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Articles Childhood Anxiety Disorders - An Interview With Ron Rapee continued The program teaches practical skills and strategies for the children to learn to manage their anxiety and parents are taught ways of helping them. At the end of treatment, approximately 80% of the children are markedly improved and these effects continue for at least a year (which is as far as we have followed people). We have set up a similar program at Royal North Shore Hospital to demonstrate that similar results can be found in a general community setting. In addition, with the help of a Rotary grant we briefly ran an intensive, one week program for children from rural NSW. These children came to Sydney and went through a similar program that was run over a single week on a daily basis. This gave these children from distant and remote areas a chance to have access to this type of program. Unfortunately, funding was stopped after one year, so the program has closed. We have also conducted workshops for professionals in many places, including Melbourne, Newcastle, Brisbane, Adelaide, Sydney, and Orange so there are growing numbers of psychologists and school counsellors who are learning about these techniques. Jasmine: Is there a trend in Australia, as there seems to be in the USA, to use medications for children's anxieties. Does this have negative effects? Ron: The USA is strongly medically oriented and there is a strong pressure to find drug "cures" for everything. Luckily in Australia, we do not have this degree of pressure. While many medical practitioners do prescribe medication for anxious children, this is not as common a practice as in the United States, probably largely because of public pressure against prescription. We do not know whether these medications are harmful, and there may be circumstances under which they are very useful. But given the excellent effects that we are able to get with non-medical treatment, there seems to be no need for medication in anxious children. In addition, the aim is to teach children skills that they can carry with them throughout their life to prevent a lifetime of anxiety. The effects of any medication stop as soon as the person stops taking it. Jasmine: Is school phobia the same as panic disorder? Ron: School phobia refers to children who refuse to go to school because of anxiety. It can vary from children who miss the occasional day, to those children who do all of their schooling at home. Children may fear going to school for many reasons and a thorough assessment is necessary to decide on the most important reason and the best course of action. The most common reason children avoid school is because of fear of leaving an important person (usually their mother). These children often worry that something terrible will happen to Mum while they are away. In most cases this will be diagnosed as separation anxiety disorder and is a very different problem to panic disorder. While it is possible that some children may avoid school due to panic attacks, panic disorder is actually very rare in children before the late teens. Children can certainly "panic" - so do we all. But this is different to what we mean by the diagnosis of panic disorder. The main characteristic of panic disorder is unexpected panic attacks. These are characterised by a sudden rush of fear, several physical symptoms (e.g. pounding heart, breathlessness, chest pain), and beliefs that you are going to have a heart attack, die, or pass out. Children will very rarely report these types of episodes. Jasmine: Will there be an Anxiety Disorders awareness campaign in the future? Ron: We are not planning such a campaign because it requires a lot of funding and is not in our brief. However, it is a very good idea. Organisations such as the Anxiety Disorders Foundation NSW and the Panic Anxiety Disorders Association are precisely the types of groups who should be doing this sort of thing. The more education that the public and professionals can get about anxiety the better, and knowledge about children's anxiety is especially limited. As our part of the equation, we do run workshops for professionals teaching them to identify anxiety disorders and about our treatment program. In addition, we are often asked for opinions in the media about these problems and there are growing numbers of newspaper, magazine, radio, and television programs reporting on these problems in children. Finally, we are currently in the process of writing books on recognising and treating anxiety in children, both for professionals and the general public, which will hopefully be completed toward the end of the year. Jasmine: Thank you for doing the interview Ron. To purchase Ron's book, "Helping your Anxious Child" visit the Panic Anxiety Disorder Association Inc website. For further information on childhood anxiety visit Childhood Anxiety a Web Ring for childhood anxiety disorders. International CBT Referrals  |
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Last modified: June 12, 2007