Cognitive-behavior therapy for childhood anxiety disorders.
ABSTRACT Over the past decade, multiple controlled trials have demonstrated the efficacy of cognitive-behavior therapy (CBT) for the treatment of anxiety disorders in children and adolescents. Relying heavily on behavioral exposure, cognitive restructuring, and psychoeducation, CBT for child anxiety has been shown to be adaptable to a variety of implementation formats, including individual, family, and group treatment. This article describes the conceptual framework underlying CBT and the key elements of this treatment approach. Important developmental and family considerations in treatment are discussed, and the empirical literature is reviewed.
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ABSTRACT: Mood and anxiety disorders occur at high rates in the ado- lescent population, yet these disorders are alarmingly under-recognized and under-treated in medical settings. Due to the current controversy regarding antidepressants and suicidality, many adolescents may not be getting the care they need. While it is appropriate for primary care physicians to treat the majority of adolescents with these disorders, the physician must first feel comfortable managing these types of patients. Establishing rapport and developing a trusting doctor-patient relationship is an essential goal when working with adolescents. Cognitive-behavioral therapy, used in a primary care setting, can be an important non-phar- macologic tool which the physician can administer to depressed and anxious teens to assist in decreasing their distress. Referral for family therapy is also highly recommended. Overview "Isn't it sort of the norm for adolescents to be depressed and anxious? Most teenagers I know, my kids included, seem to experience mood swings a lot during this time of their lives." Mother of a Depressed Adolescent Patient Adolescence is a time of great change and also often a stormy time of developmental turmoil and conflicting emotional states. Despite this, mood and anxiety disorders are not a "normal" consequence of this stage of life. Most teenagers emerge from this turbulent period unscathed by clinical depression or anxiety, but there are also a significant number who are affected, and, unfortunately, they often go undiagnosed in the medical setting. The number of children and adolescents with depression is growing, with an estimated 5% affected at any one time¹ , ² and a lifetime prevalence of 15-20%.³ It continues to be under-recognized and under-treated despite its poor long- term outcomes, including risks for suicide4 and impairment in academic, occupational and interpersonal functioning. In addition, it is estimated that nearly 20% of adolescents with depression will go on to develop bipolar disorder.5 Mood and anxiety disorders are often co-morbid conditions; 15%-75% of depressed youths also have an anxiety disorder, and 11% to 69% of youth with anxiety disorders have a co-morbid mood disorder6. Other conditions which often exist with both anxiety and depression include personality disorders, Attention-deficit/hyperactivity Disorder (ADHD), substance abuse and eating disorders. These co-morbidities can lead to a more severe symptom presentation and often precede the depression or anxiety.7
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ABSTRACT: The following multiple baseline case series examines school refusal behavior in 4 male adolescents. School refusal symptom presentation was ascertained utilizing a functional analysis from the School Refusal Assessment Scale (Kearney, 2002). For the majority of cases, treatment was conducted within a 15-session intensive format over a 3-week period. Treatment elements included cognitive-behavioral therapy with the adolescent, parent training sessions, or a combination of these strategies. Treatment was effective for 3 of 4 cases in the short term. At 3-year follow-up, all 3 of the acute treatment responders had switched to alternative educational programs, although parents rated them as significantly improved and less impaired compared to pretreatment. Obstacles to treatment, and recommendations for program improvement, are discussed.Cognitive and Behavioral Practice 08/2009; DOI:10.1016/j.cbpra.2009.02.003 · 1.33 Impact Factor
Different Views of Anxiety Disorders, 09/2011; , ISBN: 978-953-307-560-0