Anxiety Disorders

Abstract:

In the first part of this chapter, we describe the anxiety disorders of childhood and the factors that maintain them (e.g., avoidance and safety behaviors, cognitive errors and biases), as well as evidence-based interventions that have been developed for their efficacious treatment. We also speculate on the mechanisms of change that underlie these effective interventions and how these mechanisms address the core psychopathology of these disorders. In the second part of the chapter, we explore issues of competency including both basic and expert competencies. We submit that the competent treatment of the anxiety disorders in childhood requires attention to relational, developmental, and contextual issues as well as the implementation of specific intervention strategies based on specific models of developmental psychopathology. Moreover, we indicate that expert competency is achieved only when one can implement these basic assessment and intervention strategies in a way that addresses such important issues as comorbidity and difficult-to-treat children and their families. We conclude by indicating that attainment of these competencies is a life-long process that is both fluid and dynamic. It is not at all static. We conclude that although much has been learned about the anxiety disorders in childhood and the competencies that underlie their effective treatment, much remains to be accomplished. The journey to understanding, assessing, and developing these competencies is in its own early stage of development.