By Wendy K. Silverman
For a long time, nervousness and phobie problems ofchildhoodand youth have been missed through clinicians and researchers alike. They have been considered as principally benign, as difficulties that have been particularly light, age-specific, and transitory. With time, it used to be suggestion, they might easily disappear or "go away"-that the kid or adolescent might magically "outgrow" them with improvement and they wouldn't adversely impact the starting to be baby or adolescent. consequently ofsuch considering, it used to be concluded that those "internalizing" difficulties weren't important or deserving of our concerted and cautious attention-that different difficulties of formative years and formative years and, specifically, "externalizing" difficulties comparable to behavior disturbance, oppositional defiance, and attention-deficit difficulties de manded our expert energies and assets. those assumptions and asser tions were challenged vigorously in recent times. Scholarly books (King, Hamilton, & Ollendick, 1988; Morris & Kratochwill, 1983) have documented the substantial misery and distress linked to those issues, whereas experiences ofthe literature have validated that those issues are something yet transitory; for an important variety of early life those difficulties persist into overdue early life and maturity (Ollendick & King, 1994). basically, such findings sign the necessity for remedy courses that "work"--programs which are potent within the brief time period and efficacious over the lengthy haul, generating results which are sturdy and generalizable, as weil as results that improve the existence functioning of youngsters and teenagers and the households that evince such problems.
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Extra resources for Anxiety and Phobic Disorders: A Pragmatic Approach
To best obtain these pieces ofinfonnation, you need to broaden the methods of assessment you use . , what your patients look like when they feel anxious or afraid) requires that you go beyond the use ofmethods that asses s children' s and parents' subjective views . Specifically, it requires that you use a method that allows for the direct assessment of children 's behaviors--namely, an observational method of assessment. In most c1inical settings, observing children in their natural environment, such as in their horne or school, is not feasible .
Nevertheless, obtaining a quantitative index can be useful in that it may assist you in determining whether further assessment of anxiety symptoms and behaviors is warranted. Another way to identify and quantify problematic child anxious symptoms and behaviors is to use particular subsections of a child- or parent-structured interview schedule as minimodules. For example , ifyou are interested in leaming whether a child is experiencing difficulties with the symptoms of Generalized Anxiety Disorder, you could ask the interview questions contained on any ofthe schedules that cover this diagnostic subcategory.
Despite this, we have found the daily diaries to be clinically useful. The information obtained helps to provide a more complete picture ofthe types ofsituations that children find anxiety-provoking, and their subsequent reactions, in terms of their thoughts , feelings, and behaviors. The information also serves to facilitate and to focus our discussions with the children during the treatment sessions . However, as we have noted, we are not natural -born observers and recorders of our thoughts, feelings , and behaviors , and keeping track of such information can be areal burden and nuisance .