BRAVE is an acronym for the CBT anxiety management strategies covered in the program. Each letter refers to a different strategy. Child sessions focus on the acquisition of these strategies throughout the program
Relax: a method for calming down one’s body signs through the use of progressive muscle relaxation, guided imagery, or deep breathing.
Activate helpful thoughts: training in coping self-talk and cognitive restructuring.
Victory over fears: incorporating strategies for overcoming fears by using graded exposure and problem solving.
Enjoy yourself: training the child and parent in positive reinforcement and self reward.
BRAVE-ONLINE was designed for children (age 8-12) and adolescents (age 13-17) experiencing Separation Anxiety Disorder, Social Phobia, Specific Phobia and Generalised Anxiety Disorder. The material can be tailored by the therapist to meet the needs of the individual young person.
The program contains examples relating to all of these anxiety disorders and a wide range of anxiety-provoking situations. Thus, during the program, it is likely that the young person will be exposed to examples relevant to their anxiety. In weekly feedback emails, the therapist is able to assist the young person, and their parent(s), to tailor the anxiety management strategies for their specific type of anxiety. Graded exposure forms a significant component of BRAVE-ONLINE and the therapist spends a substantial amount of time ensuring that the young person creates and implements an exposure hierarchy suitable to their individual type of anxiety.
Parents Partner with Your Child
Parent sessions are designed to accompany the material covered in the child (age 8-12) and teen (age 13-17) programs. Sessions focus on psychoeducation about child anxiety, contingency management, relaxation training, and information about cognitive restructuring, graded exposure and problem solving. As such, the parent receives training in anxiety management strategies and is empowered to help his or her child acquire and use the skills learned in the program, and to manage situations in which his or her child becomes anxious. Both mothers and fathers are able to complete the parent sessions together or independently.
Ideally, the parent and young person will complete BRAVE in tandem; however, BRAVE can be completed by just an adult or just a young person, if you so choose.
BRAVE-ONLINE sessions are intended to be completed once per week, and are accessed in a prescribed order and rate. That is, children and parents can only progress through their sessions in a particular order, and are only able to access the next session 7 days following their completion of the previous session. A 7-day interval allows participants sufficient time to implement and practise skills before progressing to the next session that builds upon previous skills, thus maximising treatment effectiveness.
At the end of each session, children and parents are assigned homework tasks to be completed before the next session. On most occasions, children and parents are required to print off a worksheet to assist them with their homework task over the week. At the beginning of the following session, children and parents are then asked to enter a written account of their homework task, and describe any difficulties experienced with the tasks. As will be discussed in the following sections, the online therapist is then able to respond to these reports via email and offer reinforcement, encouragement and assistance where required.
BRAVE RCTs: Randomised Control Trials (RCT)
- Donovan, CL; March, S; Spence, S. (2008). The efficacy of an internet-based cognitive-behavioral therapy intervention for child anxiety disorders. Journal of Pediatric Psychology 34(5):474-87 Read More
- Donovan, CL; Kenardy, J; March, S; Spence S. (2011). A randomized controlled trial of online versus clinic-based CBT for adolescent anxiety, Journal of Consulting and Clinical Psychology, 79(5) Read More
- Holmes, JM; Lipp, OV; March, S; Spence, S. (2006). The feasibility and outcome of clinic plus internet delivery of cognitive-behaviour therapy. Journal of Consulting and Clinical Psychology, 74(3), 614-621 Read More
- Donovan, CL and March, S. (2004). Online CBT for preschool anxiety disorders: A randomised control trial, Behaviour Research and Therapy 58C:24-35 Read More
To view more RCTs, please click here.