Cognitive Behavioral Therapy for Separation Anxiety
Cognitive Behavioral Therapy (CBT) is an empirically-based psychotherapy used to treat anxiety disorders. Anxiety disorders include Obsessive Compulsive Disorder (OCD), Specific Phobia, Post Traumatic Stress Disorder (PTSD), Generalized Anxiety Disorder and Social Phobia. In children, a common type of anxiety is called Separation Anxiety. Separation Anxiety occurs when a child has difficulty separating from her parent. Children with Separation Anxiety often show clingy behaviors and crying when it is time to separate from her parents. These children often have a hard time going to school or any other activities where the parent is not in the same room. Separation Anxiety may be treated with Cognitive Behavioral Therapy (CBT).
Cognitive Behavioral Therapists (CBT) are usually faced with separation anxiety with children under the age of seven. It is important for a Cognitive Behavioral Therapist (CBT) to do a thorough intake evaluation with a parent if a child is under seven years old. The intake session should include a thorough assessment of the child’s developmental history (noting for developmental delays), temperament, emotional issues, medical history, home life, academic functioning and social functioning. It is often difficult to cover each of these areas in detail in one session. For this reason it is important for Cognitive Behavioral Therapist (CBT) to tell parents that the intake made car over two or three sessions. Allowing for multiple sessions will give the Cognitive Behavioral Therapist (CBT) enough time to fully assess each of the child’s life domains.
Child Separation Anxiety
For children with Separation Anxiety, it is important for therapists to ascertain from parents during the intake sessions specific triggers for the child Separation Anxiety. For most children with Separation Anxiety, it is difficult to separate from her parents in almost every setting. Being that mothers are often the primary caretakers, children usually have a more difficult time separating from their mothers than they do their fathers. In Cognitive Behavioral Therapy (CBT) the therapist will educate the parent on anxiety, how it develops, possible genetic components and the treatment for anxiety.
Exposure Therapy is an empirically validated treatment for anxiety, including Separation Anxiety. Cognitive Behavior Therapy (CBT) utilizes exposure therapy as part of the treatment process. Parents should be educated on the Exposure Therapy process, including that if it is decided that in vivo exposure is recommended, they must participate in particular assignments throughout the week. It is often the case in children with Separation Anxiety, where they fear being alone in a particular room or floor of the house. A Cognitive Behavioral Therapist (CBT) will teach the parents the components to exposure therapy, and devise a gradual exposure homework assignment for them. For example, the child may first be in a room alone for 30 seconds, and work her way up to one hour, at which point the anxiety will likely no longer be an issue. Children may be included in Cognitive Behavioral Therapy (CBT) sessions, particularly if they were awards program is going to be used as part of the Exposure Therapy. A Cognitive Behavioral Therapist (CBT) should help parents devise a reward system for complying with exposure therapy homework assignments. For example, for every minute a child is in a room alone in the house, she is rewarded with extra television time or a small toy.
Separation Anxiety often occurs outside of the home as well. Cognitive Behavioral Therapist (CBT) teach parents that a gradual separation is optimal. Children have difficulty going to school, the Cognitive Behavioral Therapist (CBT) may work with the school psychologist and teacher to help the child separate from her parent. The separation process should be gradual. Perhaps the parents can first walk the child into the school. The parent should be allowed to enter the classroom with the child. Each day the parent should stand closer to the door until she is eventually outside the door. Ultimately, the parent will be able to leave the child in the classroom setting without the child experiencing significant crying or emotional outbursts. Again, Cognitive Behavioral Therapist (CBT) often choose to use rewards to help the child through school Separation Anxiety. Teachers may reward the child for separating from her parent by giving her a particular privilege in school or special job.
In general, children may experience anxiety beginning in early childhood. Separation Anxiety is usually one of the first manifestations of anxiety disorders. Parents should be educated about anxiety in general, and taught how to recognize cues if anxiety starts to develop in other areas as well. Other common areas for children to experience anxiety are in social settings, perfectionistic tendencies, or trying out something new. Overall, parents should be educated about the importance of encouraging their children to engage in tasks that may be anxiety provoking, which will ultimately minimize the anxiety and prevent it from getting worse.