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- Anxiety Treatment for Children (PATCH)
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Our Treatment Approach
Our assessment and treatment approach at PATCH is grounded on the principles of evidence-based practices, most notably cognitive-behavioral therapy (CBT).
CBT for Anxiety
CBT is the most proven effective psychotherapy for childhood and adolescent anxiety disorders. CBT helps children and adolescents cope with anxiety, challenge anxious thoughts, and face (rather than avoid) the things that make them anxious. CBT is always tailored to the specific problem and the individual, but typically includes both cognitive and behavioral strategies. Cognitive strategies may include identifying and challenging anxious thoughts, problem-solving, and learning about emotions. Behavioral strategies include modeling, problem-solving, exposure to feared situations, and rewards. Clients are encouraged to actively participate in their therapy and often will be asked to practice the techniques in between sessions. Parents, teachers, and other adults around the child learn strategies to support the child's progress, often acting as "coaches" to help children and adolescents put into practice the skills they have learned. Once the skills are learned and practiced, clients can keep using what they have learned in therapy to approach other problems in their lives. CBT can be used alone or with medication, depending on the severity and nature of each client’s problem.
Exposure and Response Prevention (EX/RP) for OCD
Exposure and response prevention (EX/RP) is a type of CBT for children and adolescents with obsessive-compulsive disorder (OCD). Individuals with OCD reduce their anxiety and distress by repeatedly using rituals or compulsions. Common examples include washing, checking, or ordering, seeking reassurance from parents, or mental rituals such as thinking about certain numbers or words. These compulsions or rituals successfully reduce the distress temporarily; however, this temporary reduction prevents the clients from learning that the distress would have decreased even without the rituals. As long as they perform their compulsive rituals, clients will continue to believe that the rituals protect them from disastrous consequences such as illness, death, or making serious mistakes.
The best way for patients to learn that the rituals do not protect them is to gradually and repeatedly face feared situations and anxiety triggers (exposure) while refraining from performing the associated rituals or compulsions (response prevention). EX/RP involves systematic exercises, designed by the therapist and the client, to help clients confront situations and objects that elicit the unwanted thoughts or ideas, worries and fears. Through the exposure exercises clients learn that they can manage the fear and distress associated with their thoughts. Engaging in repeated exposures without compulsions/rituals teaches them that their fears are highly unrealistic or exaggerated. By doing this, exposure and response prevention is designed to change the child’s beliefs that rituals prevent disastrous consequences from occurring or that they cannot handle the distress and anxiety if rituals are not acted upon. Over time, children and adolescents learn how to control their own thoughts, feelings, and behaviors, rather than having their OCD control them.
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