The information in this program outline is provided by the program representative and edited by the CEBC staff. The Building Confidence program has been rated by the CEBC in the area of: Anxiety Treatment (Child & Adolescent).

• Types of Maltreatment: Does not target any specific kind of maltreatment
• Target Population: Typically developing school-aged children diagnosed with childhood anxiety disorders (6-11 years old) and their families.

Building Confidence is a cognitive-behavioral therapy (CBT) that is provided to school-aged children who demonstrate clinically significant symptoms of a range of anxiety disorders (e.g., separation anxiety disorder). The format consists of individual child therapy combined with parent-training and involvement. The goal is to enhance the learning and maintenance of treatment strategies via child and parent involvement in treatment. Both children and their parents are taught fundamental CBT principles and techniques as well as integrating ways to build confidence through graduated learning and practice of age-appropriate self-independence skills. In-session exposures are extended into the home where parents assist children complete home-based exposures in the community by providing coaching in CBT strategies and naturalistic opportunities to practice and maintain treatment goals and effects. In line with these overarching treatment goals, the intervention program also works closely with the children’s schools and teachers to promote the practice and generalization of treatment goals in the school (e.g., social anxiety).

The essential components of Building Confidence include:

• Assessment of anxiety and age-appropriate self-help skill milestones
• Development hierarchy to gradually help child build confidence to anxiety provoking situations (including areas of self-help) and obtaining child/parent ratings
• Developing in-session and home-based exposure tasks that are implemented in real-word settings (i.e., not based only within the therapy setting)
• Providing psychoeducation to parents and training on CBT strategies for parents to “coach” children to develop confidence and manage anxiety symptoms
• Developing close partnerships and collaborative working relationship with school and key personnel (e.g., teachers) to bridge the gap between clinic, home, and school goals and provide real-life opportunities to build confidence and success with CBT skills and anxiety management (e.g., teacher provides opportunities for skills being learned in treatment and provides additional monitoring of acquisition and maintenance of skills)
• The use of humor and rewards to build skills and develop positive and meaningful experiences in which they are confident and successfully manage anxiety symptoms

Building Confidence was designed with a child component that addresses the following presenting problems and symptoms:

• Childhood anxiety disorders—Specifically, separation anxiety disorder, social anxiety, obsessive-compulsive disorder, and generalized anxiety disorder.

Age range: 7 – 11

Developmental Delays:

This program was not developed for children with developmental delays; but has been tested for children with developmental delays.

Relevant research studies:

Treatment Involves Family/Support Structures:

This program involves the family or other support systems in the individual's treatment: Parents are provided with psychoeducation about anxiety, independence skills, and CBT strategies to both help coach children during home-based exposures and provided opportunities to target treatment goals with the natural setting of the home, community, etc. The school system is also elicited as a support system so that key school personnel (e.g., teachers) can provide opportunities for treatment goals and monitoring of the child with the school environment.

Building Confidence was not designed with a parent/caregiver component.

Building Confidence was not designed to be conducted in a group setting, and has not been tested for use in a group setting.

Recommended Intensity:

Weekly 1.5-hour session

Recommended Duration:

16 weeks

This program is typically conducted in a(n):

• Community Daily Living Settings
• Outpatient Clinic
• School

Building Confidence includes a homework component:

Homework is given at weekly sessions.

Building Confidence does not have materials available in a language other than English.

The typical resources for implementing the program are:

Clinicians, confederates (e.g., university students or other staff who can serve as confederates for exposure activities), access to local community settings (e.g., restaurants or stores), access to a telephone (for exposures requiring phone calls), treatment room and waiting area, assistants to supervise or watch the child while therapist conducts the parent portion of the treatment session, child appropriate games or toys, child appropriate rewards (e.g., edibles, stickers), tape recorder to record sessions, paper and writing materials to create homework sheets or session materials.

Experience working in clinical setting with children and families; experience with cognitive-behavioral interventions; and at least a Master’s level clinical training experience.

There is a manual that describes how to implement this program, and there is training available for this program.

Training is obtained:

Provided in Los Angeles or remotely (online)

Number of days/hours:

4-6 hours

Since Building Confidence is highly rated on the Scientific Rating Scale, information was requested from the program representative on available pre-implementation assessments, implementation tools, and/or fidelity measures.

This program is rated a "2 - Supported by Research Evidence" on the Scientific Rating Scale based on the published, peer-reviewed research available. The practice must have at least one rigorous randomized controlled trial with a sustained effect of at least 6 months. Please see the Scientific Rating Scale for more information.

Child Welfare Outcome: Child/Family Well-Being

No reference materials are currently available for Building Confidence.