TOL maintains a healthy skepticism regarding the medication of young children and its untested effects on their neurological development. But a large-scale, government-sponsored National Institute of Mental Health study confirms that some combination of personal therapy and prescription meds can help many young people work their way through chronic anxiety. 

An unfortunate number of children and adolescents suffer from recurring bouts of stresses severe enough to disable their most basic functions: expressing themselves, performing in school and developing emotional connections with others. Repeat attacks can become a very real medical problem stemming from any number of bases including various childhood traumas, the separation or divorce of parents, dramatically impaired self-esteem and related problems with social assimilation.

A study tracking the progress of 500 subjects, aged 7-17 and drawn from a larger anxiety disorder project, looked to measure the respective efficiency of popular SSRI anti-depressant Zoloft and the short-term talk treatment approach known as Cognitive Behavioral Therapy (CBT). All subjects suffered from some form of moderate to severe social phobia, separation anxiety or generalized anxiety disorder, and many more had also been diagnosed with concurrent ADHD and attending behavioral problems. Researchers treated each over a 12-week period with medication, therapy, a combination of both or a placebo pill and a series of neutral psychiatric “monitoring” sessions.

Their results, despite a somewhat limited subject pool and a brief trial period, are significant: while previous data implies that a near-majority of affected children makes no real progress under standard treatment plans, approximately 8 in 10 subjects in this study displayed symptomatic improvements when treated with a combination of daily Zoloft doses and regular CBT. And the two approaches seem to compliment each other as subject success rates were considerably lower for every other group; improvements among SSRI and CBT subjects numbered 55 and 60 percent, respectively, while less than a quarter of placebo subjects made any notable progress. The CBT plans involved in this study amount to organized efforts to pinpoint the specific sources of recurring anxiety by encouraging subjects to talk and guiding them through structured tasks to better master their own uncontrollable fears.

Zoloft has attracted fire for prompting a perceived increase in suicidal thoughts and behaviors, but none of these major side-effects made an appearance in the study as medicated subjects reported no more adverse symptoms than their placebo counterparts. Any concerns raised by the prescription of Zoloft to a 7-year-old must be addressed by parent, patient and practitioner. Regardless of one’s stance on the issue, the study is encouraging in important ways: it illustrates the fact that, while treatment has historically proven less effective than we’d like, noted or dramatic improvement is possible with some form of treatment, whether personal or medicinal. Experimenting with a little of both appears to be the most effective method. Perhaps the most potent message to be drawn from this study: CBT regimens are a big element of effective treatment for range of disorders and must be covered, at least in part, by all standard health insurance plans.