A 10-year-old girl is brought to her pediatrician by her father for frequent headaches beginning six weeks ago. The patient has been late to school because of the headaches, and subsequently the father has been late to work. Two months ago, the patient’s mother moved out of the family home. The father reports that his daughter has been texting him from school multiple times a day to check in, and her teachers have noticed that she seems distracted during class activities. When interviewed in the presence of her father, the patient reports that she has been feeling worried because she is concerned that her father is going to get into a car accident on the way to work and die.
Which of the following is the most appropriate treatment for this child?
- A) Antipsychotics
- B) Cognitive behavioral therapy
- C) Dialectical behavioral therapy
- D) Exposure therapy
- E) Serotonin reuptake inhibitor
B) Cognitive behavioral therapy
The child in the vignette is displaying signs of separation anxiety. Separation anxiety is successfully treated with cognitive behavioral therapy .which is a type of therapy that challenges the beliefs which are the root cause of the psychiatric distress.
Answer choice A: Antipsychotics, is incorrect. Separation anxiety is not treated with antipsychotic medication.
Answer choice C: Dialectical behavioral therapy, is incorrect. Dialectical behavioral therapy (DBT) is a therapy created to treat borderline personality disorder.
Answer choice D: Exposure therapy, is incorrect. Exposure therapy is primarily used in the treatment of obsessive-compulsive disorder or specific phobia.
Answer choice E: Serotonin reuptake inhibitor, is incorrect. A serotonin reuptake inhibitor can be helpful for many anxiety disorders but is not first-line treatment for separation anxiety.
Key Learning Point
Separation anxiety should be treated with cognitive behavioral therapy (CBT).
Dr. Ted O'Connell