Cognitive-Behavioral Treatment for Child and Adolescent Anxiety Disorders

By: Emily Hanna, LLMSW & Suzi Naguib, Psy.D.

Sylvia is a 6-year-old whose parents sought help due to her persistent worrying. They noted that Sylvia has difficulty “letting go” of her worries related to school, peers, her parents’ health, and the future. In addition to these excessive worries, Sylvia has difficulty concentrating at school, handling uncertainty in day-to-day situations, and falling asleep at night. Sylvia experiences frequent nausea and headaches unrelated to any medical condition. She complains of her heart “racing,” and experiencing extreme fear when needing to interact with new people or talk in class. These concerns have negatively impacted Sylvia’s school performance and have caused her to resist going to school and engage with her peers. These concerns have also put a strain on her parents, who do not know how to react to Sylvia’s constant need for reassurance.

What is Cognitive Behavioral Therapy, Coping Cat, and the C.A.T. Project?
Cognitive Behavioral Therapy (CBT) is an evidence-based, time-limited treatment that addresses negative thinking and behavior patterns in order to lessen anxiety. Coping Cat is an evidence-based CBT treatment for children ages 7-13 with various anxiety disorders, and the C.A.T. Project is a version for adolescents 14-17 years of age.

Who can benefit from these treatments?
Children and adolescents experiencing problematic levels of anxiety may benefit from Coping Cat and the C.A.T. Project. Every child experiences some level of anxiety, but treatment is recommended to children and adolescents who are experiencing anxiety that causes significant distress or impacts their overall functioning.

What does this treatment involve?
The treatment goal for both of these programs is to lessen anxiety. This is done by focusing on helping the child or adolescent 1) recognize anxious thoughts and physical reactions to anxiety; 2) clarify thoughts and feelings in anxiety-provoking situations; 3) develop a coping plan; and 4) track progress and create a reward system. Treatment typically takes place over the course of 12 to 16 weekly sessions and involves completing homework assignments between sessions.

What benefits have these treatments been shown to have for children and families?
Research on Coping Cat has generally found positive results in treating anxiety disorders in children. Approximately 71% of children who went through the 16 weeks of Coping Cat no longer met criteria for their initial anxiety diagnosis as a primary clinical diagnosis and 53% no longer met criteria for a primary anxiety disorder (Kendall et al., 1997). Additionally, studies have shown that these programs lead a reduction in reported anxiety and fear, decreased frequency of negative thoughts and symptoms of depression as well as improved self efficacy and perceived ability to cope with most-dreaded situations (Kendall, 1994 & Van Starrenburg et al., 2017). Studies have also shown parent reported improvements in family functioning and overall psychological well-being (Keeton et al., 2013).

When should I seek help?
You should seek professional help if your child or adolescent is experiencing anxiety that is leading to significant distress and is interfering with their everyday functioning. Sunfield Center clinicians are available to help anxious children and adolescents develop better coping strategies using the Coping Cat and the C.A.T. Project evidence based interventions. To schedule an appointment, please call us at (734) 222-9277.

Recommended Readings:
What To Do When You Worry Too Much: A Kid’s Guide to Overcoming Anxiety (2015). Dawn Huebner. Helping Your Anxious Child: A Step-by-Step Guide for Parents (2008). Ronald Rapee & Ann Wignall.