27 - Childhood anxiety disorders: best treatment options and practice

Summary

This chapter provides an overview of how to identify normal from abnormal anxiety in childhood, reviews evidence-based treatment options, presents recommendations for best practice, and proposes directions for future anxiety treatment research. Most children experience some developmentally appropriate fear or worry. Cognitive-behavioral therapy (CBT), behavior therapy (BT), and medications have all been found to be effective for the treatment of childhood anxiety. Selective serotonin reuptake inhibitors (SSRIs) are useful for treating children and adolescents with generalized anxiety disorder (GAD), social anxiety disorder (SAD), or obsessive-compulsive disorder (OCD). Children should have a physical examination to rule out medical conditions that might be related to anxiety. Finally, there is a need to study combinations of evidence-based treatments to address the problems of partial and non-responders. Since children with anxiety may have comorbid depression, using treatment strategies from Interpersonal Psychotherapy for Adolescents (IPT-A) in combination with CBT or BT may be beneficial.