Table 1 Intervention content

Session 0: ‘Pre-Treatment Feedback Session’

Present and discuss anxiety assessment results with participant^a (parent is present for child assessment feedback).

Familiarise the participants with the treatment structure.

Describe and illustrate subjective units of distress ratings and coping response.

Set treatment goals by developing a trigger response hierarchy.

Session 1: ‘Introduction to the Anxiety Treatment Program’

Psychoeducation to create shared understanding of terminology and to normalise the experience of anxiety. Psychoeducation on: The development and maintenance of anxiety disorders and the relationship between thoughts, feelings and behaviours.

Child only: introduction to the workbook, achievement charts, and rewards.

Parent only: psychoeducation on modelling of anxiety.

Session 2–Session 3: ‘Challenging and Changing our Anxious Thoughts’

Additional psychoeducation on the importance of thoughts as antecedents to anxiety.

Introduction to the concept of cognitive restructuring. Participants will learn to identify anxious thoughts, recognise cognitive biases and assumptions through the utilisation of challenging questions, and generate adaptive alternative responses to reduce habitual anxious cognitions.

Parent only: psychoeducation on bidirectional nature of anxiety in parent–child dyads, overprotective and accommodating parenting behaviours.

Session 4–Session 6: ‘Facing Our Fears Together’

Participants undertake exposure activities to systematically confront items on their trigger-response hierarchies^a. Parent and child dyads observe each other completing exposures.

Exposures function to habituate clients to the physiological responses of anxiety, provide a learning opportunity to evaluate the validity of catastrophic fears, and reduce avoidance/escape behaviours.

Cognitive restructuring and review is completed pre- and post-observing and participating in exposure tasks.

Session 7–Session 9: ‘Facing Our Fears’

Participants continue individual exposure activities. Sessions follow the same format as previous exposure sessions but without the observational component.

Parent only: parent’s anxiety triggers that may be distressing to children will be targeted during these sessions.

Session 10: ‘Finishing Treatment: Where to From Here?’

Relapse prevention including treatment review, psychoeducation, and skills development on maintaining successes and continuing to make progress and managing setbacks.

Congratulations and celebration of treatment completion^a.