Child and Adolescent Psychiatric Clinics of North America
Evaluation and Treatment of Anxiety Disorders in the General Pediatric Population: A Clinician's Guide
Section snippets
Diagnostic evaluation of anxiety
A satisfactory evaluation process needs to resolve several issues, including the differential diagnosis, particularly given the high rates of comorbidity, the severity of symptoms relative to appropriate peers, and the impact of the symptoms on functioning. For the purpose of planning treatment, it is also essential to conduct an assessment (often referred to as functional assessment) of factors that maintain symptoms. The variety of questions to be answered leads to a need for a multimethod
Maintaining factors in child and adolescent anxiety
Research on anxiety disorders in children and adolescents have implicated four primary factors that potentially maintain the disorder individually or in combination. These factors are targeted within the highly successful cognitive-behavioral treatment (CBT) approach favored in the empirical literature [65]. A fundamental maintaining factor in child anxiety disorders is avoidance of feared situations. By minimizing direct and prolonged contact with feared situations, anxious children have no
Cognitive-behavioral approaches to treatment
Various manualized approaches to child anxiety based on cognitive behavioral therapy have been developed that address the maintaining factors described above. In common across these programs are treatment components of graded exposure to address avoidance, cognitive restructuring to address interpretive and attentional biases, and skills training that can include relaxation, problem solving, social skills, and assertiveness or stress management techniques to improve problem-focused coping
Summary
There have been significant advances in the assessment and treatment of child and adolescent anxiety disorders over the past 10 years. These advances provide clinicians with psychometrically sound diagnostic interviews, and self-report measures of symptoms and maintenance factors. Manualized cognitive behavioral treatment packages address the four major maintenance factors with significant success across a variety of populations and are sufficiently flexible to incorporate additional treatment
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