What is SPACE?
SPACE stands for Supportive Parenting for Anxious Childhood Emotions and is a parent-based treatment program for children and adolescents with anxiety, OCD, and related problems.
SPACE was developed by Dr. Eli Lebowitz at the Yale Child Study Center and has been tested and found to be efficacious in randomized controlled clinical trials.
SPACE aims to treat children and adolescents with anxiety disorders and obsessive-compulsive disorder. Although children do not have to attend SPACE sessions – they are the patients! When SPACE treatment is successful children feel less anxious and function better following treatment, especially for some of the most common anxiety issues children face, including Separation Anxiety, Social Anxiety, Generalized Anxiety, Specific Fears and Phobias, Panic Disorder, Agoraphobia, Selective Mutism, and Obsessive-Compulsive Disorder.
If children don’t attend treatment in SPACE, who does?
Parents/caregivers are the focus of SPACE treatment sessions, and in most cases, the child or adolescent does not need to attend the treatment sessions. Why? Because parents who participate in SPACE will learn skills and tools to help their child overcome anxiety, OCD, or related problems by focusing on changes that parents can make to their own behavior.
The two main changes that parents learn to make in SPACE treatment are to 1) respond more supportively to their anxious child and 2) reduce the accommodations they have been making to the child’s symptoms.
Therefore, a SPACE-trained provider works specifically with the parent(s) with the goal of reducing parental anxiety. This is unique because most other treatments for pediatric anxiety directly target the child on reducing their anxiety symptoms. The most proven interventions for pediatric anxiety are based on Cognitive Behavioral Therapy or CBT, by increasing awareness of anxiety problem areas challenging unhealthy thoughts, and then gradually exposing the child to the feared situation.
There is plenty of science and proven research (including randomized controlled trials) to prove that CBT for pediatric anxiety is effective. However, this effectiveness doesn’t apply to all children, all problem areas, or all families with anxious kids.
At the core of the SPACE treatment is attention to family accommodation or parent accommodations, also known as “FA.” What does Family Accommodation mean?
Family Accommodation addresses all the different changes the parents make in response to their child’s anxiety or distress. It is these changes the parent makes to help their child feel less anxious. This can be an active effort, such as answering your child’s repeated and unnecessary anxious questions, modifying schedules, and routines, or more passive (doing less of something, like not inviting guests to the house to reduce your child’s social anxiety). Paradoxically, however, FA actually reinforces and increases the anxiety long-term. This does not mean your child’s anxiety is your fault. It actually means that the parent is a major part of the solution! Especially true because research has proven that FA takes place between 95-100% of families with anxious children. There are more than 100 peer-reviewed papers on this topic in the US and other countries.