Course excerpt from Anxiety in Children
Anxiety disorders in children are very common, usually chronic, and frequently disabling. Since everyone experiences anxiety at some point, the first step is to determine whether the disorder falls within the bounds of “normal” anxiety, or whether it is something that requires professional treatment.
Parents often need help making this determination. Mental health professionals can present the following checklist to parents so that they can determine if they need to access medical or psychological help for their child:
- Are you spending enormous amounts of time reassuring your child about engaging in normal activities?
- Is your child’s anxiety out of sync with what is expected developmentally?
- Is your child having difficulty with or have you noticed a significant change with sleeping, eating, or intrusive physical symptoms?
- Is your child crying a lot? Does your child seem inconsolable?
- Is the anxiety occurring regularly? Are the symptoms increasing?
- Is your child becoming socially isolated? Is your child avoiding social situations or school?
- Are there sudden changes in your child’s academic achievement or behavior?
- Is your child unusually irritable?
- Have these symptoms persisted over a few months?
- Is the anxiety interfering with social, emotional, or behavioral functioning?
The two most common forms of treatment for anxiety are cognitive behavioral therapy (CBT) and medication, usually selective serotonin reuptake inhibitors like fluoxetine, fluvoxamine, sertraline and paroxetine. Research has consistently demonstrated that cognitive-behavioral therapy and pharmacological therapies are most effective when used in conjunction with each other. Chansky (2014) does not recommend medication without concurrent cognitive-behavioral therapy.
Cognitive Behavioral Therapy (CBT)
Cognitive-behavioral therapy is based on the idea that feelings can be affected by our thoughts and behaviors. Thoughts are internal ways in which we talk to ourselves, and behaviors are the actions we take in everyday life.
Unhelpful thoughts and unhelpful behaviors lead to negative feelings, whereas helpful thoughts and helpful behaviors are related to positive feelings. It is cyclical: feelings lead to thoughts, which then lead certain actions (that is, behavior). Behavior can lead to negative thoughts and negative feelings. Negative thoughts can lead to negative behaviors and then negative feelings.
“The take home message is that understanding our feelings and how they affect us can lead us to do something to prevent our feelings from getting the better of us. We cannot make our feelings just go away, we can manage them. This can be accomplished by expressing our feelings…or by changing our thinking and behaving.”
Children who suffer from anxiety need to learn to think helpful and positive thoughts. The basis of treatment for children who suffer from anxiety is helping them understand that they can change their thinking patterns.
When is medication necessary? A pediatrician or psychiatrist needs to make that assessment and discuss the pros and cons of medication.
Medication is generally used when the level of anxiety is so high that the child is unable to use the skills that the therapist is attempting to teach the child. If medication is prescribed, parents need to know that it is not a “life sentence” and that their child might not always need to be on medication.
As noted earlier, the most common and demonstrably effective medications for childhood anxiety are selective serotonin reuptake inhibitors like fluoxetine, fluvoxamine, sertraline and paroxetine. Also – again as noted earlier – they are most effective when used in combination with cognitive-behavioral therapy.
While the primary focus of this course is on behavioral interventions for children with anxiety disorders, some readers may be interested in more information on pharmacological treatment. For those interested, a NIMH article on multimodal treatment of child/adolescent anxiety can be found at the following website: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4695375/
Anxiety in Children is a 4-hour online continuing education (CE/CEU) course that focuses on behavioral interventions for children with anxiety disorders. According to the Anxiety and Depression Association of America (2017), it is estimated that 40 million Americans suffer from anxiety disorders. Anxiety disorders affect one in eight children, but is often not diagnosed. Untreated anxiety can lead to substance abuse, difficulties in school, and depression. Professionals who work with children, including speech language pathologists, mental health professionals, and occupational therapists, frequently encounter anxiety disorders among their young clients. This course is intended to help clinicians recognize and understand the anxiety disorders that frequently occur in children and learn a wide variety of communication and behavioral strategies for helping their clients manage their anxiety. Included are sections on types and causes of anxiety disorders, strategies for prevention, evidence-based treatments, techniques for helping children manage worry, relaxation techniques for use with children, and detailed discussions on school anxiety and social anxiety. Course #40-43 | 2017 | 69 pages | 25 posttest questions
- CE Credit: 4 Hours
- Target Audience: Psychologists | Counselors | Speech-Language Pathologists | Social Workers | Occupational Therapists (OTs) | Marriage & Family Therapists (MFTs) | School Psychologists | Teachers
- Learning Level: Introductory
- Course Type: Online
This online course provides instant access to the course materials (PDF download) and CE test. After enrolling, click on My Account and scroll down to My Active Courses. From here you’ll see links to download/print the course materials and take the CE test (you can print the test to mark your answers on it while reading the course document). Successful completion of the online CE test (80% required to pass, 3 chances to take) and course evaluation are required to earn a certificate of completion.