Abstract
Anxiety is a common and very severe childhood condition often affecting the child’s social and academic performance negatively. Untreated anxiety may persist disrupt-ing emotional development and overall functioning and may also continue into adulthood. This calls for immediate and effective treatment for anxious children. Results from randomized, clinical trials (RCTs) support the utility of child-focused cognitive-behavioral therapy (CBT) in treating anxiety in children. However, a considerable variability in success rates indicates the need to investigate variables that may affect treatment response, and a pivotal research area is active parent involvement. However, despite sound theoretical and clinical arguments for the benefits of including parents in the treatment, RCTs have not been able to give convincing documentation that parent involvement enhances the effects of CBT. This is a cause for puzzlement for which reason the objective of the thesis is to investigate possible mediating factors affecting the child’s recovery and process of change not captured by RCTs. Such mediating factors might be illuminated through an examination of the parents’ perspectives when being involved in the child’s therapy. These considerations add up to the following problem statement:
How do parents experience being involved in their anxious child’s cognitive therapy? Which perspectives can the parents’ experiences give on the potential significance of parent involvement in relation to the child’s process of change?

The theoretical introduction of the thesis highlights different theoretical and empiri-cal approaches as to why and how parents should and could be involved in the child’s therapy. From a social cognitive developmental viewpoint parents provide necessary cognitive scaffolding for the child. In addition a more contextual and systemic perspective argues that parents can be both risk and protective factors in relation to the anxiety disorder, which is why they must be involved in the treatment so that risk factors can be addressed and protective factors enhanced.

Drawing on these theoretical and empirical insights the thesis’ methodological section presents a phenomenological and hermeneutic inspired qualitative research design that is employed to investigate the problem statement. The design comprises a method triangulation combining individual interviews carried out with two sets of parents, a focus group with a therapy group of parents, and observations of therapy sessions with active parent involvement. The collection of data takes place at a University Clinic which runs a manualized cognitive intervention program for anxious children with a high level of parent involvement.
Following the empirical collection of data a phenomenological interpretative analysis (IPA) revealed four central themes in the parents’ experience of being involved in their children’s therapy: the importance of acknowledgement, the dual impact of the group therapy, the anxiety’s embedment in the family, and the notion of hope in the anxiety disorder.

In light of the analysis of the parents’ narratives about their involvement it is discussed how the involvement and the parents’ experiences of it may become important for the process of change of both the child and the parents, arguing that parent involvement and lifestyle changes in the family might affect the durability of the treatment effect.
An evaluation of the quality of the knowledge generated from the thesis includes a critical methodological discussion considering the validity and reliability of the present study and underlines that qualitative methodology seen from the standpoint of a positivistic ideal of knowledge has pitfalls. The thesis has sought to take the shortcomings into consideration by applying systematic procedures, being transparent in the description of methods and procedures, triangulation of data collection methods, and analytic instead of statistical generalization. In a final discussion meant to add perspective the clinical implications of the results of the thesis are discussed in relation to their potential contribution to clinical practice in the treatment of anxious children. It is suggested how therapy for anxious children and parent involvement could benefit from actively involving both parents in the treatment, conducting therapy in a group format, outlining clear expectations for the role of the parents, and from using hope as a coping mechanism focusing on helping the families to develop a resource oriented narrative about themselves.