Anxiety Disorders in Children and Adolescents

TREATMENT Treatment of children with anxiety disorders of mild severity and minimal impairment should begin with psychotherapy.2 Combining psychotherapy with medication treatment may be necessary in children with moderate to severe anxiety, when treating a comorbid disorder, or when there is a parti...

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Bibliographic Details
Published inPsychiatric Times Vol. 26; no. 10; p. 40
Main Authors Connolly, Sucheta D, Nanayakkara, Sonali D
Format Trade Publication Article
LanguageEnglish
Published Monmouth Junction UBM LLC 01.10.2009
Subjects
Anxiety
Children & youth
Parents & parenting
Preschool children
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Summary:TREATMENT Treatment of children with anxiety disorders of mild severity and minimal impairment should begin with psychotherapy.2 Combining psychotherapy with medication treatment may be necessary in children with moderate to severe anxiety, when treating a comorbid disorder, or when there is a partial response to psychotherapy alone.5 To investigate monotherapies versus combined treatment, the Child/ Adolescent Anxiety Multimodal Study (CAMS), a placebo-controlled trial in youths with moderate to severe SAD, GAD, and/or social phobia, compared CBT, sertraline, or placebo with combination treatment with sertraline and CBT.6 CBT (60% improved) and sertraline (55% improved) showed relatively equal efficacy and were superior to placebo (24% improved) for the treatment of childhood anxiety disorders, and the combination of CBT and sertraline (81% improved) had a response rate superior to either modality alone. Velting and colleagues9 describe several components of CBT for childhood anxiety disorders as follows: * Psychoeducation with child and parents about anxiety and CBT for anxiety disorders * Somatic management skills training: self-monitoring, muscle relaxation, diaphragmatic breathing, relaxing imagery * Cognitive restructuring: challenging negative thoughts and expectations, learning positive self-talk * Practicing problem solving: generate several potential solutions for anticipated challenges and generate a realistic action plan ahead of time * Exposure methods: imaginal and live exposure with gradual desensitization to feared stimuli * Relapse prevention plans: booster sessions and coordination with parents and school Along with these components, parents are taught to provide consistent and frequent positive reinforcement for the child's efforts and successes.
ISSN:0893-2905