Anxiety disorders are known to affect 25% of children between 13 and 18 years of age and can severely interfere with your child’s life. Untreated anxiety disorders are known to lead to a decline in school performance, substance abuse disorders and poor social interactions. Anxiety disorders include a broad spectrum of disorders from generalized anxiety disorder and obsessive-compulsive disorder to panic disorder, social anxiety disorder and posttraumatic stress disorder. Anxiety disorders in children are best treated with psychotherapy techniques such as cognitive behavioral therapy, dialectal behavior therapy and exposure therapy. Medications for anxiety treatment include antidepressants; specifically selective serotonin reuptake inhibitors (SSRIs) and outcomes are best when these are used in combination with psychotherapy. Finding a mental health professional that treats children and adolescents may take some time but it is important that you and your child both feel comfortable with your provider and therefore is important to ask questions and establish a relationship.

Questions to ask your child’s mental health professional:

  • What training and experience do you have in treating anxiety disorders?
  • Do you specialize in treating children? (If your child is a teenager, you may want to ask the age limit that your child can remain under this specialist’s care.)
  • What is your training in cognitive-behavioral therapy (CBT) or other therapies?
  • What is your basic approach to treatment?
  • Can you prescribe medication or refer me to someone who can, if that proves necessary?
  • How long is the course of treatment?
  • How frequent are treatment sessions and how long do they last?
  • Do you include family members in therapy?
  • How will I know that my child is responding to the treatment and getting better?
  • If my child does not respond to treatment, how will you decide when to change or modify the treatment?
  • As my child ages, will any symptoms change? Will the response to treatment change?
  • What should I explain to the school about my child’s anxiety disorder?
  • How do you approach the topic of alcohol and substance use in teens who take medication?
  • Will you coordinate my child’s treatment with our family doctor or pediatrician?
  • What is your fee schedule, and do you have a sliding scale for varying financial circumstances?
  • What kinds of health insurance do you accept?

Treatment approaches

  • Cognitive-behavioral therapy (CBT): Also known as talk therapy. This type of therapy identifies the negative thoughts, feelings and distorted emotions associated with anxiety and uses behavioral techniques to transform these negative thoughts into positive outlooks and positive actions. Behavioral techniques include self-control therapy, problem solving and social skill training. Your child will learn to identify and replace negative thinking patterns and behaviors with positive ones. He/she will also learn to separate realistic from unrealistic thoughts.
  • Dialectal Behavior Therapy (DBT): Combines the acceptance of change with thoughts and behaviors in cognitive-behavioral therapy (CBT) while focusing on mindfulness, regulating emotions and stress relief techniques.
  • Exposure therapy: Used primarily for OCD and specific phobia. This type of therapy works by establishing an increasing order of challenges that provoke anxiety and exposes the child gradually to these situations over time.

Example: Fear of public speaking. You will begin with communication such a texting in a group then will work on speaking on the phone then gradually speaking in person to an increasing number of people.

  • Eye Movement Desensitization and Reprocessing (EMDR): Used to treat PTSD and includes brief, interrupted exposures to the traumatic event, eye movement tracking, and recall of feelings and emotions associated with the traumatic event.