Changing maladaptive behaviors, part 1: Exposure and response prevention

Anxiety disorders are among the most common disorders in childhood and put children at-risk for missing important developmental experiences. Exposure therapy has demonstrated efficacy and is the treatment of choice for childhood anxiety, but many clinicians choose not to deliver exposure therapy. The current chapter provides a road map for competently delivering exposure therapy to children and adolescents. We begin by describing an evidence-based approach to conducting exposure therapy, highlighting key factors for successful implementation as well as key areas of competence for the successful clinician. We then discuss variations on this theme, describing the application of these central principles to treating specific types of anxiety. Next, we examine developmental considerations when working with children and adolescents that can further complicate the design and delivery of exposure therapy. Finally, we identify and suggest ways to overcome obstacles commonly encountered while delivering exposure therapy to children and adolescents.