The Phoenix Sessions is a brief, exposure-based cognitive behavioral therapy (CBT) program adapted to train parents as in-home coaches to reduce childhood anxiety. This adaptation draws upon evidence-based CBT principles and integrates cultural tailoring, streamlined content, and brief sessions to improve scalability, relevance, and feasibility for families.
Purpose of Intervention
To deliver a responsive, evidence-based CBT program in which parents guide their children through structured, real-world exposure practices and anxiety-reducing skills. The aim is to empower caregivers to reduce child anxiety symptoms through home-based interventions that support skill generalization and parent-child collaboration.
Intervention Primary Outcome
• Reduction in child anxiety severity and symptom levels.
Intervention Secondary Outcomes
• Increased parent self-efficacy
• Decreased parental accommodation of child anxiety
• Improvement in child coping confidence and daily functioning
Findings
Pina et al. (2012) conducted a randomized controlled trial evaluating an indicated prevention and early intervention CBT protocol for childhood anxiety among Caucasian and Hispanic/Latino youth. The study demonstrated statistically significant reductions in anxiety symptoms, highlighting the feasibility and cultural relevance of caregiver-involved exposure-based CBT. Results also supported the effectiveness of a streamlined intervention for diverse populations, with meaningful reductions in avoidance and improved functioning across multiple time points.
Silverman et al. (2009) evaluated the dynamics of change in youth anxiety treatment, revealing that both youth-to-parent and parent-to-youth influences are critical to outcome. Parental anxiety and relational conflict were reduced when youth anxiety improved, supporting bidirectional pathways of influence.
A meta-analysis by Stoll, Pina, and Schleider (2023) confirmed the efficacy of brief, non-pharmacological interventions, especially those including caregiver coaching and exposure elements. Exposure-based approaches demonstrated moderate-to-large effect sizes in reducing pediatric anxiety symptoms across multiple randomized trials.
Statistical Method Used
Efficacy was assessed using repeated measures designs, mixed-effects models, and multivariate analyses across multiple informants (youth, parent, provider). Effect sizes, structural equation modeling, and longitudinal follow-up data were applied to understand treatment durability and directionality of change.
Essential Aspects for Success
• Structured parent-led exposures promote fear reduction in natural contexts
• Coaching parents enhances generalization beyond therapy sessions
• Brief, manualized format reduces training burden and improves adherence
• Materials and flexible delivery formats boost engagement
Principal Citations
Pina, A. A., Zerr, A. A., Villalta, I. K., & Gonzales, N. A. (2012). Indicated prevention and early intervention for childhood anxiety: A randomized trial with Caucasian and Hispanic/Latino youth. Journal of Consulting and Clinical Psychology, 80(5), 940–946. https://doi.org/10.1037/a0029460
Silverman, W. K., Kurtines, W. M., & Jaccard, J. (2009). Directionality of change in youth anxiety treatment involving parents: An initial examination. Journal of Consulting and Clinical Psychology, 77(3), 474–485. https://doi.org/10.1037/a0015761
Stoll, R. D., Pina, A. A., & Schleider, J. (2023). Brief, non-pharmacological interventions for pediatric anxiety: Meta-analysis and evidence base status. Journal of Clinical Child & Adolescent Psychology. Advance online publication. https://doi.org/10.1080/15374416.2023.2223615
March S, Spence SH, Donovan CL. The efficacy of an internet-based cognitive-behavioral therapy intervention for child anxiety disorders. J Pediatric Psychology, 2009 Jun;34(5):474-87. doi: 10.1093/jpepsy/jsn099. Epub 2008 Sep 15. PMID: 18794187.