Treatment of Separation Anxiety Disorder

There are a number of commonly used treatments for separation anxiety disorder, most of which focus on one or more types of psychotherapy. As with most childhood issues, the earlier the intervention, the more likely the treatment will be successful. That’s why it’s important to seek professional care for your child if you suspect he or she might suffer from this disorder. There are also strategies you can do to help your child with separation anxiety disorder.

Cognitive-behavioral psychotherapy is the primary type of treatment used for separation anxiety disorder. Such therapy is focused on teaching children several major skills, such as how to recognize anxious feelings regarding separation and to identify their physical reactions to anxiety. They are taught to identify their thoughts in anxiety provoking separation situations, and are taught to develop a plan to cope adaptively with the situation.

In cognitive-behavioral therapy (CBT), children are also taught to evaluate the success of the coping strategies they employed. In addition, behavioral strategies such as modeling, role-playing, relaxation training, and reinforced practice are used. Children are guided in developing a list of situations that are challenging for them, such as attending a birthday party without their parent, or staying home with a sitter. Children are taught to implement their coping skills while gradually facing each of these situations. Children’s successes are praised highly by the therapist and by parents.

Recent research has suggested that incorporating parents more centrally into the treatment of children with anxiety disorders can be extremely useful in reducing children’s anxious behavior and may enhance treatment effectiveness and maintenance. Parents are often taught new ways to interact with their children so that the child’s fears are not inadvertently reinforced. Parents are also taught ways to give children ample praise and positive reinforcement for brave behavior.

For younger children who have more difficulty in identifying their thoughts, a form of play therapy may be used. Play therapy uses toys, puppets, games, and art materials for expression of feelings. The therapist validates the child’s feelings, and helps the child understand some of the reasons behind them. The therapist then provides alternative ways of coping with the feelings that a younger child can relate to.

Family therapy may sometimes be appropriate to tease out the family issues that may be contributing to the child’s anxiety. Such an intervention includes the participation of parents and sometimes siblings to address how the identified patient (the child with the separation anxiety) affects everyone else in the family (or may be a result of hidden family dynamics). Family therapy also helps create a sense of teamwork and reduce the sense of “it’s the child’s problem, not mine.” Family therapy can also reveal when it’s something in the parents’ lives or parenting style may be contributing to the separation anxiety in the first place.

Other techniques are sometimes used to treat this disorder as well. For instance, systematic desensitization gradually introduces separation, measured by time and distance. Relaxation techniques, such as deep breathing, self-soothing language, and biofeedback, can help the child learn to relax more easily.

Strategies for Helping Your Child with Separation Anxiety Disorder

Don’ts

  • let your child stay home when he does not want to go to school, day care, etc.
  • surprise your child with a change in plans or activities.
  • let your child focus on what unlikely bad things might happen.
  • punish for behaviors that are a result of separation anxiety/fears.

Do’s

  • focus on fun activities at school, day care, etc.
  • help your child get settled at school or day care and then leave.
  • let your child know you will return to pick her up from school, day care, etc.
  • compliment your child when he is acting appropriately.
  • remind him how you have returned for him in the past.
  • help him think of ways a favorite superhero might handle the situation.
  • reward targeted and desired behaviors.
  • reward behaviors as they become more appropriate and less dictated by fears.