Defense Date


Graduation Date

Summer 8-10-2019


Immediate Access

Submission Type


Degree Name



Counseling, Psychology, & Special Education


School of Education

Committee Chair

Kara E. McGoey

Committee Member

Laura M. Crothers

Committee Member

Elizabeth McCallum


anxiety, PCIT, early childhood, attachment, parenting styles, single-subject


Anxiety is one of the most common disorders in children that can often lead to detrimental outcomes. Empirically-supported risk factors for child anxiety include the child’s temperament and behavioral inhibition, insecure attachment, parental over-controlling behaviors, parental anxiety, and the impact of adverse life events on the child. Targeting these risk factors early on has the ability to lead to a decrease in anxiety symptoms later in adolescence and adulthood.

Evidence suggests behavioral, therapeutic interventions are effective for treating anxiety and other mood disorders for middle childhood and adolescents. Recent research has begun to focus on developmentally-appropriate adaptations for younger children to benefit from these current therapies, such as using play techniques and incorporating parental involvement. Specifically, Parent-Child Interaction Therapy (PCIT) has been adapted from an evidence-based treatment of disruptive disorders in young children, to its utilization in treating internalizing behaviors. Further, the Coaching Approach Behaviors and Leading by Modeling (CALM) program was developed as an adaptation for PCIT to decrease child anxiety symptoms as well as strengthen the overall parent and child relationship.

It is the aim of this study to add to the literature base of the CALM program as an adaptation to PCIT by also examining risk factors for a child’s anxiety levels such as attachment and parental behaviors. Using a single-subject, nonconcurrent multiple baseline design across subjects, this study provided overall mixed results for the CALM adaptation to PCIT using an early childhood population diagnosed with anxiety.