Being Brave

Mental Health Does Not Currently Meet Criteria

Being Brave, an adaptation of Coping Cat – Individual, is a cognitive-behavioral approach designed to treat children ages 4–7 who are diagnosed with or at high risk of being diagnosed with an anxiety disorder (e.g., generalized anxiety disorder, social phobia, separation anxiety disorder) and their parents. Treatment is divided into two parts. Part 1 consists of six parent-only sessions where the therapist teaches parents anxiety management strategies and parenting skills. The therapist provides instructions on planning, implementing, and reinforcing the exposure component of the program. Part 2 consists of 8–13 parent-child sessions where the therapist teaches relaxation techniques and creates coping plans with the family to aid in completing exposure activities. In between sessions, the parent completes reading assignments and practice exercises. Being Brave adapts the content and structure of Coping Cat – Individual to include age-appropriate skills and strategies and address the sources of anxiety and social phobias young children may face, with corresponding differences in the exposure tasks.


Being Brave does not currently meet criteria to receive a rating because no studies of the program achieved a rating of moderate or high on design and execution.


Date Research Evidence Last Reviewed: May 2022


Sources

The program or service description, target population, and program or service delivery and implementation information were informed by the following sources: the program or service manual.


This information does not necessarily represent the views of the program or service developers. For more information on how this program or service was reviewed, visit the Review Process page or download the Handbook.

Target Population

Being Brave is designed to treat children ages 4–7 who are diagnosed with or at high risk of being diagnosed with an anxiety disorder (e.g., generalized anxiety disorder, social phobia, separation anxiety disorder) and their parents.

Dosage

Being Brave is typically delivered over 14–19 sessions. In the first six sessions, the therapist meets with just the parents. In the next 8–13 sessions, the therapist meets with both the child and the parents. The number of parent-child sessions depends on the number of sessions each family needs to complete the exposure exercises. Sessions typically last about 60 minutes and occur weekly.

Location/Delivery Setting
Recommended Locations/Delivery Settings

Being Brave is delivered in clinical settings.

Education, Certifications and Training

Being Brave is designed to be implemented by psychologists or other mental health professionals who have training and experience conducting cognitive-behavioral therapy with children and adults. Education requirements are determined by the organization implementing Being Brave.

Program or Service Documentation
Book/Manual/Available documentation used for review

The Being Brave Manual is implemented in conjunction with the Parent Workbook.

Hirshfeld-Becker, D. R. (2006). Being Brave: A program for coping with anxiety for young children and their parents.

Hirshfeld-Becker, D. R. (2006). Being Brave: A program for coping with anxiety for young children and their parents – parent workbook.

Available languages

Being Brave materials are available in English.

Contact Information for Developers

Email: dhirshfeld@mgh.harvard.edu 

Results of Search and Review Number of Studies Identified and Reviewed for Being Brave
Identified in Search 4
Eligible for Review 1
Rated High 0
Rated Moderate 0
Rated Low 1
Reviewed Only for Risk of Harm 0
Sometimes study results are reported in more than one document, or a single document reports results from multiple studies. Studies are identified below by their Prevention Services Clearinghouse study identification numbers.


Studies Rated Low

Study 12304

Hirshfeld-Becker, D. R., Masek, B., Henin, A., Blakely, L. R., Pollock-Wurman, R. A., McQuade, J., DePetrillo, L., Briesch, J., Ollendick, T. H., Rosenbaum, J. F., & Biederman, J. (2010). Cognitive behavioral therapy for 4-to 7-year-old children with anxiety disorders: A randomized clinical trial. Journal of Consulting and Clinical Psychology, 78(4), 498-510. https://doi.org/10.1037/a0019055

This study received a low rating because it did not meet design confound standards.


Studies Not Eligible for Review

Study 14320

Hirshfeld-Becker, D. R., Masek, B., Henin, A., Blakely, L. R., Rettew, D. C., Dufton, L., Segool, N., & Biederman, J. (2008). Cognitive-behavioral intervention with young anxious children. Harvard Review of Psychiatry, 16(2), 113–125. https://doi.org/10.1080/10673220802073956

This study is ineligible for review because it does not use an eligible study design (Study Eligibility Criterion 4.1.4).

Study 14362

Hirshfeld-Becker, D. R., Henin, A., Rapoport, S. J., Wilens, T. E., & Carter, A. S. (2019). Very early family-based intervention for anxiety: Two case studies with toddlers. General Psychiatry, 32(6), e100156. https://doi.org/10.1136/gpsych-2019-100156

This study is ineligible for review because it does not use an eligible study design (Study Eligibility Criterion 4.1.4).

Study 14363

Driscoll, K., Schonberg, M., Stark, M. F., Carter, A. S., & Hirshfeld-Becker, D. R. (2020). Family-centered cognitive behavioral therapy for anxiety in very young children with autism spectrum disorder. Journal of Autism and Developmental Disorders, 50(11), 3905-3920. https://doi.org/10.1007/s10803-020-04446-y

This study is ineligible for review because it does not use an eligible study design (Study Eligibility Criterion 4.1.4).