. Examples of IAs include riding a bus to school, cooking a meal, and climbing trees with friends. Although it appears that IAs are unrelated to a child's fears, they nonetheless target mechanisms implicated in the development of child anxiety (e.g., parental overinvolvement, child avoidance) and are thus “antiphobic.” We hypothesize that children in the IFT condition will have on average, significantly lower symptoms of anxiety than those in the control group after treatment and that these improvements will maintain; that behavioral mechanisms, and cognitive mechanisms will improve in the treatment group compared to the control group; and that children, parents, and clinicians will, on average, rate IFT highly on measures of acceptability and satisfaction according to relative benchmarks. We will conduct a well-powered and rigorous randomized clinical trial to test the efficacy of a five-session IFT treatment versus a waitlist control group in a community setting.

Broader Impact:

IFT is now ready for a rigorous RCT in a community setting, which is the critical next step to establishing IFT as an evidence-based treatment. This would dramatically increase its visibility and use in addressing the child mental health crisis.