Application of the transtheoretical model to parent facilitation of healthy anxiety management in their children

Anxiety disorders represent one of the most common and debilitating forms of psychopathology among children, with prevalence rates estimated to be between 12% and 17.3%. Although a number of efficacious treatments for child anxiety exist, there is a distinct need for prevention programs as well. Moreover, research suggests that parents play a crucial role in how their children manage anxiety, underscoring the importance of involving parents in both the treatment and prevention of child anxiety. For a variety of reasons, parents may be at different levels of readiness to engage in behaviors that promote their child's healthy coping with anxiety. Although most existing prevention and treatment programs do incorporate parental components, no study to date examines how parental readiness effects this parental involvement. The present study aims to address this gap in the literature by developing theoretically-based measures to assess parental attitudes toward and readiness for helping their children to manage anxiety in a healthy manner using the Transtheoretical Model of Behavior Change. Results provide support for the use of the TTM applied to parent facilitation of healthy anxiety management in their children. Exploratory and confirmatory analyses for Decisional Balance, Confidence, and Parenting Behavior scales produced three internally consistent measures. Analyses resulted in one pros and one cons scale for the Decisional Balance construct, two subscales for the Confidence construct, and one scale representing Positive Parenting Behaviors. Stage of change measures including one-item and three-item categorical staging algorithms and a URICA continuous stage measure were developed and compared with regard to their relationship to other constructs of interest. Despite a skewed staging distribution under-representing the early stages of change, expected theoretical patterns by stage of change were found for all three scales. Evaluations of the decisional balance and confidence measures by stage suggest that a three-item categorical staging algorithm may be best. However, additional research is necessary to fully evaluate the potential utility of a continuous stage measure. In addition, the sample for this study was primarily white, affluent, and educated so future research will need to examine the use of these measures in more diverse populations. The measures developed in this study have important implications for the future development of effective assessment and intervention tools to increase parental use of behaviors that facilitate healthy management of anxiety in their children.