Anxiety and Phobic Disorders: A Pragmatic Approach by Wendy K. Silverman

By Wendy K. Silverman

For a long time, nervousness and phobie issues ofchildhoodand early life have been overlooked by means of clinicians and researchers alike. They have been considered as mostly benign, as difficulties that have been really gentle, age-specific, and transitory. With time, it was once idea, they'd easily disappear or "go away"-that the kid or adolescent may magically "outgrow" them with improvement and they wouldn't adversely have an effect on the turning out to be baby or adolescent. hence ofsuch pondering, it was once concluded that those "internalizing" difficulties weren't precious or deserving of our concerted and cautious attention-that different difficulties of youth and formative years and, specifically, "externalizing" difficulties equivalent to behavior disturbance, oppositional defiance, and attention-deficit difficulties de­ manded our specialist energies and assets. those assumptions and asser­ tions were challenged vigorously lately. Scholarly books (King, Hamilton, & Ollendick, 1988; Morris & Kratochwill, 1983) have documented the massive misery and distress linked to those issues, whereas reports ofthe literature have proven that those problems are whatever yet transitory; for an important variety of early life those difficulties persist into past due early life and maturity (Ollendick & King, 1994). in actual fact, such findings sign the necessity for remedy courses that "work"--programs which are powerful within the brief time period and efficacious over the lengthy haul, generating results which are sturdy and generalizable, as weil as results that improve the lifestyles functioning of youngsters and young people and the households that evince such problems.

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Sample text

3. In sum, behavioral analogs are useful ways to obtain information about what your patients "look like" when they feeI anxious or afraid . Devising and using them in your practice may call for some ingenuity on your part . However, particularly for children and parents who have trouble describing the nature of the child's problem behaviors, using analogs can provide useful information and prove very worthwhile. The second piece of information you may be interested in, as part of your goal to obtain a richer picture ofyour patients' problem behaviors, is the specific situations or objects that provoke daily anxiety or fear.

Reliability and validity. In the first situation, for example, the school district has a very specific goal in mind: how to identify which children should be included in a program because they may be at risk for anxiety. Because the contextualistic part ofour orientation directs that we focus on the goals in this particular setting, we draw on our knowledge of assessment to translate the question into one of the common assessment goals. In this case , the assessment goal that matches the question is screening.

In older children, however, if excessive , distress and protest surrounding separation are viewed as diagnosable problems. 3. The core feature of Generalized Anxiety Disorder is excessive worry . , someone misinterpreting something they said) . Because alI children "worry,' a diagnosis ofGeneralized Anxiety Disorder is only applicable when the worries are c1early excessive and when it is difficult to control the worry . Although this is not always so easy to determine, finding out how the worrying is interfering with the child's functioning in various of areas of his or her life is usually a good way to proceed.

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