Harvard Mental Health Letter

Commentary: Treatment that works for anxious children

Commentary

Treatment that works for anxious children

Parents who are trying to choose the right treatment for a child diagnosed with an anxiety disorder are apprehensive (with justification) about the effects of psychotropic medication on the developing brain. Yet when they seek psychotherapy for their children, they often learn that a good therapist is hard to find and that the costs in time and money can be difficult for families to bear.

An article published in the Oct. 30, 2008, issue of The New England Journal of Medicine should help clarify the relative value of various treatment options for anxiety disorders in children, especially separation anxiety, generalized anxiety disorder, and social phobia. The authors reported on a 12-week, randomized, controlled trial comparing cognitive behavioral therapy (CBT), the antidepressant sertraline (Zoloft), the combination of the two, and a placebo drug. Almost 500 children with these disorders, ranging in age from 7 to 17, participated in the research. More than 80% of children receiving combined therapy experienced significant improvement, compared with 60% of children receiving only CBT and 55% of those receiving only sertraline. The difference between CBT and sertraline response was not statistically significant, but both solo treatments were more than twice as effective as the placebo.

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