Working collaboratively with parents and carers in cognitive behaviour therapy (CBT)

© Cambridge University Press 1998, 2005, 2013. This chapter will explore some of the issues involved in working with parents and carers within a cognitive-behavioural framework. It will begin with an exploration of the evidence base relating to the involvement of parents in cognitive behaviour therapy (CBT). It will then cover some of the difficulties that commonly arise, with our suggestions for managing these. Since the majority of the evidence focuses on involving parents where the child has a behaviour problem or an anxiety disorder, much of the chapter will focus on these two conditions. However, many of the conclusions drawn here are transferable to working with parents whose children have other difficulties. Parental factors have frequently been associated with the development of emotional and behavioural problems in young people. Intergenerational studies have shown that psychological disorders commonly run in families (Beck, 1999) and environmental factors appear to have a major role in their development (Gregory & Eley, 2007). As a result, in the last two decades much research attention has been paid to associations between parental factors (such as parental mental health and behaviours) and the development of psychopathology. Consistent associations have been found between these parental factors and childhood emotional and behavioural problems (Connell & Goodman, 2002; McLeod et al., 2007), and there is now a widespread assumption amongst clinicians that parental involvement in treatment for childhood problems is essential (Stallard, 2005). Whilst we concur that involving parents or carers in treatment is indeed important, the manner and extent to which parents should optimally be involved in treatment is not always clear and two important considerations must be borne in mind. First, associations between parental factors and childhood disturbance are often modest in magnitude (Beck, 1999; McLeod et al., 2007), and second, studies that have compared outcomes from individual child-focused CBT (CCBT) with family-based CBT (FCBT) have not always shown superiority of FCBT (Creswell & Cartwright-Hatton, 2007; In-Albon & Schneider, 2007).