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Anxiety and panic often first appears in adolescence, making effective treatment, while still young, imperative. The Treatments That Work series explains the most effective interventions for a particular problem in user-friendly language.  In Mastery of Anxiety and Panic for Adolescents, Riding The Wave: Therapist Guide, by Donna B. Pincus, Jill T. Ehrenreich and Sara G. Mattis, the aim is to help adolescents with panic disorder and agoraphobia.  In the excerpt below the authors focus on the importance of parental involvement in effective treatment.

Research on the importance of including parents in child and adolescent anxiety treatment has grown substantially during the past decade.  Numerous studies indicate that children and adolescents have the most significant and lasting gains in anxiety treatment when parents are involved.  Recent systemic research has suggested that incorporating parents more centrally into the treatment of children and adolescents with anxiety disorders may enhance treatment effectiveness and maintenance (Ginsburg, Silverman, & Kurtines, 19915; adds, Heard, & Rapee, 1992).  Ollendick and King (1998) highlight the need for intensive parental involvement when treating children with fears and anxiety.  They suggest that parents might be regarded as co-therapists, responsible for the implementation of procedures developed by the therapist and for giving children or adolescents ample praise and positive reinforcement for brace behavior.  Although this may seem common-sense, a review of the literature reveals that involving parents directly in the treatment process has been the exception rather than the rule (Braswell, 1991)…Since the parent is one of the most significant persons in an adolescent’s life, and an adolescent’s avoidance of activities often causes considerable disruption in most families, the inclusion of parents in the active treatment process should yield greater clinical benefit…

General Tips for Parental Involvement

As an adolescent is learning new concepts and tools for dealing with his panic attacks, it is very helpful to have parents on the “same page” as their child.  This can be accomplished by teaching both the adolescent and his parents a “common language” regarding the most appropriate tools to use during a panic attack.  For example, during a panic attack, a parent might suggest that the adolescent “restructure his maladaptive panic thoughts” or “notice the triggers of panic attacks” and “not avoid the feelings.”  While it is important for an adolescent to know how to cope most effectively with a panic attack, it is also crucial that parents also understand how to help most effectively.  Thus, including parents in a portion of treatment sessions ensures that they will be able to help reinforce concepts that the adolescent learned in therapy.

Many parents of adolescents with panic disorder (PD) are worried that their child might be in significant distress during a panic attack, and my inadvertently reinforce the child’s avoidance of places or situations that might trigger panic.  It is important that parents are educated about the nature of anxiety and panic, the fact that anxiety won’t hurt or harm their child, and the importance of nonavoidance of physical sensations and of situations that might trigger panic attacks.  Although parents are typically given handouts and reading materials regarding the nature of anxiety and panic, it is also helpful to have parents join part of the session, to teach these importance concepts in person.

A common fear of parents of adolescents with panic is whether getting rid of their adolescent’s PD will make them feel “less close” to their child.  Parents state that, unlike many adolescents who are trying to separate from their parents, their teenager tries to “stay close” to them out of fear of getting a panic attack and having to deal with it alone.  This often makes parents feel a sense of importance and emotional closeness to their teenager.  When attempting to treat PD, it is important to discuss with the adolescent and his parents other way that they might maintain a close relationship if panic attacks were no longer occurring.

Although parents can be involved in treatment in many ways, it is important to first discuss the plan with the adolescent and parent(s), so that both parties are comfortable and aware of the plan.  In addition, the inclusion of parents at the end of sessions does not mean that they must be informed about everything the adolescent talked about in therapy; only the important treatment concepts need to be conveyed.

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Author Kevin J. Hayes has been very busy writing American Literature: A Very Short Introduction, but he needs your help. Find out what you can do below.

Last week I boasted to friends that I had written my first blog. Longtime bloggers may find my sense of accomplishment overblown, but last week’s blog did mark my entry to this innovative world of communication. Being new to the blogosphere, I was unsure what kind of responses I would receive. As things turned out, the comments were quite useful. They point to a major problem facing American Literature: A Very Short Introduction. This little book about a big topic requires me to make some tough choices. Who should I include? Who can I exclude? Where should I discuss each author?

Responding to my query about American travel writers, James suggested I include Hunter S. Thompson. Though a great Thompson fan, I am excluding him from the travels chapter. Instead, I’ll put him with novels. The sixties took the postmodern novel to a dead end, but it gave rise to an exciting literary movement: New Journalism. For a time, journalists exceeded novelists in terms of literary virtuosity. As a digression in my novels chapter, I will discuss the work of such writers as Truman Capote, Peter Maas, Tom Wolfe, and Hunter S. Thompson.

Ideally, I would like to discuss every author only once. But what should I do about authors who wrote in different genres? Pick their most important genre and ignore the others? Only major figures who excelled in multiple genres can justify separate discussions. Take Henry James for instance. Best known as a novelist, James was also a fine travel writer and memoirist. I can justify discussing James in two or three different places, but I do not have room to discuss every genre of every author.

So, here are my questions. Which American authors excelled in more than one literary genre? Where should I discuss them? Are they important enough to deserve discussion in more than one chapter? Boy, that’s a loaded question. Here’s a more fundamental one: what constitutes literary importance?

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