Childhood anxieties, fears, and phobias: A cognitive-behavioral, psychosituational approach

Abstract

It is perhaps unfortunate that in the field of childhood psychopathology and psychotherapy the old treatment models are no longer sufficient. In some ways, it was easy to view the referred child as "owning" a problem and then simply go about "fixing" it for him or her. A good many recent developments, however, have shown this "child-oriented" approach to be woefully inadequate and, indeed, very often wrong. The development of systems models of family therapy, factor-analytic studies of aberrant childhood behavior in which the childs impact on the environment is integral to problem definition, the emergence of the behavioral and cognitive-behavioral movements in psychotherapy; and the legal advances vis-a-vis childrens rights are just a few of the things that argue for a model of childhood pathology and therapy that incorporates the interplay between the child and his or her significant environment as co-perpetrators of childhood clinical problems and their solution (Bersoff and Grieger, 1971; Grieger and Abidin, 1972; Mischel, 1968, 1973, 1990; Peterson, 1968). The consensus of current models of child treatment is that children function in a context and that not only does the child need treatment, but also the context (Kazdin and Weisz, 2003; Lerner, 1991). Those who work clinically with children testify to the frustrations inherent in being limited only to direct work with a disturbed" child. Current-day cognitive-behavioral treatment models for the treatment of childhood anxiety focus both on treating the child and parents (e.g., Barrett and Shoett, 2003; Bernard, 2004; Bernard and Joyce, 1984; Kazdin et al., 1990; Kendall et al., 2002). Reflecting on these developments, this chapter describes a cognitive-behavioral, psycho-situational model (Bersoff and Grieger, 1971; Grieger and Abidin, 1972; Grieger and Boyd, 1980, 1983) for understanding and treating different anxiety problems in children. It focuses on both the child and his or her significant others as "causes" of these problems and their cures. It first distinguishes among fears, anxieties, and phobias. Then, after describing the psycho-situational model as it pertains to emotional and behavioral problems in general, it emphasizes the cognitive factors in creating childrens anxiety problems in both the child and the childs significant others. The chapter then addresses methods and issues in cognitive-behavioral, psycho-situational assessment and treatment of these types of problems, with a particular emphasis on REBT for the treatment of childhood anxiety disorders (also see Vernon, 2002). © 2006 Springer Science+Business Media, Inc.