New ‘Timid to Tiger’ parenting-based group intervention for young anxious children shows promise

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This randomised controlled trial published in the Journal of the American Academy of Child and Adolescent Psychiatry looks at the effectiveness of a new cognitive-behavioural parenting-based approach for treating anxiety in young children.

Timid to Tiger is an entirely parenting-based approach to managing anxiety in children aged nine years or below. It is based on evidence that anxious children benefit substantially from a parenting style that is clear, calm and consistent. Parents learn a new approach to managing their children, using attachment-based play, lots of praise and reward for good and confident behaviours, and gentle disciplinary techniques and planned ignoring for unwanted behaviours. Parents are also taught a number of simple cognitive-behavioural techniques for managing their children’s fear and worry.

This RCT involved the families of 74 anxious children (aged 9 years or less) and compared the new 10-session, group-format intervention with a wait-list control condition. Outcome measures included blinded diagnostic interview and self-reports from parents and children.

Intention-to-treat analyses indicated that children whose parent(s) received the intervention were significantly less anxious at the end of the study than those in the control condition:

  • 57% of those receiving the new intervention were free of their primary disorder, compared with 15% in the control condition
  • 32% of treated children were free of any anxiety diagnosis at the end of the treatment period, compared with 6% of those in the control group
  • Treatment gains were maintained at 12-month follow-up

The authors of the research concluded:

This new parenting-based intervention may represent an advance in the treatment of this previously neglected group.


  • Cartwright-Hatton S, et al. A new parenting-based group intervention for young anxious children: results of a randomized controlled trial. J Am Acad Child Adolesc Psychiatry. 2011 Mar;50(3):242-251.e6. [PubMed abstract]
  • From Timid to Tiger: parenting the anxious child. British Psychological Society workshop in London, 3rd October 2011.
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