Anxiety Disorders in Children and Adolescents-Recognizing and Treating the Emerging Epidemic – Paul Foxman

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Anxiety disorders are now recognized as the most common emotional problem in 10 out of 17 countries surveyed by the World Health Organization, including the United States. The increasing rate of stress and trauma to children, which includes divorce, family breakdown, violence in society, the media, and a failing school system, has produced a “shell shocked” generation suffering from anxiety in many cases. The challenge for clinicians is to recognize anxiety in children and help them cope.

Dr. Paul Foxman will present a template for how and why anxiety develops in children and adolescents. He will present practical treatment strategies that can be applied immediately. The seven key anxiety disorders along with case examples to be addressed include:

• Separation anxiety disorder
• Panic disorder
• Overanxious disorder
• Obsessive-compulsive disorder
• Social anxiety disorder
• Phobias
• Post-traumatic stress disorder

Other co-occurring disorders (e.g. behavior problems, medical conditions, depression, ADHD, learning disabilities, selective mutism) will also be discussed. Emphasis will be on creative interventions involving insight-oriented, cognitive-behavioral, biological, mindfulness, expressive arts and family systems approaches.

1. Apply the “Three Ingredients” framework for understanding how, why and when anxiety occurs in children.
2. Draw from 10 specific stress-management strategies to target the “when” factor in child and adolescent anxiety.
3. Recommend 8 steps teachers can take to reduce anxiety in the classroom for more focused attention.
4. Implement at least one effective treatment strategy for each of the 7 key anxiety disorders to modify sources of stress.
5. Designate 3 steps that schools can take to create a safe, calm environment for meeting the needs of anxious students.
6. Create a therapeutic alliance with parents to improve the effectiveness of clinical treatment with anxious kids.

Nature and Causes of Anxiety

• How anxiety develops in children
• Three ingredients in all anxiety disorders
• The ”anxiety personality” – assets and liabilities

Seven Key Anxiety Disorders

• Separation anxiety disorder
• Panic disorder
• Overanxious disorder
• Obsessive-compulsive disorder
• Social anxiety disorder
• Phobias
• Post-traumatic stress disorder

Co-Occurring Disorders

• Depression
• ADHD
• Learning disabilities
• Selective mutism

Therapeutic Approaches

• Cognitive-behavioral
• Biological
• Mindfulness
• Expressive Arts
• Family Systems Approaches

Interventions and Self-Regulation Strategies

• The Floating Technique for panic anxiety
• Exposure and Response Prevention (ERP) for OCD
• Mindfulness for worry
• Solution Focused Intervention for worry
• Group Therapy guidelines for social anxiety
• Visualization Desensitization for separation anxiety
• Three Question Technique for parents struggling with child separation anxiety
• Three Step Technique for managing children’s stress
• Yoga games and breathing techniques for relaxation training
• LifeSkills Program for generalized anxiety
• Virtual Reality approach for phobias
• Baby Buddhas meditations for anxious preschoolers

Limitations of Research and Potential Risks

• Consider scope of practice
• Empirical and anecdotal evidence
• No “one size fits all” for any modality of anxiety treatment