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Weekly Session Overview

Here, you can find a detailed overview of the weekly LADDERS sessions to get an idea of what our intervention involves. 

The full manual to the intervention is available in a draft version upon request to qualified clinicians. Please refer to the contact form at the bottom of this page to request the manual. If you are a caregiver and wish to know more about the strategies outlined here, please see our video resources and anxiety guide.

Please note that these pages are in development as our study is still in progress. 

Week 1: Introductory session to boost engagement and alliance with the research team.

This introductory week involves a discussion of the structure of the weekly sessions and serves to create a comfortable environment for the parent/carer. The child's typical behaviour is explored and an initial hierarchy of feared situations is developed.

Week 4: Strategies for management of parent emotion.

During this week, learning from week three is reinforced. Emotion regulation strategies for helping to reduce anxiety are discussed.

Week 2: Introduction to escape-maintained and anxious avoidance behaviours.

Parents/carers learn about escape-maintained and anxious avoidance behaviours using generic examples unrelated to their child. Parents/carers are asked to observe for examples of escape or avoidant behaviours over the next week. A structured observation of child anxiety is also conducted during this week. 

Week 5: Preparing for the intervention.

This week focuses on thinking about factors that may affect the success of the intervention, such as the role of tiredness, hunger or illness. Additional strategies are proposed for sensory impairments and communication difficulties (if these are applicable to the child).

Week 3: Parent emotions in relation to child anxiety and avoidance.

Parents/carers are encouraged to identify the emotions that they experience when their child engages in avoidance or escape behaviour. This session utilises mindfulness strategies to help parents notice when they are experiencing these emotions. 

Week 6: Psychological formulation of child avoidance in a specific situation.

The parent/carer works with the researcher to select a situation in which anxious avoidance is present, and what happens in that situation for the parent/carer and child. The parent and researcher selects a situation that can be operationalised, with a clear antecedent or trigger, which is amenable to the intervention without causing significant distress to the child.

Weeks 7-8: Co-creation of an intervention plan to support the child in reducing avoidance and safety behaviours.
Parents/carers and researcher work together to consider aspects of the formulation and how avoidance can be gradually reduced using graded exposure techniques. The intervention focuses on increasing parent and child coping skills (e.g., through relaxation techniques).

Week 9: Barriers to intervention.
Discussion with parents/carers about barriers to the intervention and possible ways to overcome them. During this week, the researcher and parent/carer make a draft list of warning signs and calming strategies that can be used during the intervention.

Weeks 10-16: Implementation of the intervention plan.

Finally, the parents/carers spend 7 weeks implementing the intervention plan with support and coaching from the researcher. The researcher will either conduct observations of child anxiety or check-in via phone calls in weeks 10, 12 and 14. Feedback and outcome measures are be collected by the researcher in the final two weeks of the intervention. Parents are given access to videos that discuss the principles of intervention fading and generalisation.

Request the full manual - Qualified clinicians only
As this study is still in progress, the manual is still in the draft stages and is only available to clinically qualified practitioners. Please use your staff email to request a copy of the manual. 
 

Thank you for requesting the full manual.

We will get back to you as soon as possible.

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