Rational-Emotive Behavioral Interventions for Children with Anxiety Problems
Wilde, Jerry, Journal of Evidence-Based Psychotherapies
The purpose of this article is to provide detailed descriptions of specific clinical interventions that can be used by REBT therapists working with children and adolescents who are experiencing difficulties with anxiety. It is worth noting that anxiety disorders are among the most commonly occurring mental and emotional problems in childhood and adolescence. While a majority of publications focus on empirical research, there is still a need for articles that address clinical practices. REBT is, first and foremost, a system devoted to the practice of psychotherapy. Whether it is through articles focused on empirical research or clinical applications, the advancement of REBT is the ultimate goal.
One of the most efficient anxiety management techniques involves the use of distraction in which clients are encouraged to substitute a calming mental image to interrupt the anxiety producing thoughts. This article also provides a detailed explanation of rational-emotive imagery (REI), which is a technique that employs relaxation prior to clients generating their own rational coping statements. Finally, a progressive thought-stopping technique is examined. In this intervention, the therapist provides successively less direction and guidance in the hopes that clients will be able to master this technique for use independently.
Keywords: anxiety, children, REBT
RATIONAL-EMOTIVE BEHAVIORAL INTERVENTIONS FOR CHILDREN WITH ANXIETY PROBLEMS
Anxiety disorders are among the most common mental and emotional problems to occur during childhood and adolescence. According to the U.S. Department of Health and Human Services (1999), 13% of children and adolescents ages 9 to 17 experience some type of anxiety disorder. In community samples of adult populations, the range of anxiety disorders was between 5 - 20% with a majority of the estimates lying above 10% (Costello & Angold, 1995). Blanchard, et al., (2006) found that 36% of parents report concerns about the possibility of their children struggling with anxiety.
If left untreated, anxiety disorders can persist into adulthood (Keller, et al., 1992, Pfeffer et al., 1988; Spence, 1988) which may in part explain why the lifetime prevalence rate for anxiety disorders is 28.8%, with a 12-month prevalence of 18.8% (Kessler, R. & Merikangas, K., 2004). The same study reported the most common subtypes of anxiety disorders to be specific phobia (12.5%), social anxiety disorder (12.1%), and post-traumatic stress disorder (6.8%).
REBT and cognitive behavior therapy (CBT) have an extensive history of being successfully applied to anxiety problems in children (Brody, 1974; Cangelosi, Gressard, & Mines, 1980; Cristea, Benga, & Opre,2006; DiGiuseppe & Kassinove, 1976; Knaus & Bokor, 1975; Knaus & McKeever, 1977; Meyer, 1981; Micco, et al, 2007; Miller & Kassinove, 1978; Omizo, Lo, & Williams, 1986; Von Pohl, 1982; Warren, Deffenbacher & Brading, 1976; Wilde, 1994, 1995, 1996a). The utility of CBT with anxiety disorders has led mental health officials in the United Kingdom to identify CBT as the first-line approach to treating anxiety disorders (National Institute for Clinical Excellence, 2004).
Rational-emotive and cognitive-behavior interventions have also been found to be beneficial in a host of other commonly occurring childhood problems such as low frustration tolerance (Brody, 1974); impulsivity (Meichenbaum & Goodman, 1971); poor academic performance (Block, 1978; Cangelosi, Gressard, & Mines, 1980), and depression (Wilde, 1994). Research also suggests that CBT is effective in the prevention of depression (Clarke, et al., 2001, Gilliam, et al., 1995) and in the improvement of self-concept and coping capabilities (DeVoge, 1974; DiGiuseppe, 1975; DiGiuseppe & Kassinove, 1976; Katz, 1974; Maultsby, Knipping & Carpenter, 1974; Omizo, Lo & Williams, 1986; Wasserman & Vogrin, 1979). …