Family Accommodation

What it is

A 2015 review by K. R. Norman, Wendy Silverman and Lebowitz describes family accommodation as highly prevalent in childhood anxiety disorders, as having a potentially harmful effect on the course of illness and on response to treatment, and as associated with greater burden on caregivers. The research links changes made to spare a child distress with a worse course of anxiety; it does not argue against comforting an anxious child.

In effect

The concept underpins a treatment called Supportive Parenting for Anxious Childhood Emotions, or SPACE, which works only with parents and aims to reduce accommodation while staying supportive. In a 2020 trial led by Lebowitz, 124 children aged seven to 14 with primary anxiety disorders were randomly assigned to SPACE or to cognitive behavioural therapy delivered to the child. SPACE was noninferior to the therapy on anxiety outcomes rated by independent evaluators, parents and children, and family accommodation fell more after SPACE.

What it does not say

The research concerns children with diagnosed anxiety disorders. It does not show that comforting a child is harmful, and it is not evidence about ordinary tantrums or everyday parenting. What it does show is that easing a child's distress today and helping that child over time can pull in different directions, which is one reason critics of gentle parenting worry about versions of it that avoid every upset.

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