Integrating mentalization principles into the behavioural treatment of childhood anxiety disorders: A pilot study.

The integration of mentalization principles into behaviour therapy has been minimally explored. This paper investigates the application of these principles within a parent-assisted graded exposure intervention for child anxiety disorders. The study outlines the theoretical justification for this integration and presents the results of a pilot evaluation of this novel therapeutic approach focused on preliminary efficacy, feasibility, and acceptability. A total of 21 children (ages 5–11; M = 8.81, SD = 1.58; 52.4% female) and their parents participated in a 7-session integrated psychotherapy program delivered via telehealth. Outcome measures included parent-reported assessments of child anxiety, reflective functioning, parental self-efficacy, and symptom impact, administered at pre-intervention, post-intervention, and follow-up stages within a single-group design. Significant reductions in child anxiety symptoms (𝜂p2 = .41), and symptom impact (𝜂p2 = .35), as well as significant increases in parental self-efficacy (𝜂p2 = 0.30), were observed over time. However, no significant changes were noted in reflective functioning. The intervention demonstrated a high retention rate (71.4%), with no reported adverse events, and was rated as helpful by participants. These results support the feasibility, preliminary efficacy, and acceptability of this integrated therapeutic approach. The paper concludes with recommendations for extending this approach to more complex child populations, particularly those with attachment disruptions and developmental trauma, where it could serve as a viable alternative to traditional behaviour therapy for treating childhood anxiety.