Assessment and Treatment of Anxiety in Children and Adolescents is often undetected, misdiagnosed or untreated and the most prevalent mental health conditions experienced during childhood to adolescence. If anxiety is not treated, the long-term impact can negatively impact an individual's academic functioning and success, family relationships, career pursuits and ability to connect with peer groups. It also increases the risk of an individual's engagement with substance abuse. If anxiety continues into adulthood, it may increase significant risk to health complications including:

• Impaired sleeping patterns
• Digestive problems
• Damage to kidney, blood vessels and heart

Most parents may minimize the importance of proper Assessment and Treatment of Anxiety in Children and Adolescents stating that, "it's nothing serious," or "my child just needs to learn how to toughen things out more," or "they will grow out of it." Anxiety and Depression Association of America (2015) conducted a survey of Americans and found that more than half of the respondents did not recognize that anxiety disorders increase the risk of suicide. For children and adolescents that are affected by anxiety disorders, it is important to obtain information about treatment options as overcoming anxiety is not a simple solution of "getting over it" or developing "thicker skin." Evidence based treatment are available to effectively address these potentially debilitating disorders.

 

By the age of 18, nearly 1 out of every 3 teens meet criteria for an anxiety disorder (Merikangas et al., 2010.) 

• Taking excessive periods of time to complete tasks
• Demonstrating signs of perfectionism or overreacting to failure
• Rigidity/inflexibility in completing tasks or activities or rigidity in feelings towards others
• Sleep-related difficulties such as refusing to sleep in own bed or engaging in lengthy bedtime routine, reports of nightmares or frequent trips to the bathroom or for another sip of water, etc.
• Having trouble focusing in class or sitting still
• Seeking repeated or excessive amounts of reassurance
• Substance use
• Difficulties with transitions
• Complaints of physical ailments
• Behavioral problems and symptoms such as angry outbursts

• Excessive worry
• Persistent fear
• Avoidance behavior (e.g., school refusal)
• Difficulty concentrating
• Restlessness
• Clinginess with caregivers
• Irritability (e.g., temper tantrums)
• Sudden bouts of intense anxiety
• Sleep difficulties
• Cognitive distortions (e.g, maladaptive thoughts)
• Behavioral compulsions (e.g., repetitive acts)

OCD and PTSD may involve anxiety as a primary symptom, but are not formally diagnosed as an anxiety disorder in the DSM-5. Autism Spectrum Disorder may involve anxiety, but is not one of the defining criteria. ADHD may co-occur with anxiety. Anxiety may priced the onset of an additional disorder such as major depressive disorder or eating disorders.

• Generalized Anxiety Disorder
• Separation Anxiety Disorder
• Selective Mutism
• Specific Phobia
• Social Anxiety Disorder (social phobia)

Panic Disorder

Agoraphobia

Substance/medication-induced anxiety disorder

Anxiety disorder due to another medical condition

Other specified/unspecified anxiety disorder

When evaluating children and teens for anxiety, we will coordinate care with your primary care physician to help rule out medications and medical conditions that can cause the same symptoms presented in anxiety disorders. We then recommend a psychological evaluation to avoid misdiagnosis. We conduct anxiety assessments by first collecting a complete history of symptoms, history of mental health disorders, treatment obtained and methods of treatment. We will collect history of substance abuse and assess for suicide risk and identify contributing substances such as caffeine, nicotine, herbal preparations, stimulants, prescription medications and over-the-counter medications. We evaluate how culture, parenting techniques, environmental circumstances, and current stresses impact presenting symptoms. Questionnaires may be provided to the individual and parent/care taker to identify specific anxiety diagnosis and assess severity of symptoms.  

• Cognitive Behavioral Therapy (CBT)
• Psychoeducation
• Relaxation Training
• Mindfulness Training
• Social Skills Training
• Cognitive Restructuring
• Teaching Problem Solving Techniques
• Exposure Therapy
• Contingency Management
• Medication Management
• Coping Cat Program
• Parent Training
• Acceptance and Commitment Therapy
• Trauma-Focused Interventions