Anxiety and Children—3

In this, the final article on anxiety in children, I talk about how to seek professional help for your child who is experiencing difficulty with anxiety. If you haven’t been able to make significant inroads into your child’s anxiety problems, it is probably a good time to seek professional help.

The good news is anxiety is quite responsive to therapy and treatment. The bad news is it is really only responsive to good therapy and there is a lot of bad therapy out there. You really want to avoid “traditional therapy” when seeking help for anxiety. By traditional therapy I mean talking about the problem and trying to understand where it came from and resolve the “underlying issues.” Such therapy doesn’t do much for anxiety and in fact, may make it worse.

In interviewing a therapist for your child, and you should interview a therapist if you seek therapy, ask how they work. If they focus on understanding and insight you should probably move on to someone else. If they talk about building skills, tell you some of the skills they will help build, and talk about exposure and facing fears, they are on the right track. A good therapist will also want to involve the family in the treatment. Good skill building requires practice and family involvement helps structure that in a way that is more effective.

What about medications? Medications are often prescribed for anxiety, but my sense, and bias, I admit, is that therapy is a better path to take. Two general kinds of drugs are prescribed for anxiety. One is a type of tranquilizer, and they are very effective – but in an ineffective way. They make anxiety go away but do it in a manner that is tantamount to avoidance, making the anxiety stronger and requiring more and more drugs for the same effect. These drugs tend to be highly addictive and are almost never prescribed to children (I have never seen it). The second kind are the drugs identified primarily as antidepressants that affect the neurotransmitter serotonin. They may have some impact on general levels of anxiety, but in my experience if children have anxiety about specific events or situations they will still need some type of therapy to effectively address it.