Treatment of separation anxiety
start of any treatment required:
-A precise diagnostic evaluation
-A thorough understanding of the factors involved in the origin and development of the problem: history, trigger factors, predisposicionales factors, maintenance factors, attempted solutions, etc..
-Sufficient knowledge of the patient and their circumstances, family characteristics, degree of impairment of health and welfare, disability and interference in the action plans or significant status to the individual, personal resources, allocation of capacity and efficiency, outstanding features personality, general emotional state, etc.
-The formulation of an explanatory scheme that identifies the most important variables of the case, the critical relationships between them and the process they have been following over time.
-Establishing a proper relationship between the patient, the specialist and the families and educators, allowing them to work together effectively, mutual recognition, effective communication, confidentiality, monitoring requirements etc.
-Finally, according to the above, the establishment of measurable objectives and means conveniently sorted and secuenciasdos. The latter, the media and their deployment are those that constitute the actual treatment.
combines therapeutic intervention, usually, specific treatments, depending on the principal diagnosis, other more general or contextual, depending on personal characteristics and circumstances of the patient. Typically, the first interventions are aimed at reducing anxiety symptoms and disability they cause. Secondly, the analysis and discuss the factors that create and / or maintain anxiety and other disorders that may accompany it.
Typically, treatments include aspects of health recovery, if lost, aspects related to prevention, and issues related to the patient's personal development in some way another has to do with what happens.
SPECIFIC TREATMENT SEPARATION ANXIETY
apply in this disorder cognitive-behavioral techniques similar to those used in other anxiety disorders. However, to be reduced primarily in people age, they require a number of changes. Firstly, it is essential to consider the age and developmental level of the child, because this tells us is normal and what not. If finally is that we have a problem, and there is a decision to initiate therapy, it is preferable that this be done in a context as close as possible to what the child is accustomed. Ideally, the sessions were conducted in natural context of the child. The therapist must necessarily take a more active role, since the patient does not have sufficient capacity to decide. Furthermore, especially in the first session, you should present the usual caregivers, to provide security and support the child. Otherwise it might not achieve treatment develop properly. It is also important that parents and other educators are trained to be co-therapists, so they learn strategies taught by the therapist and the therapy used outside with your child. Finally, it is important to work with the motivation for therapy in children, to make it more rewarding to be following psychological treatment and / or medication.
most widely used techniques that have proved effective in treating separation anxiety disorder are:
- training parents and other educators on the principles of operant techniques: mainly taught to reward small steps of child nurse while strengthening behaviors that, although they seem to relieve the patient's anxiety, they merely prolong it unnecessarily.
- Live gradual exposure to situations of separation is preparing a list of situations in order from least to most feared. Gradually exposing the child goes to each. In the first sessions is accompanied by a significant other, to gradually get the patient to face only to situations which will increase your confidence. Ultimately the goal is to make the patient himself to make a regular auto exposure and in its usual context, so that finally support the situations of separation with the least anxiety possible.
- Relaxation: a response incompatible with anxiety (can not be relaxed and anxious at the same time) used to cope. The most common is to use the Jacobson Progressive Relaxation which is based on stress-relaxation exercises that show the differences between relaxation and tension. For children under 8 years sessions are shorter, about 10-15 minutes to keep their attention and not be weary, used short, clear instructions, also learn better models for the relaxation procedure, and materials that facilitate learning such as dolls or whistles.
- Other methods of relaxation, laughter, play, music, etc ...
- Modeling techniques: use a real model or not, facing the feared situation gradually and without suffering negative consequences. The most effective model is that the body is present and the child to be repeating the behaviors of the model encouraged and supported emotionally by it. These techniques are used to strengthen systematically as the child is encouraged to make the model behavior and giving indications of what the way forward (so-called "physical guidance"). It is important that the model is attractive to the child resembles him, and is a model of coping and not domination. The more models of this type better. Addressing the task is very necessary.
- Images emotional: the child has to imagine everyday situations where their favorite characters involved, which leads to pleasant emotions. Gradually the child is said to imagine situations that cause you some anxiety, to scroll to more distressing. Positive Emotions principle of the technique have an inhibitory effect on subsequent distress.
- Practice reinforced or molding, it is agreed a final goal (to go alone to school for example) and breaks into a series of intermediate targets to be the current situation where the child is the ultimate goal. Then he will reward the achievement of each of the partial objectives, to reach the final goal. This technique also uses physical guidance. It is important to be left to reinforce avoidance behavior and go to report the child's development of technology.
- Cognitive Techniques: they work those thoughts or images that would be involved in the disorder. Basically, in this condition, you use positive self. This is primarily to invite the child to change the form of talking to himself, from "I can not do it," something bad will happen "to" I'll try "," may be something happening. " This technique, however, requires a certain intellectual skills, which make it unsuitable for small children age still lack them.
While here, expository purposes, techniques have been presented separately, it is common that different techniques are used simultaneously in order to enhance treatment effectiveness.
__________ Source of Anxiety Clinic. 2002
Some references on treatment of Separation Anxiety
Echeburúa, E. (1996). Anxiety disorders in infancia.Madrid. Ediciones Piramide.
Bragado, C. (1994). Behavior therapy in childhood anxiety disorders Madrid. Fundación Universidad-Empresa.
Effectiveness of psychological treatment: Document of the English Society for the Advancement of Clinical Psychology and Health. Siglo XXI. November 2002.
Source: http://www.clinicadeansiedad.com/02/123/Tratamiento_de_las_ansiedad_por_separación..htm
