Description: Face your fears! Sounds like a pretty basic piece of advice but for children with deep anxieties over often basic things like eating or being alone offering them such advice does not tend to work. There are therapeutic approaches that can work. Exposure Therapy, based on classical conditioning and linked to the much-discussed work of Watson producing fears in a child named Little Albert can reduce or eliminate such fear linked anxieties in children. Watson, by the way, did not develop exposure therapy and did not, it seems, even treat Little Albert after giving him a fear of furry animals and other furry things. So if exposure therapy works so well why is it not in much much greater use given the alarming jumps in childhood anxiety issues in recent years? Think about why this might be the case and thin about what might be done to make exposure therapy more widely available and then read the article linked below to find out more about the exposure therapy and what is being tried to make it more widely available.
Source: With Anxiety on the Rise, Some Children Try ‘Exposure Therapy’, Virginia Hughes, The New York Times.
Date: November 21, 2022
Image by Pezibear from Pixabay
Article Link: https://www.nytimes.com/2022/11/21/health/anxiety-treatment-exposure-therapy.html
It is concerning that one of the most common reasons that effective psychotherapies are not available to children (or anyone) who would benefit from them is cost. Psychotherapy is often a limited benefit of health insurance, if it is covered at all even in Canada where we have socialized health care coverage. This means that many parents cannot afford the treatment their children would very likely benefit from or do so in a timely manner if at all. The approach taken by the psychologists discussed in the linked article involves having trained exposure coaches who work under close supervision by a psychologist provide face-to-face exposure therapy sessions with anxious children. The research data seems to be suggesting that this approach is effective (though not yet published in peer -reviewed journals). As importantly, it seems that at least 2 healthcare insurance companies are prepared to provide access to this sort of exposure therapy as part of their coverage. This idea that new approaches to the delivery of therapies that have been shown by research to be effective when delivered by psychologists or psychiatrists does add another layer of required research but an essential one if we are to demonstrate that more affordable (coverable) versions of psychotherapies Can be made available to children and other who would benefit from them.
Questions for Discussion:
- What is Exposure Therapy and what does it involve?
- Why has Exposure Therapy been so difficult for parents to access for their children trying to deal with serious anxiety issues?
- What other sorts of therapies might be made more broadly accessible in ways like those undertaken in relation to Exposure Therapy?
References (Read Further):
Seligman, L. D., & Ollendick, T. H. (2011). Cognitive-behavioral therapy for anxiety disorders in youth. Child and Adolescent Psychiatric Clinics, 20(2), 217-238. Link
Walter, H. J., Bukstein, O. G., Abright, A. R., Keable, H., Ramtekkar, U., Ripperger-Suhler, J., & Rockhill, C. (2020). Clinical practice guideline for the assessment and treatment of children and adolescents with anxiety disorders. Journal of the American Academy of Child & Adolescent Psychiatry, 59(10), 1107-1124. Link
CAHMI (2022) The National Survey of Children’s Health Link
Gola, J. A., Beidas, R. S., Antinoro-Burke, D., Kratz, H. E., & Fingerhut, R. (2016). Ethical considerations in exposure therapy with children. Cognitive and Behavioral Practice, 23(2), 184-193. Link
Whiteside, S. P., Biggs, B. K., Tiede, M. S., Dammann, J. E., Hathaway, J. C., Blasi, M. E., … & Vickers, K. (2019). An online-and mobile-based application to facilitate exposure for childhood anxiety disorders. Cognitive and Behavioral Practice, 26(3 ), 478-491. Link
Davis, J. P., Palitz, S. A., Norris, L. A., Phillips, K. E., Crane, M. E., & Kendall, P. C. (2020). Exposure therapy for generalized anxiety disorder in children and adolescents. In Exposure Therapy for Children with Anxiety and OCD (pp. 221-243). Academic Press. Link
