Does your 8-year-old daughter worry that you'll get into a car crash when you drive to work? Does your 10-year-old son become upset and panicky at the thought of meeting new kids at a birthday party? You might be dealing with an anxiety disorder.
Anxiety is the most common psychiatric disorder affecting children, according to the Child Mind Institute. More than 40% of the 17.1 million U.S. kids diagnosed with a psychiatric condition have some type of anxiety disorder, and more than 8% are severely impaired by their anxiety. But 80% of children with anxiety disorders don’t get treatment, which can lead to serious psychiatric disorders later in life like panic attacks and social phobias. Treatment can change the world for your child -- you just have to find the right therapy.
Several psychotherapy options exist, including family, group, and play therapies. An approach called cognitive behavioral therapy (CBT) is commonly considered to be the most effective treatment for anxiety in children, according to Jonathan Comer, PhD, an associate professor of psychology and psychiatry at Florida International University who specializes in childhood anxiety disorders. “It focuses on the fact that thoughts, behaviors, and feelings are all connected. By changing the thoughts, you can change the feelings. For anxiety disorders, it’s essential to combine CBT with exposure therapy, in which the child gradually and systematically confronts situations or objects that they’re afraid of.”
For example, if your child has anxiety about riding in elevators, the therapist would help them slowly approach the fear. First, they might push the button to call the elevator and just look inside when the doors open. Next, they might take one step in, leaving one foot in the hallway. Another step might be going all the way inside, but holding the emergency button so the doors won’t close. “This might all be across several weeks,” Comer says. “What’s important is that they are practicing their skills in increasingly frightening situations, with a therapist they are comfortable with.”
Cognitive behavioral therapy is very effective, but therapy alone doesn’t always get a child’s anxiety under control. If the anxiety persists, prescription medications -- particularly certain antidepressants -- can be useful in treating an anxiety disorder.
Choosing a Therapist
To find the right one for your child, follow these steps suggested by psychologist Jonathan Comer, PhD.
Search for therapists in the online directory established by the Association for Behavioral and Cognitive Therapies.
Ask how long the therapist doesin-session exposure therapy for anxiety. “Many therapists say they do CBT for anxiety, but they don’t do in-session exposure,” Comer says. “That’s like making an omelet without the eggs. The active ingredient in CBT for anxiety is exposure to the fears.”
Ask how long the therapist expects treatment to last. It shouldn’t be more than 4 months. “Extended treatment aimed at finding the root cause of the anxiety is usually not helpful because the causes are many. There’s no ‘single bullet’ model of childhood anxiety. Even awareness of the cause doesn’t help change things,” Comer says.
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