Intensive Treatments for Separation Anxiety Disorder in Children and Adolescents

Childhood separation anxiety disorder (SepAD) has only recently been recognized as a highly frequent disorder, precursor of panic disorder, and pacemaker of anxiety and other mental disorders. Although cognitive-behavioral therapy (CBT) has proven effective for the treatment of anxiety disorders in children, including SepAD, intensive forms of treatments have been developed recently to further improve treatment efficacy. This brief article describes a rationale for the development of intensive, disorder-specific treatments for SepAD, focusing on extinction learning and parental involvement in the child's therapy. We further provide an overview of three cognitive-behavioral and one psychodynamic intensive treatment programs for SepAD and review the empirical evidence for each of these programs. In conclusion, one promising treatment-intensification strategy is to deliver exposure in high doses and in multiple contexts. Parents can be coached to conduct such exposure in-between treatment sessions. In the light of initial findings from RCTs, the involvement of parents seems to benefit younger children more so than older ones.