Separation Anxiety Disorder:
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.

Primary Symptoms:
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.

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Last Updated
May 5, 2015