Evidence-Based, Non-pharmacological Interventions for Pediatric Anxiety Disorders

Anxiety disorders are among the most prevalent psychiatric problems in pediatric populations, frequently persist into adulthood, and are prospectively linked to negative sequelae, such as depression, suicidal ideation, conduct problems, and illegal substance use for some youth. Cognitive and behavioral therapy protocols have accrued the largest and most rigorous scientific support. These protocols most often involve psychoeducation, exposures (in vivo, imaginal), and cognitive restructuring. Some protocols include augmentation strategies such as relaxation training, social skills training, caregiver training, and modification of caregivers’ own anxiety symptoms. This chapter synthesizes and critically evaluates presumed mechanisms of clinical change in pediatric anxiety with an eye toward clinical application. A clinical illustration is offered relevant to child-focused, group-based CBT. The strategies and tools come from the authors’ work in developing, evaluating, and deploying in communities exposure-based CBT interventions.