Chapter 58. Cognitive-Behavioral Treatment for Anxiety Disorders

Deborah C. Beidel, Ph.D., A.B.P.P.; Teresa Marino Carper, M.S.
DOI: 10.1176/appi.books.9781585623921.478352



Historically, psychiatric descriptions of childhood anxiety disorders date back to case reports in the early part of the twentieth century (e.g., Little Hans, Little Albert, Little Peter; see Beidel and Turner 2005). These descriptions, although differing in theoretical orientation, share a common theme—anxiety in children is not simply a "developmental phase." Rather, anxiety symptoms can be serious, distressful, and functionally impairing. Yet, despite their importance, the notion that children would outgrow their fears limited scientific investigation. Until the early 1990s, there were few randomized controlled trials (RCTs) addressing the pharmacological or psychological treatment of anxiety disorders in children. Since that time, there has been an explosion of interest in treatment, primarily from pharmacological and cognitive-behavioral perspectives. In this chapter, we review cognitive-behavioral treatment (CBT) for anxiety disorders.

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Table Reference Number
TABLE 58–1. Randomized controlled trials examining the efficacy of cognitive-behavioral therapy (CBT)
Table Reference Number
TABLE 58–2. Hierarchy for a child with selective mutism


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Cognitive-behavioral therapy (CBT) has been shown to be efficacious in treating which of the following childhood disorders?
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A parent comes to you to express her concern about her 10-year-old daughter, Jackie, who is afraid of dogs and runs away whenever she sees one. You schedule a session with Jackie and her mother and arrange to have a well-behaved dog present. Although Jackie is highly fearful at first, you encourage her to remain in the office until her anxiety diminishes. You are employing a model of treatment based on
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