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There are generally two types of treatments that seem to be equally effective: cognitive behavioral therapy (CBT) and selective serotonin reuptake inhibitor (SSRI) medications. The best study that compared them directly in kids found one is no better than the other, and that combining the two works better than using one or the other alone.

Cognitive behavioral therapy is a really wonderful treatment, but the therapist has to have some experience delivering it. Specific techniques need to be followed. There are not that many therapists in the United States who are readily available to apply those methods.

In situations where a family doesn’t have access to a welltrained therapist, CBT wouldn’t be the first choice. It would be better to use an SSRI rather than try to do CBT with a therapist who isn’t well-trained and experienced.

Pediatricians are often comfortable prescribing SSRIs, but we don’t completely understand how these medications help children with anxiety disorders. Because of this, I think some parents are uncomfortable using them.

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