Phobic and Anxiety Disorders in Children and Adolescents: A Clinician's Guide to Effective Psychosocial and Pharmacological Interventions

589 Pages·2004·3.14 MB·English

by  Thomas H. Ollendick, John S. March

Phobic and Anxiety
Disorders in Children and
Adolescents:
A Clinician’s Guide to
Effective Psychosocial and
Pharmacological
Interventions
THOMAS H. OLLENDICK
JOHN S. MARCH,
Editors
OXFORD UNIVERSITY PRESS
Phobic and Anxiety Disorders in
Children and Adolescents
This page intentionally left blank
Phobic and Anxiety Disorders in
Children and Adolescents
A Clinician’s Guide
to Effective Psychosocial
and Pharmacological Interventions
Edited by
THOMAS H. OLLENDICK
JOHN S. MARCH
1
2004
3
Oxford New York
Auckland Bangkok Buenos Aires Cape Town Chennai
Dar es Salaam Delhi Hong Kong Istanbul Karachi Kolkata
Kuala Lumpur Madrid Melbourne Mexico City Mumbai Nairobi
São Paulo Shanghai Taipei Tokyo Toronto
Copyright © 2004 by Oxford University Press, Inc.
Published by Oxford University Press, Inc.
198 Madison Avenue, New York, New York 10016
www.oup.com
Oxford is a registered trademark of Oxford University Press
All rights reserved. No part of this publication may be reproduced,
stored in a retrieval system, or transmitted, in any form or by any means,
electronic, mechanical, photocopying, recording, or otherwise,
without the prior permission of Oxford University Press.
Library of Congress Cataloging-in-Publication Data
Phobic and anxiety disorders in children and adolescents : a clinician’s
guide to effective psychosocial and pharmacological interventions /
[edited by] Thomas H. Ollendick, John S. March.
p. cm.
Includes bibliographical references and index.
ISBN 0-19-513594-6
1. Anxiety in children. 2. Phobias in children. I. Ollendick,
Thomas H. II. March, John S., MD.
RJ506.A58 P48 2003
618.92'85223—dc21 2002156296
1 3 5 7 9 8 6 4 2
Printed in the United States of America
on acid-free paper
To the real giants in the field—Albert Bandura,
B. F. Skinner, and Joseph Wolpe. They have greatly
influenced not only my professional development but
my personal development as well.
—THO
To John Greist, Edna Foa, and Keith Conners,
mentors and friends extraordinaire.
—JSM
This page intentionally left blank
PREFACE
Anxiety disorders are common, cause considerable morbidity and per-
haps mortality, and (most important) are now treatable with evidence-
based treatment procedures. This book is designed to help clinicians from
a variety of disciplines learn about the etiology, developmental course, as-
sessment, and treatment of children and adolescents with anxiety disorders.
Thus, clinicians and their patients are the primary targets for this book.
In the past, psychology and psychiatry have been at odds over these
issues—sometimes for scientific reasons and at other times because stake-
holder issues were paramount. Theeditors and chapter authors of this book
believe strongly that it is not possible to practice competent and ethical
psychopharmacology without the availability of empirically supported
psychotherapy. Similarly, it is not possible to practice competent and
ethical psychotherapy without the availability of empirically supported psy-
chopharmacology. We believe that physicians (who typically write pre-
scriptions) and psychologists (who, for the most part, have developed and
are better versed in psychological treatments) must join hands in the care
of individual patients, if for no other reason than that the complexity of
modern mental health care is beyond the capacity of any one individual
to master.
In this context, this book intentionally models both the benefits and
the difficulties of multidisciplinary practice in which practitioners of both
disciplines become stakeholders for the experiment (the research question)
or the benefit of the individual patient (the clinical question). Without this
commitment to multidisciplinary practice, we shortchange our patients.
viii preface
ORGANIZATION OF THE BOOK
In writing this book, we married as authors an outstanding group of psy-
chologists and psychiatrists who are expert in their respective areas. The
book is organized in three parts.
In part I, “Foundational Issues,” we lay the foundation for the chapters
on specific phobic and anxiety disorders that follow by providing a broad and
integrative view of issues that affect the psychopathology, assessment, and
treatment of the various childhood anxiety disorders. Specific chapters cover
diagnostic issues, etiology, epidemiology development, and comorbidity.
In part II, “Assessment and Treatment of Specific Disorders,” we
focus on the DSM-IV anxiety disorders. Each chapter includes sections on
clinical manifestation or phenomenology of the disorder, diagnosis and clas-
sification (including differential diagnosis and comorbidity), and develop-
mental course of the disorder, with the bulk of the chapter focused on
assessment and treatment. With respect to assessment, the authors focus
on best assessment practices—using an assessment tree—to arrive at a cor-
rect diagnosis and to assist in treatment planning and evaluation of treat-
ment outcome. In this way, assessment serves treatment (i.e., it should
possess clinical or treatment utility). In turn, treatment is discussed in a
stages-of-treatment model, illustrating the decision-making process in de-
termining which treatments to use and the order in which the treatments
should be selected or tried. As such, the best treatment practices will be
illustrated. Selected treatments must have some empirical support for their
use and (ideally) have been subject to randomized clinical trials for their
consideration.
In part III, “Future Directions for Research and Practice,” we high-
light issues that will continue to characterize the field in the new millen-
nium, in an attempt to set the stage for future research and practice. In
particular, we focus on prevention and early intervention, the need to move
from efficacy to effectiveness research, translating research to practice, and
services research to see if our treatments are actually implemented and
working.