Journal of Cognitive Psychotherapy: An International Quarterly
Volume 20, Number 3 • 2006

Principles of Cognitive-Behavioral Therapy for Anxiety Disorders in Children
Elizabeth A. Gosch, PhD, ABPP
Philadelphia College of Osteopathic Medicine Philadelphia, PA

Ellen Flannery-Schroeder, PhD, ABPP
University of Rhode Island, Kingston

Christian F. Mauro, PhD Scott N. Compton, PhD
Duke University Medical Center Durham, NC

This article elucidates the theoretical underpinnings of cognitive-behavior therapy (CBT) as applied to the treatment of anxiety disorders in children, focusing on social phobia, generalized anxiety disorder, and separation anxiety disorder. It reviews behavioral and cognitive theories that have influenced this approach. We argue that it is necessary to understand the essential components of this approach in the context of these theories in order to provide effective, clinically sensitive, and child-focused treatment. Components discussed include assessment, psychoeducation, affective education, self-instruction training, cognitive restructuring, problem solving, relaxation training, modeling, contingency management, and exposure procedures. Hypothesized key processes, such as the need to be experiential in treatment, are presented for consideration. Keywords: anxiety; children; cognitive behavior therapy; theory A nxiety disorders are among the most common mental health disorders in youth with / \ prevalence rates ranging from 12% to 20% (Achenbrach, Howell, McConaughy, & Stan. Z r \ . g e r , 1995; Velting, Setzer, & Albano, 2004). Left untreated, these disorders tend to have long-term effects on social and emotional development. Negative consequences associated with anxiety disorders in youth include lower levels of social supports, academic underachievement, underemployment, substance use, and high comorbidity with other psychiatric