Anxiety and Phobic Disorders: A Pragmatic Approach by Wendy K. Silverman

By Wendy K. Silverman

For decades, anxiousness and phobie issues ofchildhoodand youth have been overlooked via clinicians and researchers alike. They have been considered as mostly benign, as difficulties that have been really gentle, age-specific, and transitory. With time, it was once concept, they might easily disappear or "go away"-that the kid or adolescent may magically "outgrow" them with improvement and they wouldn't adversely have an effect on the growing to be baby or adolescent. for that reason ofsuch pondering, it used to be concluded that those "internalizing" difficulties weren't worthwhile or deserving of our concerted and cautious attention-that different difficulties of adolescence and youth and, particularly, "externalizing" difficulties corresponding to behavior disturbance, oppositional defiance, and attention-deficit difficulties de­ manded our specialist energies and assets. those assumptions and asser­ tions were challenged vigorously in recent times. Scholarly books (King, Hamilton, & Ollendick, 1988; Morris & Kratochwill, 1983) have documented the enormous misery and distress linked to those issues, whereas studies ofthe literature have confirmed that those issues are whatever yet transitory; for an important variety of adolescence those difficulties persist into past due formative years and maturity (Ollendick & King, 1994). in actual fact, such findings sign the necessity for therapy courses that "work"--programs which are powerful within the brief time period and efficacious over the lengthy haul, generating results which are sturdy and generalizable, as weil as results that improve the lifestyles functioning of youngsters and youth and the households that evince such problems.

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Nevertheless, some gauging of treatment outcome is still possible. In our view, this can be done by using a child-structured interview schedule (with both child and parent versions being administered), and at least one child self-rating scale. These should be administered both before treatment and at the end of treatment. Specifically, using one of the interview schedules (discussed in the next chapter), you can determine whether or not the child continues to meet diagnostic criteria. Ratings of severity and interference, which are contained on many of the interview schedules, should also be obtained pre- and posttreatment.

Lonigan, Carey, & Finch, 1994; Watson, Clark, & Carey, 1988). That is, negative affectivity appears to be related to both anxiety and depression; low positive affectivity appears to be related only to depression. Accordingly, a possible way to improve the distinctiveness of anxiety and depression self-rating scales is to assess the degree to which respondents report high positive affective states and then to infer depression from the relative absence of such experiences. In other words, a greater number of items contained in self-rating scales need to be reflective ofpositive affectivity--not negative affectivity (Watson & Kendall, 1989).

ASSESSMENT METHODS Now that we have identified the goal for each of the assessment settings, we discuss some of the concrete issues and details involved in identifying the 20 Chapter 2 assessment method that is best to use in that setting and for that goal. As we have noted , within our pragmatic framework, the concept of "best" means the same thing as most useful, and what is most useful is contextual in significance; that is, "most useful" is a concept to be evaluated in relation to a particular problem and the actual (and foreseeable) alternatives for solving that problem.

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