Case study of family centred PBS with a parent with an anxiety disorder and child with autism and an anxiety disorder: Challenges and implications for successful implementation

Background: Parents with a mental health condition raising a child with autism who engages in problem behaviour pose significant challenges to family interventionists and researchers implementing family centred positive behavioural support (FCPBS) with families. Method and materials: A mother with an anxiety disorder and her child with autism and an anxiety disorder participated in an empirical case study of FCPBS that addressed the child's problem behaviour in a community-based swimming routine. Adaptations accommodated the mother's anxiety disorder. Baseline and intervention conditions were conducted. Results: The child progressed to the fifth of 16 steps in an anxiety hierarchy and problem behaviour decreased by 39%. However, in the fifth month of the study, the mother withdrew due to an increase in anxiety symptoms. Conclusion:The case study offers guidance to interventionists and researchers implementing FCPBS in collaboration with parents who have a mental health condition, including the importance of adjunctive treatment for parents, and interventionists being trained in cognitive behaviour therapy methods.