Separation anxiety disorder refers typically to younger children who are
extremely unwilling to separate from major attachment figures (e.g., parents
grandparents, older siblings) or from home (DSM-IV 1994). The threat of
having to separate from a caregiver often results in anxiety as well,
such as when parents plan to go out for the evening and leave the child
with a sitter.
Excessive worry about potential harm toward oneself (e.g., getting sick at
school) or one’s primary caregivers (e.g., being in a car accident). The child
may also avoid activities that may result in separation from parents. Nightmares
and somatic complaints are common, inducing trembling, headaches, stomachaches,
nausea, vomiting, stomach pain and sweating.
Cognitive-behavioral treatment for separation anxiety disorder is focused
on teaching children several major skills. Children are taught to recognize
anxious feelings regarding separation and to identify their physical reactions
to anxiety. They are taught to identify their thoughts in anxiety provoking
separation situations, and are taught to develop a plan to cope adaptively
with the situation. Children are also taught to evaluate the success of
the coping strategies they employed, and are taught to praise themselves
for positive coping. In addition, behavioral strategies such as modeling,
role-playing, relaxation training, and reinforced practice are used. Children
are guided in developing a list of situations that are challenging for
them, such as attending a birthday party without their parent, or staying
home with a sitter. Children are taught to implement their coping skills
while gradually facing each of these situations. Children’s successes
are praised highly by the therapist and by parents. Recent research has
suggested that incorporating parents more centrally into the treatment
of children with anxiety disorders can be extremely useful in reducing
children’s anxious behavior and may enhance treatment effectiveness and
maintenance. Parents are often taught new ways to interact with their
children so that the child’s fears are not inadvertently reinforced. Parents
are also taught ways to give children ample praise and positive reinforcement
for brave behavior.
© 2001 The Child Anxiety Network. All Rights Reserved.
Sponsored by Psychzone Inc.