Non-medication based Non-medication based treatments are the first choice when treating individuals diagnosed with<unk> . Counseling tends to be the best replacement for drug treatments. There are two different non-medication approaches to treat<unk>  anxiety. The first is a psychoeducational intervention, often used in conjunction with other therapeutic treatments. This specifically involves educating the individual and their family so that they are knowledgeable about the disorder, as well as parent counseling and guiding teachers on how to help the child. The second is a psychotherapeutic intervention when prior attempts are not effective. Psychotherapeutic interventions are more structured and include behavioral, cognitive-behavioral, contingency, psychodynamic psychotherapy, and family therapy. Anchors Away program for children with anxiety disorder. Exposure and behavioral therapy Behavioral therapies are types of non-medication based treatment which are mainly exposure-based techniques. These include techniques such as systematic desensitization, emotive imagery, participant modelling and contingency management. Behavioral therapies carefully expose individuals by small increments to slowly reduce their anxiety over time and mainly focuses on their behavior. Exposure based therapy works under the principle of habituation that is derived from learning theory. The core concept of exposure therapy is that anxiety about situations, people, and things does not go away when people avoid the things that they fear, but rather, the uncomfortable feelings are simply kept at bay. In order to effectively diminish the negative feelings associated with the situation of fear, one must address them directly. In order to administer this treatment, the therapist and the anxious child might sit together and identify progressively intense situations. As each situation is dealt with masterfully, the child advances to the next phase of intensity. This pattern continues until the child is able to handle being away from their parent in a developmentally typical way that causes them and their caregiver(s) minimal amounts of stress. While there is some controversy about using exposure therapy with children, it is generally agreed upon that exposure therapy in the context of SAD is acceptable as it may be the most effective form of therapy in treating this disorder and there is minimal risk associated with the intervention in this context. Contingency management Contingency management is a form of treatment found to be effective for younger children with SAD. Contingency management revolves around a reward system with verbal or tangible reinforcement requiring parental involvement. A contingency contract is written up between the parent and the child, which entails a written agreement about specific goals that the child will try to achieve and the specific reward the parent will provide once the task is accomplished. When the child undergoing contingency management shows signs of independence or achieves their treatment goals, they are praised or given their reward. This facilitates a new positive experience with what used to be filled with fear and anxiety. Children in preschool who show symptoms of SAD do not have the communicative ability to express their emotions or the self-control ability to cope with their<unk>  anxiety on their own, so parental involvement is crucial in younger cases of SAD. Cognitive behavioral therapy Cognitive behavioral therapy (CBT) focuses on helping children with SAD reduce feelings of anxiety through practices of exposure to anxiety-inducing situations and active metacognition to reduce anxious thoughts. CBT has three phases: education, application and relapse prevention. In the education phase, the individual is informed on the different effects anxiety can have physically and more importantly mentally. By understanding and being able to recognize their reactions, it will help to manage and eventually reduce their overall response. According to Kendall and colleagues, there are four components which must be taught to a child undergoing CBT: # Recognizing anxious feelings and behaviors # Discussing situations that provoke anxious behaviors # Developing a coping plan with appropriate reactions to situations # Evaluating effectiveness of the coping plan In the application phase, individuals can take what they know and apply it in real time situations for helpful exposure. The most important aspect of this phase is for the individuals to ultimately manage themselves throughout the process. In the relapse prevention phase, the individual is informed that continued exposure and application of what worked for them is the key to continual progress. A study investigated the content of thoughts in anxious children who suffered from<unk>  anxiety as well as from social phobia or generalized anxiety. The results suggested that cognitive therapy for children suffering from<unk>  anxiety (along with social phobia and generalized anxiety) should be aimed at identifying negative cognition of one's own behavior in the threat of anxiety-evoking situations and to modify these thoughts to promote self-esteem and ability to properly cope with the given situation. Cognitive procedures are a form of treatment found to be ideal for older children with SAD. The theory behind this technique is that the child's dysfunctional thoughts, attitudes, and beliefs are what leads to anxiety and causes anxious behavior. Children who are being treated with cognitive procedures are taught to ask themselves if there is "evidence" to support their anxious thoughts and behaviors. They are taught "coping thoughts" to replace previously distorted thoughts during anxiety-inducing situations such as doing a reality check to assess the realistic danger of a situation and then to praise themselves for handling the situation bravely. Examples of such disordered thoughts include polarized thinking, overgeneralization, filtering (focusing on negative), jumping to conclusions, catastrophizing, emotional reasoning, labeling, "shoulds", and placing blame on self and others. Sometimes therapists will involve parents and teach them behavioral tactics such as contingency management. Medication The use of medication is applied in extreme cases of SAD when other treatment options have been utilized and failed. However, it has been difficult to prove the benefits of drug treatment in patients with SAD because there have been many mixed results. Despite all the studies and testings, there has yet to be a specific medication for SAD. Medication prescribed for adults from the Food and Drug Administration (FDA) are often used and have been reported to show positive results for children and adolescents with SAD. There are mixed results regarding the benefits of using tricyclic antidepressants (TCAs), which includes imipramine and clomipramine. One study suggested that imipramine is helpful for children with "school phobia," who also had an underlying diagnosis of SAD. However, other studies have also shown that imipramine and clomipramine had the same effect of children who were treated with the medication and placebo. The most promising medication is the use of selective serotonin reuptake inhibitors (SSRI) in adults and children. Several studies have shown that patients treated with fluvoxamine were significantly better than those treated with placebo. They showed decreasing anxiety symptoms with short-term and long-term use of the medication.
Separation anxiety disorder
Hodophobia
Social anxiety disorder
Agoraphobia
Generalized anxiety disorder
Somatization disorder
Blood phobia
Body dysmorphic disorder