Table 2.

CBT Framework and Techniques Used in the “Your Teeth. You Are in Control” Self-help CBT Resource.

Five Areas Model of CBT: Main Areas Targeted	Information/Activities included in the CBT Resource “Your Teeth. You are in Control” and Supporting Resources
1) Altered thoughts and 2) altered feelings	The CBT self-help resource: • Explains how dental anxiety is common to normalize children’s feelings (e.g., “Not everyone loves their dentist” section). • Explains the common unhelpful thoughts that children with dental anxiety experience (using data provided by children in qualitative interviews) and how they can challenge these unhelpful thoughts. • Provides information on cognitive techniques/tools that children can use when at the dental clinic (e.g., “Here’s how to take control” section). • Contains procedural and treatment information (e.g., “The facts” section). • Encourages children to reflect on their experiences and reappraise their anxiety (e.g., “Now you’ve finished” section).
3) Altered behaviors and 4) physical symptoms	The CBT self-help resource: • Provides information on specific behavioral techniques/tools children can use (e.g., “Here’s how to take control” section). • Encourages patients and dentists to develop a shared treatment plan (e.g., “Now make a plan” section). • Includes a communication tool that can be used by patients to communicate information about their anxiety to the dentist (“Dentist message” section). • Encourages children to write down the specific cognitive and behavioral techniques they are going to use next time they visit the dentist (e.g., “Preparing for next time” section). • Encourages the use of positive reinforcement to increase probability that helpful behaviors, such as attending the dentist and/or receiving treatment, will be repeated (e.g., “Time for a reward” section).
5) Situational influences of dental anxiety (e.g., improving the patient–dentist relationship, dealing with parental anxiety)	The CBT self-help resource: • Requires patients and dentists to work through parts of the resource together to build up trust and a beneficial patient–dentist relationship. • Contains supporting resources for dental team members and parents/carers to facilitate a “team approach” to the management of children’s dental anxiety.