title: Family Accommodation of Child and Adolescent Anxiety: Mechanisms, Assessment, and Treatment.
abstract: OBJECTIVE
  Anxiety disorders are the most common mental health concern for youth. Unfortunately, a substantial number of children and adolescents do not respond positively to current evidence-based interventions and/or relapse. As pediatric anxiety disorders are fundamentally a systemic phenomenon, focusing on the ways in which parents become involved in their children's anxiety symptoms may be a promising alternative approach to treatment.
  
  
  OBJECTIVE
  To inform psychiatric mental health nurse practitioners (PMHNPs) about the phenomenology, associated neurobiology, and assessment of family accommodation (FA) as well as clinical interventions targeting FA. FA refers to ways that parents adapt their own behaviors to reduce their children's anxiety-related distress.
  
  
  METHODS
  A literature search was performed using Psyc-INFO and PubMed.
  
  
  CONCLUSIONS
  Current findings indicate a high prevalence of FA associated with pediatric anxiety disorders. FA has a potentially deleterious impact on course of illness and treatment response and is associated with greater caregiver burden. Potential neurobiological underpinnings of FA include dysregulation of parent cortico-limbic circuitry and the oxytocinergic system. PMHNPs are in a unique position to identify families engaged in problematic FA, educate their clientele, provide psychotherapy services with the goal of reducing FA, and consult with multidisciplinary team members.
authors.affiliation: Yale University School of Medicine, New Haven, CT, USA.
authors.forename: Kaila R
authors.initials: KR
authors.lastname: Norman
authors.affiliation: Yale University School of Medicine, New Haven, CT, USA.
authors.forename: Wendy K
authors.initials: WK
authors.lastname: Silverman
authors.affiliation: Yale University School of Medicine, New Haven, CT, USA.
authors.forename: Eli R
authors.initials: ER
authors.lastname: Lebowitz
mesh_terms: D000293:Adolescent; D001008:Anxiety Disorders / Q000451:nursing*; D002648:Child; D005195:Family Relations / Q000523:psychology*; D005196:Family Therapy / Q000379:methods*; D006801:Humans; D010290:Parents / Q000523:psychology*
keywords: Assessment; family accommodation; neurobiology; nursing; oxytocin; pediatric anxiety disorder; treatment