Social Phobia In Children

WHAT YOU SHOULD KNOW:

  • Social phobia (SP), also called social anxiety disorder, is a common anxiety problem seen in school-aged children. Older children and adolescents (teenagers) with SP have a phobia (strong, ongoing fear) of being in social situations. This may be a situation where your child has contact with people or when he must perform in public. Your child may be very shy, quiet, and self-conscious around other people, even those he knows. Younger children may get selective mutism (not talking) where they cannot talk at all in social situations. Your child feels very uncomfortable in settings where he meets new people or might be judged by others. He fears that he will do or say something that will embarrass himself. Common fears include speaking in public, reading aloud, eating or writing in public, or playing sports or music.

  • Your child's caregiver will need information about your child's health history and family history of having anxiety problems. He may want to know about your child's behavior, such as at school and in social activities. He will need to know about your child's fears and worries, and what makes them worse. He will assess all of these in looking for signs and symptoms of SP. Tests may be done to check if your child's symptoms are caused by medical conditions. Behavioral (how one acts) and other therapies, and medicines may be used to treat your child's SP. With treatment, your child's social phobia may be relieved and his quality of life improved. Getting treatment is important to prevent him from having worse problems from SP when he is an adult.

CARE AGREEMENT:

You have the right to help plan your child's care. Learn about your child's health condition and how it may be treated. Discuss treatment options with your child's caregivers to decide what care you want for your child.

RISKS:

  • Treatment for SP may bring unwanted side effects, such as sleeping problems, thoughts of self-harm, or seizures (convulsions). If left untreated, your child's SP may not go away and can get much worse. In avoiding social activities, your child may have poor self-esteem and become isolated, lonely, and very sad. He may have problems with his school learning and problem-solving skills. His social skills may be poor and he may have problems with friendships and other relationships. Adolescent children with SP have higher rates of cigarette smoking, and of using alcohol and drugs. Adolescent girls with SP may have an increased risk for unplanned pregnancy. Your child with SP may also have other mental health problems.

  • If not recognized and treated, SP may become a lifelong problem that continues as your child becomes an adult. Adults with SP can become very socially isolated as they fear both ridicule and rejection by others. They have lower rates of attending college and problems with being steadily employed. They have lower rates for getting married and higher rates for divorce and separation. They also have higher rates of drug and alcohol use and abuse. Most adults with SP also have at least one other mental disorder. They have an increased risk for getting major depression that can be very bad, long lasting, or recurring. They are at an increased risk for suicide (wanting to harm or kill oneself) attempts.

WHILE YOU ARE HERE:

Informed consent

is a legal document that explains the tests, treatments, or procedures that your child may need. Informed consent means you understand what will be done and can make decisions about what you want. You give your permission when you sign the consent form. You can have someone sign this form for you if you are not able to sign it. You have the right to understand your child's medical care in words you know. Before you sign the consent form, understand the risks and benefits of what will be done to your child. Make sure all of your questions are answered.

Emotional support:

Stay with your child for comfort and support as often as possible while he is in the hospital. Ask another family member or someone close to the family to stay with your child when you cannot be there. Bring items from home that will comfort your child, such as a favorite blanket or toy.

Medicines:

  • Medicines: Medicines may be given if your child has severe anxiety. He may have any of the following:

    • Antianxiety medicine: This medicine may be given to help your child feel less nervous.

    • Antidepressants: This family of medicines helps decrease or prevent symptoms of depression. These medicines can also be used to treat other behavior problems.

    • Tranquilizers: These medicines are also called sedatives. They may be given when your child has severe anxiety symptoms to help him stay calm and relaxed.

Treatment options:

These may be used to make changes in your child's fear level and his response to his fears:

  • Behavioral therapies: These are programs that work towards changing how a person behaves (acts) and responds in certain situations:

    • Cognitive behavior therapy: This is the most commonly used therapy for SP. It works to change how a person acts in part by changing how he thinks. It may be done by your child alone, with a group, or along with you or your family. This therapy helps your child learn how to control his actions and improve his behavior. Your child may be taught how to change his behavior by looking at the results of his actions. He may learn that certain actions have different results that may make him feel either good or bad about himself. Good behaviors will be rewarded and encouraged, while unwanted behaviors will be discouraged. This therapy may include any of the following:

      • Assertiveness training: This is therapy to help your child better control his feelings. It may help him understand his feelings and learn how they cause him to act. This therapy can train your child to become more confident. It teaches him ways to handle situations that cause negative thinking and anxiety.

      • Exposure or desensitization: Exposure or desensitization therapy helps your child face a feared object, person, or situation. Fantasy (not real) or real-life situations are used with this therapy. The goal of desensitization therapy is to help decrease your child's fear or anxiety.

      • Parent training: You may be given special training to help you cope and handle your child's anxiety. This training will also help you control your own anxiety.

      • Relaxation training: Your child may be taught ways to relax through special exercises. This therapy teaches your child how to calm his body and mind. The goal is to decrease your child's body and emotional (mental feelings) stress.

      • Social skills training: This teaches and trains your child how to get along with other people. Training may include teaching your child to maintain eye contact and smile. He may also be taught on how to accept praises and ask questions.


  • Cognitive therapies: This is a type of therapy that helps people understand why and how they think a certain way. How they think can affect how they act. This is therapy or counseling that is usually done in a series of meetings or talks. These may be attended by you, your child, and your family. These therapies include:

    • Cognitive restructuring: Caregivers help your child learn which thoughts bring anxiety. These thoughts are replaced with realistic and more pleasant ones. Your child may be taught on using positive self-statements to help him handle his anxiety.

    • Psychodynamic therapy: This therapy helps your child to deal with conflict in a healthier way. It helps your child deal with rejection and bad things that happened in his past. This therapy may help your child to feel better about him, and to feel more in control of his life.

© 2014 Truven Health Analytics Inc. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. All illustrations and images included in CareNotes® are the copyrighted property of A.D.A.M., Inc. or Truven Health Analytics.

The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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