Separation Anxiety Disorders, Therapy, & Interventions - Holly Fidler & Jennifer Jackson

Separation Anxiety Disorders, Therapy, & Interventions
By Holly Fidler & Jennifer Jackson

Separation anxiety disorder is a medical condition characterized by anxiousness and agitation when a person is in distress over a separation from a guardian, parent, caregiver, or home. Environmental and complex genetic factors tend to lead to the development of separation anxiety disorder. This disorder effects people’s life by, disabling their ability to engage in everyday activities, such as, school, sports and games, and socialization. Another factor contributing and distinguishing the characteristics of separation anxiety disorder from common anxiety is an overwhelming sense of worry comparative to peers. The anxiety can be triggered by simple separation, for instance, sleeping, parents leaving child home to run brief errands, or leaving to attend school. These fears are often characterized by irrational thoughts and tendencies, like, thoughts of parents dying.
Symptoms of separation anxiety disorder are similar at home and school, but reliant on the environment. At home children may be convinced that they will become injured, whether fatally or by just a scratch, their parents will fall ill or die, lost, or very reluctant to participate in simple outings or activities. Children with separation anxiety disorder will have difficulty sleeping alone and during sleep will have nightmares about separation, and will become suddenly inflicted with physical pains or sickness upon separation. At school the child or adolescent with separation anxiety disorder will attempt to hide the disorder because of social stressors that warrant the child’s attention to fit in with his or her peers. But, some characteristic would include: transition difficulty from home or school or pure reluctance to attend, avoiding interaction with peers, low social and academic self-esteem, and difficulty concentrating due to worry (Bostic & Bagnell, 2004). Obviously, separation anxiety disorder can overtake several aspects of a child’s life, if not the whole; therefore, separation anxiety disorder must be treated immediately in a proactive manner.
Although there are many types of therapies for anxiety disorders, Cognitive Behavioral Therapy (CBT) is proven to be the most effective. Unlike individual or group psychotherapy, CBT does not dwell on the disorder, but helps the young individual to redirect his or her negative thought into positive thoughts; this is facilitated, or taught, by a trained clinician. This process re-wires ones way of thinking; the individual relatively breaks down an old muscle, the brain, and replaces it with a new one. Also, this treatment can be utilized for the remainder of his or her life, unlike medication. Cognitive-behavioral therapist and researcher Aldo R. Pucci states:
“Cognitive-behavioral therapy is focused on "getting better" rather than "feeling better". So while we are encouraged that clients improve their symptoms with cognitive-behavioral therapy, we are more interested in helping them with the underlying thoughts and core beliefs that caused their emotional distress, helping them rid themselves of problematic, inaccurate thoughts, and replacing them with thoughts that are healthy and accurate” (2005).
This therapy can be used to intervene at home and school, and has been found more beneficial when there is parent involvement.
At home making adaptations as simple as a comfortable home environment and paying attention to the emotions, even if exaggerated, is important and beneficial. Researchers Dulcan, Martini, and Lewis encourage the following ways to intervene at home, they include; advanced planning for enjoyable outings by preparing the child with social stories, praising the child’s efforts at remaining calm, being firm and consistent with spoken rules and limits, and reminding the child that they successfully were separated the last time and they are able to do it again. Since the home is the main display of separation anxiety it is important to integrate the strategies and provide a supportive, understanding environment (1999; 2002). Otherwise, the child might not overcome the anxiety and it may lead to other disorders.
In the school environment the child needs to be under the care of a teacher who understands and accepting of the disorder. A safe place for the child to rest during the day if he or she feels anxiety is also important. In addition, one of the most powerful pieces is communication with the parents whether by scheduled phone calls or notes left by the parent for the child to read during the day, this will insure the child of the parents safety and attachment. The child needs to learn proper strategies for managing their worries and behavior. This can be done by the child becoming involved in developing their own problem solving techniques and methods. The strategy may not be successful because the child could use the technique to avoid separation.
A child’s difficulty never exists in one environment; therefore, the school and guardians need to work as a cohesive whole to help the child. Interventions at home and school are just as important as the child receiving proper therapy, like Cognitive Behavioral Therapy. The most important aspect is the reworking of a child’s or adolescence thought process from a negative, worrisome one to a healthy, positive one.
References
Bostic, JQ and Bagnell, A.(2004). "School Consultation." In Comprehensive Textbook of Psychiatry, 8th Edition . (Kaplan, BJ and Sadock, VA, eds.). Philadelphia: Lippincott Williams and Wilkins.
Dulcan, MK and Martini, DR. (1999). Concise guide to child and adolescent psychiatry (2nd ed.). Washington, DC: American Psychiatric Association.
Lewis, Melvin, ed. (2002). Child and adolescent psychiatry: a comprehensive textbook (3rd ed.). Philadelphia: Lippincott Williams and Wilkins.
Pucci, A. (2005, September). Evidence-based counseling & psychotherapy. Retrieved July 2, 2008, from The National Association of Cognitive Therapist Website: http://nacbt.org/evidenced-based-therapy.htm