Anxiety disorders onset earlier than most mental health conditions, with preschool-age children showing prevalence rates comparable to children ages 5 to 17 years. Yet, there are limited treatment options suitable for preschool-age children that account for still-developing abstract thinking and metacognition. The Coaching Approach Behavior and Leading by Modeling (CALM) Protocol was adapted from Parent-Child Interaction Therapy (PCIT) to target a broad range of anxiety disorders in children ages 3 to 8 years. This case study outlines the implementation of a 10-session CALM treatment protocol for a 5-year-old female presenting with generalized anxiety disorder (GAD). The treatment implemented PRIDE skills through parent coaching, followed by exposure-based sessions. Post-intervention assessments indicated significant improvement in anxiety symptoms measured by the Preschool Anxiety Scale (PAS) and high parent satisfaction measured by the Therapy Attitude Inventory (TAI). These findings support early intervention through parent-coaching as a viable alternative to cognitive therapies for young children with anxiety disorders.
Conducting a functional analysis and implementing derived treatments can produce effective behavior plans for severe problem behavior (e.g., self-injury, aggression, and disruptive behavior). Nonetheless, skills training and an effective plan may not be sufficient to produce parent adherence. Low levels of treatment adherence may persist because parent responses that reinforce problem behavior also produce negative reinforcement for the parent response through immediate problem behavior cessation. This case study presents a contextual behavioral informed approach to target the negative maintaining contingencies supporting parent accommodation of problem behavior, and to increase adherence with behavioral treatment plans. Despite parent mastery of treatment components while under direct clinical observation, accommodation of the child’s severe problem behavior persisted periodically between clinical appointments. Case conceptualization highlights the borrowed concept of family accommodation as it relates to parent-child interactions that exacerbate and maintain the maladaptive behaviors of both. The course of intervention outlines strategies aimed at undermining the contingencies that maintain accommodation while providing parents with new behavioral treatment-related committed actions that are consistent with adherence. Outcomes are reviewed and presented within a multiple-baseline single case design across parents. Implications of the findings are discussed, along with recommendations for clinicians and students who identify parent accommodation of problem behavior within their clinical work.
Persistent anxiety and repetitive, restricted behaviours are common experiences for autistic young people and can be barriers to valued living and thus the opportunity to thrive. This case study presents the use of the DNA-V intervention framework, an ACT model, in an 18-month co-constructed, values targeted approach with an autistic young woman. Outcome measures were administered at multiple time points from baseline through to 3-month follow up post discharge from the service. The young woman was observed to experience improved well-being and psychological flexibility, and in particular, engaged in an increased amount of activities that aligned with her identified values. This case study offers use of the DNA-V model in practice and suggests how the importance of value identification and nurturing this skill may lead to an increase in behaviour related to enhanced psychological flexibility and well-being. The pattern observed in this case also suggests how the use of a stepped away approach in which a faded transition from intensive level to reduced involvement may link to improvements in well-being sustained over time.
Low-income Black perinatal individuals are disproportionately affected by maternal mortality and poor mental health outcomes. Cognitive-behavioral therapy (CBT) and the Mothers and Babies Course have been shown to be effective interventions for the treatment and prevention of perinatal mental health disorders. This article describes the treatment of a 30-year-old Caribbean-American Black immigrant participant with significant perinatal anxiety and birth-related trauma, randomized to the intervention arm, who received individualized CBT-based treatment within the Mommy&Me study, a two-arm pragmatic randomized controlled trial that combined patient navigation with culturally adapted CBT. The intervention was delivered across 12 sessions spanning the prenatal-postnatal period, with outcomes assessments of anxiety, depression, and stress measures. Patient navigation and peer-led support group sessions were integrated throughout treatment, along with collaborative coordination of care with community mental health resources during periods of increased symptom severity. By the end of treatment, the participant demonstrated a significant decrease in anxiety symptoms and perceived stress severity. This case highlights the importance of integrating evidence-based interventions with collaborative care and community-based supports among underserved perinatal populations.
Adolescents and young adults (AYAs) diagnosed with cancer often experience psychological distress that reflects the interaction of medical uncertainty, developmental disruption, and pre-existing cognitive and coping patterns. This clinical case study illustrates the use of cognitive behavior therapy (CBT), informed by the Generic Cognitive Model, with a 23-year-old young adult survivor of Hodgkin lymphoma experiencing anxiety, depressive symptoms, fear of cancer recurrence, avoidance, and difficulty re-engaging with academic and social goals after completing treatment. Case formulation emphasized the dynamic interaction among cancer-related triggers, beliefs about vulnerability and falling behind, heightened attentional focus on threat, and avoidance-based coping. Treatment consisted of eight structured CBT sessions targeting cognitive flexibility, attentional refocusing, behavioral activation, exposure to avoided activities, and relapse prevention. Across treatment, the client demonstrated clinically meaningful reductions in depressive symptoms, anxiety, and fear of cancer recurrence, alongside increased engagement in valued activities and improved tolerance of uncertainty. This case highlights the clinical utility of a formulation-driven CBT approach that neither minimizes the realities of cancer survivorship nor assumes that cancer is the sole cause of distress. Findings underscore the importance of attending to the post-treatment transition, surveillance-related anxiety, developmental concerns, and access pathways when providing psychosocial care for AYAs with cancer.
