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Treatment planning for childhood anxiety disorders should consider both severity and impairment (American Academy of Child and Adolescent Psychiatry 2007). For children with anxiety disorders of mild severity and associated with minimal impairment, it is recommended that treatment begin with psychotherapy. However, combination treatment with medication and psychotherapy may be necessary for acute symptom reduction in a severely anxious child, concurrent treatment of a comorbid disorder, or partial response to psychotherapy and potential for improved outcome with combined treatment (March and Ollendick 2004). Residual symptoms of an anxiety disorder can increase the risk for persistence or relapse of the same or another anxiety disorder (Birmaher et al. 2003; Dadds et al. 1997). Functional impairment, not just reduction of anxiety symptoms, needs to be monitored during the treatment process.

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Table Reference Number
TABLE 20–12. Placebo-controlled pharmacological treatment studiesa

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