Clinical issues in treating children with anxiety and phobic disorders

Issues involved in conducting cognitive behavioral treatment with children who present with anxiety and phobic disorders are discussed. The rationale for using cognitive behavioral treatment procedures is based on our premise that effective, long-term child behavior change depends on an adequate "transfer of control" from therapist to parent to child. The treatment involves separate and conjoint child and parent sessions and is implemented in three phases: education, application, and relapse prevention. Specific treatment strategies, common obstacles to implementing these strategies, and suggestions to address these obstacles are described for each phase of the treatment. A case vignette illustrates some of the treatment issues discussed.