What is SPACE Therapy?
SPACE Therapy is a unique and exciting therapy which stands for supportive parenting of anxious childhood emotions. It was developed by Dr. Eli Lebowitz out of Yale and is based largely on attachment theory. It is often done individually with the therapist meeting with the parents but can be done in group or modified into a workshop format as well. In short, SPACE Therapy treats the child’s anxiety through the parents.
Like all mammals, children look to their parents during times of stress to learn how to react and what to do. Parents are naturally primed to offer comfort and support to their children when in distress. This is effective, adaptive, and works effectively in most situations. However when a child has an anxiety disorder, this approach can backfire. Children with anxiety disorders such as OCD experience a constant flood of anxiety which makes them want to compulsively seek help and reassurance from their parents. When parents give reassurance (or some other accommodation) it reduces the child’s anxiety in the short term but prolongs the anxiety disorder. These parental accommodations can also have the effect of confirming, in the child’s mind, that “the bad thing will happen” and it also prevents children from learning more appropriate responses like facing their fears, minimizing avoidance, and other adaptive coping skills.
Leave Your Child at Home!
SPACE therapy is treatment for the child’s anxiety but the therapist works only with the parents to make this happen. This approach can be very helpful as children often do not want to be in therapy and sometimes refuse to come at all. Traditional CBT therapy has worked to teach the parents how to change their children’s behavior. SPACE Therapy is much different in that it aims to help the parents modify their own behavior, specifically regarding how they respond to their child’s anxiety. Focusing on modifying the parents behavior (and not the child’s) helps reduce the conflict and escalation that can happen between parents and children. The child might get upset at the parents for acting differently (i.e., by not accommodating) but the parents will have little reason to escalate or get angry as they are following the specifics of the SPACE Therapy plan.
What’s an Accommodation?
In SPACE Therapy, accommodation is sort of a bad word. An accommodation is all the things that the parents do or say to lessen a child’s distress. Some examples might be to answer a child’s repeated and unnecessary anxious questions or to modify schedules and routines. Another more passive example might be doing less of something, like not inviting guests to the house to reduce your child’s social anxiety. We call the parents’ response an accommodation because it accommodates the child’s anxiety. Functionally, this response has the effect of lessening the child’s anxiety in the short term but it makes it worse in the long-run. This does NOT mean that it’s the parents fault but it does mean that we can work with the parents for the solution to their child’s anxiety.
What is SPACE Therapy Good For?
SPACE Therapy has been designed to treat children with anxiety disorders which can include obsessive compulsive disorder, separation anxiety, generalized anxiety, social anxiety, phobias, selective mutism, and panic disorder.