Coaching Approach Behavior and Leading by Modeling (CALM) Program for Treating Early Childhood Anxiety: A Case Study

Anxiety disorders onset earlier than most mental health conditions, with preschool-age children showing prevalence rates comparable to children ages 5 to 17 years. Yet, there are limited treatment options suitable for preschool-age children that account for still-developing abstract thinking and metacognition. The Coaching Approach Behavior and Leading by Modeling (CALM) Protocol was adapted from Parent-Child Interaction Therapy (PCIT) to target a broad range of anxiety disorders in children ages 3 to 8 years. This case study outlines the implementation of a 10-session CALM treatment protocol for a 5-year-old female presenting with generalized anxiety disorder (GAD). The treatment implemented PRIDE skills through parent coaching, followed by exposure-based sessions. Post-intervention assessments indicated significant improvement in anxiety symptoms measured by the Preschool Anxiety Scale (PAS) and high parent satisfaction measured by the Therapy Attitude Inventory (TAI). These findings support early intervention through parent-coaching as a viable alternative to cognitive therapies for young children with anxiety disorders.

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Publication Details

Journal
Clinical Case Studies
Published
2026-10-26
DOI
https://doi.org/10.1177/15346501261502396
Primary Topic
Child and Adolescent Psychosocial and Emotional Development
Type
article
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article

Coaching Approach Behavior and Leading by Modeling (CALM) Program for Treating Early Childhood Anxiety: A Case Study

Sarah Dickinson, Heather C. Agazzi, Dana G John
Clinical Case Studies
Child and Adolescent Psychosocial and Emotional Development
article

Coaching Approach Behavior and Leading by Modeling (CALM) Program for Treating Early Childhood Anxiety: A Case Study

Sarah Dickinson, Heather C. Agazzi, Dana G John
article en

Abstract

Anxiety disorders onset earlier than most mental health conditions, with preschool-age children showing prevalence rates comparable to children ages 5 to 17 years. Yet, there are limited treatment options suitable for preschool-age children that account for still-developing abstract thinking and metacognition. The Coaching Approach Behavior and Leading by Modeling (CALM) Protocol was adapted from Parent-Child Interaction Therapy (PCIT) to target a broad range of anxiety disorders in children ages 3 to 8 years. This case study outlines the implementation of a 10-session CALM treatment protocol for a 5-year-old female presenting with generalized anxiety disorder (GAD). The treatment implemented PRIDE skills through parent coaching, followed by exposure-based sessions. Post-intervention assessments indicated significant improvement in anxiety symptoms measured by the Preschool Anxiety Scale (PAS) and high parent satisfaction measured by the Therapy Attitude Inventory (TAI). These findings support early intervention through parent-coaching as a viable alternative to cognitive therapies for young children with anxiety disorders.

Clinical Case Studies
University of South Florida (US)
Good health and well-being
Openalex Percentile: Top 46%
Child and Adolescent Psychosocial and Emotional Development
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Coaching Approach Behavior and Leading by Modeling (CALM) Program for Treating Early Childhood Anxiety: A Case Study — Sarah Dickinson, Heather C. Agazzi, et al. · Clinical Case Studies (2026) | TGRS Research Map | TGRS