The Effectiveness of Psycho-educational Program Based Parental Reflective Functioning on the Improvement of Children with Separation Anxiety Disorder: A Single Subject Study

Background: Diagnosis of separation anxiety disorder (SAD) inchildhood is a critical risk factor of mental health in adulthood.Etiology studies have indicated the significant role of parentalpsychological factors in children with SAD phenomena. The aim ofstudy was to investigate the effectiveness psycho-educational programbased parental reflective functioning (PRF) on the improvement ofchildren's SAD.Methods: A single-case experimental design with multiple baselineshas been utilized to conduct the present study. Subjects of the studyincluded ۴ parents (two mothers and two fathers) with childrensuffering from SAD who referred to the psychiatric counseling centerand clinic of child and adolescent psychiatrist in Mashhad during Mayand June of ۲۰۱۹. These parents were selected through conveniencepurposeful sampling method based on inclusion and exclusion criteriaand participated in ۱۲ sessions (two sessions per week) of a psychoeducationalprogram based PRF. The participants completed the parentseparationanxiety questionnaire in three stages of baseline, during theimplementation of the program (in sessions ۵, ۹ and ۱۲), as well as onemonth after follow-up. The obtained data were analyzed using indicatorsof percentage recovery / PR, effect size and reliable change index (RCI).Results: At the end of the psycho-educational program, the resultsindicated a significant clinical decrease in the severity of separationanxiety in all four children of participants. The total score of recoverypercentage for the first, second, third and fourth subjects was equal to۷۰.۸۶, ۷۱.۳۰, ۷۲.۲۱ and ۷۰.۹۶, respectively. The RCI indicator ofsubjects was -۹.۹۳, -۱۰.۹۷, -۱۱.۵۹ and -۱۱.۲۶, respectively. Also, theeffect size for the first, second, third and fourth subjects was equal to۷.۴۳, ۸.۲۱, ۸.۶۷ and ۸.۴۳, respectively. Moreover, the overallimprovement of all four subjects in subscales of fear of being left alone,fear of abandonment, fear of physical illness and fear of dangerousevents was ۶۶.۷۵%, ۷۱.۱۰%, ۷۰.۳۹% and ۷۱.۷۳%, respectively which thevalues were significant clinically. This improvement process continuedthroughout the follow-up period.Conclusion: According to research findings, the Psycho-educationalprogram based parental reflective functioning has a positive effect onimproving the symptoms of SAD in children. Therefore, it isrecommended to utilize this program in treatment interventions forSAD.

Keywords:

Separation anxiety disorder , Psycho-educational program , Parental reflective functioning