18 May 2010

Anxiety: choosing a child-friendly therapist

Several health professionals, including psychiatrists, psychologists, clinical social workers, and psychiatric nurses offer treatment for anxiety disorders in children.

Several health professionals and counselors, including psychiatrists, psychologists, clinical social workers, and psychiatric nurses offer treatment for anxiety disorders in children.

Given this vast array of professionals, it can be difficult to decide whom to choose as a therapist. Finding the right therapist is extremely important as anxiety disorders respond well to treatment with the appropriate professional help.

A good first step in choosing a therapist is to receive a list of mental health professionals in your area who have experience treating anxiety disorders in children and adolescents by contacting the South African Depression and Anxiety Support Group on (O11) 783-1474/6. Your GP church and, neighbours, probably also know of mental health care professionals, after you have obtained some names of potential therapists, there are several things to consider in making your choice.

Type of therapy
The most important consideration in choosing a therapist is that anxiety disorders in children and adolescents are treated most effectively by behaviour therapy (BT) or cognitive behavioural therapy (CBT). BT and CBT are particular types of treatment that are based firmly on research findings.

BT/CBT helps children and adolescents suffering from anxiety disorders by decreasing children's anxiety symptoms and increasing children's ability to cope more effectively. As part of BT/CBT, children are helped to gradually confront or enter into the situations they fear until those situations no longer evoke anxiety. In addition, children are taught to examine and change their ways of thinking about feared situations, as well as to manage distressing feelings in their body. If needed, children may also receive assistance with their social or communication skills.

Therefore, the first questions to ask a professional are: What is your approach to treatment and what type of training and experience do you have in treating childhood anxiety disorders using behavioural or cognitive behavioural therapy?

Family members included?
A second consideration in choosing a therapist is whether or not family members are included in treatment. Anxiety disorders in children and adolescents can often be stressful for parents and other family members. Treatment may be more effective if family members are taught skills to assist them in handling the child's anxiety. Thus, another question to ask a professional is: Are family members included in some aspects of the treatment?

Therapeutic relationship
In addition to ensuring that the professional can provide you with the type of treatment that you are looking for, it is important for you and your child to feel comfortable with the person you choose as a therapist. If possible, talk to a few potential therapists to find the one most compatible with you and your child. You might consider whether or not he or she listens well, seems to understand the problem, and puts you at ease.

You might ask a professional if they specialise in the treatment of children and adolescents. You might also ask yourself if the therapist explains things in language that you (and your child) can understand. Do you feel comfortable asking for re-explanation or clarification of what you do not understand? Would the therapist work closely with your child's teachers and/or school? Would they visit the school to explain your child's needs if that becomes necessary?

Finally, you should ask about the costs, length of treatment with questions such as: Approximately how long is the course of treatment? How frequent are treatment sessions and how long do they last and are they covered by medical aid?

Although the amount of treatment a child needs may vary, you should expect to see some improvement within six to eight weeks. If your child's anxiety is not substantially improved after three to four months of treatment, you should:

  • Determine whether or not your child is practising the strategies taught in therapy, and
  • Talk to your therapist about possibly changing the treatment plan.

If improvement does still not occur, you might consider choosing another therapist.

(South African Depression and Anxiety Support Group, Health24, 2009)




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