Research findings have supported the efficacy of cognitive behavioral therapy (CBT) in reducing anxiety symptoms and increasing function in anxious children.30,31 In one study, anxious children who underwent CBT for primary anxiety disorders were found less likely than untreated children to engage in substance use during adolescence and young adulthood.32 This study also identified a slightly decreased incidence of chronic depression and anxiety in the treatment group.
For children with anxiety disorders, key components of CBT include acknowledging anxious feelings, clarifying thinking in situations that provoke anxiety, developing a plan for coping, and evaluating the effectiveness of the strategies used. Parental involvement appears to enhance CBT.11,31
In other research, certain psychopharmacologic therapies have been shown to decrease anxiety symptoms in pediatric patients; the safety of these medications in children continues to be researched.33-35 Combining CBT with pharmacotherapy has been associated with an improved response, compared with either treatment option alone.1
In patients with a predisposition to anxiety disorders, such as children of a parent with a diagnosis of an anxiety disorder, preventive intervention strategies may also have a role.36 Further study is needed to determine the most effective method for preventive intervention among higher-risk children.
Conclusion According to data from a growing body of evidence, anxiety disorders are disabling conditions that affect a significant portion of the pediatric population. Because children with anxiety will likely be seen in pediatric or family care practices, providers in these settings are called on to familiarize themselves with the signs and symptoms of common anxiety disorders, their diagnostic criteria, and the simple screening tools that are available. Accelerating patients’ access to available mental health services can help the provider prevent significant impairment in these children’s lives.
