Therapist's Guide to Clinical Intervention - Sigmund Freud

Additional
Considerations
3. Excessive Worrying
A. Explore fears related to concerns—rational and irrational
B. Deal with issues related to rational fears and problem-solve more adaptive
coping responses
C. Confront irrational fears and beliefs
4. Refusal to Attend School
A. Child needs to attend school
1. Contact school to prepare the staff for the situation
2. Parents and teachers to be consistent with a mutual understanding of the plan
to manage the child
5. Difficulty Dealing with Emotional Conflict
A. Play therapy to identify and work through issues
B. Relaxation training (with reaffirming messages such as "mommy is at work, but
will be home at ..., Everything is the way it is supposed to be ...")
C. Keeping a journal for venting feelings and for problem solving
D. Encourage appropriate behavior; do not focus on negative behavior
E. Explore presence of physical symptoms associated with anticipation of separation.
Facilitate development of management skills to decrease symptoms.
F Positive feedback and reinforcement
6. Teacher
A. Inform teacher of difficulties that child is experiencing
B. Coordinate consistency between efforts of school personnel and parents in being
supportive to the child
While separation anxiety is seen as a normal response in young children, when it interferes
with age-appropriate tasks (school attendance, peer interaction, daily activities etc.), it
needs to be dealt with.
For children residing in inner-city settings there may be legitimate issues of safety associated
with high crime rates. Parents may be reluctant to let their children go outside and play without
adult supervision, feeling anxious and unsafe themselves. Therefore, the parent's level of
anxiety and coping must be carefully evaluated. If there is an instance of actual harm or
abrupt separation from a caretaking figure, a child's anxiety may increase.
Note that a diagnosis of anxiety disorder is only appropriate when a child's fear, anxiety,
worries are persistent and unrealistic.
AVOIDANT DISORDER
The central feature of this disorder is the excessive negative reaction to unfamiliar people.
Additional features include heightened anxiety and low self-esteem. These children desire
warm and satisfying relationships with familiar people, but their severe reaction to unfamiliar
people interferes with social functioning.
Goals 1. Correct irrational thinking
2. Improve self-esteem
3. Facilitate self-management through identification of personal
goals and objectives
4. Improve coping
14 1. Treatment Planning-. Goals, Objectives, and Interventions