SPACE Treatment

Parent-based treatment can reduce youth anxiety.

What is SPACE? 

SPACE stands for Supportive Parenting for Anxious Childhood Emotions and is a parent-based treatment program for youth and young adults with anxiety, OCD, and related challenges including ARFID and transitioning to adulthood. SPACE was developed by Dr. Eli Lebowitz at the Yale Child Study Center and has been tested and found to be effective in randomized controlled clinical trials. For youth with anxiety, parents learn to let them face their fears.

Who is SPACE for? Who is the patient?

Childhood anxiety disorders are common and contribute to major short-term and long-term risks to physical and mental health when not treated successfully. Effective treatments include cognitive behavioral therapy (CBT) and medications, but have been found insufficient in up to half of cases in clinical trials, indicating the need for additional treatment options.

SPACE aims to treat youth and young adults with anxiety disorders including obsessive-compulsive disorder. Although children do not have to attend SPACE sessions - they are the patients! When SPACE treatment is successful children feel less anxious and function better following treatment, especially for some of the most common anxiety issues youth face.

Some of the anxiety challenges treated with SPACE include:

​Who participates in treatment?

Parents, and other caregivers, participate in SPACE treatment sessions. In most cases, the youth or young adult does not need to attend the treatment sessions. Because SPACE focuses entirely on parent and caregiver change, caregivers can implement SPACE even when a child is not amenable to treatment.

What happens in SPACE treatment?

Parents who participate in SPACE will learn skills and tools to help their child overcome anxiety, OCD, or related challenges. Treatment occurs over twelve sessions, typically with a “booster” session four to six weeks post-treatment to further solidify skills and tools.

The treatment focuses on changes that parents can make to their own behavior, they do not need to make their child change. Two main changes that parents learn to make in SPACE treatment are to respond more supportively to their anxious child and to reduce the accommodations they have inadvertently been making in order to reduce symptoms related to worry and fear. SPACE focuses on systematically identifying and monitoring family accommodation, developing and implementing detailed plans for reducing accommodation, and equipping parents with strategies for coping with children’s distressed and/or aggressive responses to reduced accommodation.

 

FAQs

  • SPACE Treatment is a treatment modality designed for parents to learn more about how they can support their children with anxious emotions. It was designed and researched at Yale University and has been found to be particularly helpful in reducing symptoms of generalized anxiety and obsessive-compulsive disorder. The treatment is much like individual parent consultation yet with specific goals in mind. I meet with parents separate from their child for approximately ten to twelve sessions for the entire course of treatment. Once that series is complete, you should be able to continue using the principles independently. It is recommended that we meet at one-month, three-month, and then six-month intervals for “booster” sessions and support with any areas that feel challenging. I bill each session at my regular rate and consider it a form of parent consultation or family therapy.

  • Ideally, all adults involved in the parenting of a youth living with anxiety should attend treatment. However, realistically with the demands of daily life, this can be challenging. At intake, we will discuss available options given your family’s unique needs. One thing to note is that SPACE provides an opportunity for strengthening co-parenting skills, so whenever adults can attend together there are benefits to treatment. Youth do not attend SPACE Treatment sessions but might be invited to join at any point in time if it is jointly agreed that they might benefit from psychoeducation.

  • Services are provided both in-person and via telehealth. Often, parents and guardians prefer the ease and convenience of telehealth for SPACE treatment sessions. In-person, standard precautions for healthcare settings are followed to minimize risk. This could include mask-wearing, social distancing, and daily cleaning of all high-touch areas of the office. Integrated practice management software from SimplePractice allows for HIPAA-compliant telehealth visits.

  • Before our first session, you will receive intake paperwork that can be submitted electronically through your client portal on SimplePractice. Additionally, you will be able to establish the online payment method you prefer. There may be other providers that you would like me to coordinate care with. Please consider signing a Consent for Release of Information with them prior to our first meeting.

    There are several resources you might wish to review before we meet. Links to articles are available on my website. Additionally, the book Breaking Free of Childhood Anxiety and OCD: A Scientifically Proven Program for Parents, by Eli Lebowitz and Treating Childhood and Adolescent Anxiety: A Guide for Caregivers, by Eli Lebowitz and Haim Omer are excellent guides for the work we will be doing together.

  • SPACE Treatment is billed as Family Psychotherapy without Patient Present. This means that each session is billed the same as a family therapy session and can be submitted to your insurance company as such. Family therapy session fees for a 45-50 minute session or 60-minute session apply. A one-time Diagnostic Interview fee is billed for our first session together and can also be submitted for reimbursement to your insurance provider.

  • I do not work directly with insurance companies. This means that I do not bill directly or provide treatment updates to insurance providers, and you are financially responsible for fees at the time of service. Depending on your out-of-network benefits, a portion of the cost may be covered by your insurance plan. Documentation for submitting a claim with your health plan provider will be generated by SimplePractice at the end of each session, or the end of every month. If you have insurance through your employer, I recommend that you contact your employer's human resources department for assistance.

  • A superbill is used to submit information to insurance providers for reimbursement. It includes appropriate codes related to service and diagnosis. Provider business information and tax identification are also included on the superbill. The superbill is separate from an invoice. Seeking pre-authorization or reimbursement from your insurance provider can be challenging and confusing. Please let me know how I can support you with this process.

  • Payment information is required upfront and charges are made after each session. Visa, MasterCard, American Express, and FSA cards are accepted.

  • If it is necessary to cancel an appointment, office policy states that you must cancel 48 hours before your scheduled appointment time. You will be charged the regular fee for the session if you have not provided notification of your cancellation 48 hours before the time of the appointment.