Anxiety is a very common condition in children and adolescents. Anxiety Disorders are among the most common reasons that people seek therapy, or take their children to therapy. Research tells us that one in three people will be diagnosed with anxiety at some point in their life. That is a lot of anxiety! In reality though, the actual occurrence of anxiety may be even higher.
Anxiety is becoming more and more common in young children. Recent research (Egger et all, 2006) found that up to 20% of preschool students (under the age of 5) in pediatric primary care settings meet criteria for at least one anxiety disorder. These concerns are likely to impact daily living, family relationships, peer relationships, school readiness, sleep hygiene, and academic development.
The good news is that there are effective treatments for young treatment with anxiety.
So what are effective treatments for anxiety disorders in young children?
Parents and providers often seek out ways to bring relief to the child. Sometimes, the world of mental health is very confusing and difficult to access, particularly for young children. It can be very hard to know what is going to be helpful for young children and their families in these circumstances. However, the good news is that there are effective treatments for young children with anxiety.
Recently, in the Journal of Clinical Child and Adolescent Psychology, a group of researchers reviewed over 1400 studies on treatment of anxiety in young children to determine which treatments were most effective (Comer et al, 2019). Then they categorized them into 4 categories: well established, probably efficacious, experimental, and questionable efficacy. The results are below:
The best results for treatment of anxiety in young children (“well-established in the literature”) were with Family-Based Cognitive Behavioral Therapy (CBT).
Family-based CBT addresses the relationships between the child’s thoughts, feelings, and behaviors. It also includes a component of exposure therapy, which means it taught children (and their families) how to face their fears both in and outside of session. Family-based CBT also typically involves the child and parent, often helping the parent to learn specialized parenting skills to help their child better manage stress. Typical skills that are taught to parents and children include relaxation training, emotional identification, changing stressful thoughts, and facing fears one at a time.
The next best results for treatment of anxiety in young children included Group Parent CBT (with and without a group Child CBT component). These were termed “probably efficacious treatment” by the study.
Group cognitive behavioral therapy (CBT) teaches techniques and skills to manage a child’s anxiety in a group. Oftentimes groups include parents, and may also include groups of children. These kinds of groups also cover some of the same skills as the Family CBT, such as relaxation training, emotional identification, changing stressful thoughts, and facing fears one at a time. However, because they are taught in a group, skills are likely to be less personalized to an individual child or family.
The third category, “experimental treatment,” meant that the interventions were not yet tested in a randomized trial OR they were tested, but not sufficient in terms of effectiveness. The two interventions in this category included traditional play therapy and attachment-based therapy.
Play therapy and attachment-based therapy could be potentially effective. They often involve a therapist and child using toys or play techniques to better manage the anxiety. There is a tremendous amount of variability in the implementation of play therapy. As a result, effects vary widely in terms of effectiveness. More study is needed to better determine how helpful these treatments are in the treatment of anxiety.
The last category, “questionable efficacy,” included the intervention of relaxation training alone.
Relaxation training alone did not have as many helpful results when it was the only intervention used, particularly in young children with OCD. These findings may indicate that it is very important for parents and families to learn skills to help their young child. Other skills, such as facing one’s fears, are also a very important component of long-term success in treatment.
Conclusions about the treatment of anxiety in young children:
In sum, there are effective treatments, which offer good results for treating anxiety in young children. The treatments with the best proven effectiveness involve cognitive behavioral strategies, involving parents in their care. In the study, parents also reported positive responses about their participation in Family CBT.
At Hope Springs, we offer family cognitive behavioral treatments for treatment of child anxiety. Dr. Anderson, Dr. Stai, and Ms. Luria all provide this kind of care. If you would like to read more on child anxiety, you can click here and here.
Comer, J.S., Hong, N., Poznanski, B., Silva, K, and Wilson, M. (2019). Evidence Base Update on the Treatment of Early Childhood Anxiety and Related Problems. Journal of Clinical Child and Adolescent Psychology, 48(1), 1-15.
Author: Cindy AndersonDr. Anderson is a Board Certified Clinical Child Psychologist. She also owns Hope Springs Behavioral Consultants. Dr. Anderson has achieved a high degree of specialization in working with children and families. She holds a Ph.D. in Clinical Psychology and completed APA Accredited internship and postdoctoral training in Clinical Child and Pediatric Psychology. She prides herself as a life-long student and tries to learn something new every day.
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