You could try adding mindfulness based stress reduction to CBT techniques. My son, who was treated by another psychologist for panic attacks was treated with Mindfulness-based CBT . Cd's were give to him as part of the program and the CBT was incorporated into the 6 weeks. He is no longer suffering anxiety or panic attacks. It is evidence-based and easy to learn (although you must learn it yourself first before you can apply it) Google Mindfulness and Jon Kabat Zin. ACT therapy may also be beneficial

It would be useful to first determine whether or not there is an organic cause of the anxiety and panic attacks e.g. hyperthyroidism, hypoglycaemia, or premenstrual syndrome related to hormonal imbalances, and the cause should be treated. If none are found, then herbs such as American skullcap, chamomile, lemon balm, valerian, passionflower and verbena can help - perhaps alongside CBT. PMS can be treated with Vitex agnus castus.

I suggest some papers I have read:

Piacentini J, Roblek T. Recognizing and treating childhood anxiety disorders.

West J Med. 2002 May;176(3):149-51

Manassis K. Childhood anxiety disorders. Approach to intervention. Can Fam

Physician. 2004 Mar;50:379-84

Haugaard JJ. Recognizing and treating rare behavioral and emotional disorders

in children and adolescents who have been severely maltreated: schizophrenia.

Child Maltreat. 2004 May;9(2):161-8

For adolescence I attached this manuscript herewith.

Bye

I agree with Debbie V. Mindfulness-Based Stress Reduction (MBSR) or anything similar is very effective for all ages. I've seen it eliminate panic attacks and anxiety of all sorts. Simple meditation is a life changing habit that has evidence-based literature to support its efficacy for many conditions that plague our crazy world.

We also use mindfulness techniques in our child anxiety clinic and have found them useful as an adjunct or precursor to exposure-based CBT. Not all programs out there are suitable for younger children. Two good resources are Semple and Lee's manual for treating child anxiety with mindfulness-based cognitive therapy and Gina Biegel's stress reduction workbook for teens. You can find them on amazon.com..

Hi Philile,

As others have noted, there is growing popularity for "third-wave” acceptance- and mindfulness-based therapies (e.g., Kabat-Zinn’s MBSR), some of which integrate CBT approaches (e.g., Segal’s MBCT). The growing literature here is generally promising. It will be interesting to see more comparisons here to CBT and other approaches for child anxiety treatment. Notably, research on CBT and alternatives for child panic disorder is still limited. And not all anxious children respond to CBT.

Barlow's (2002) Panic Control Treatment (PCT), a form of CBT, has been adapted by Mattis & Ollendick (2002) for use with children, and for adolescents (PCT-A; Mattis et al., 2006). Pincus et al. (2010) recently completed an randomized controlled trial for PCT-A, which supported its efficacy. Components of PCT include psychoeducation, relaxation and breathing training, cognitive reappraisal (reinterpretation of catastrophic thoughts about physiological sensations), interoceptive and in vivo exposure, modeling, and reinforcement.

Medications may alleviate anxiety disorder symptoms, but relapse is common when they are discontinued. There is limited research (no RCTs, some open trials) supporting the short-term effectiveness of SSRI antidepressants in youths with panic disorder. Benzodiazepines might also work in the short term, but they require high dosage, and there is risk for dependency and sometimes emergence of depressive symptoms.

There are some recent investigations training anxious children to disengage attention from threat using computerized tasks, thereby reducing stress vulnerability (e.g., Bar-Haim et al., 2011). Much of this work is still in the research/trials stage, and not readily available in most clinical settings.

Thank You to everyone for their comments, I will definitely do some reading on these areas.

Hi Philile Makhaye,

Try Transcendental Meditation, it is very effective, and give permanent results.

See the link below:

http://www.maharishi.ca/10-facts.php

All Luke,

When working with clients I start with showing the power of their thoughts on how they feel and how their body reacts by going through a guided imagery of cutting a lemon and tasting it. You hope that the client will have some physical reaction like extra saliva or a puckering feeling in their mouth. If so, you can point out that the lemon was not real and yet their body reacted to the stimuli, therefore their thoughts are powerful in affecting both feelings and physical reactions. I then work with the cognitive distortions they have (stinking thinking) and general coping through cognitive reframing. You wanted more than CBT suggestions though, so from there I work on helping the client to be aware that their anxiety is a part of themselves attempting to protect them in some way and explore in what ways that may be the case. I suggest the client "make friends" with the fear or anxiety and not resist it so much. I teach how to be present with the troublesome feeling or thought (mindfulness) and accept it for what it is at the time, understanding it will pass. I talk about the impermanence of feelings and how you can not control thoughts, but how you react, etc. I suggest clients use their coping skills such as grounding techniques, distractions, etc. (cognitive behavioral), along with an acceptance without judgment of themselves for being fearful or anxious. I explain "what we resist persists" and use the example of if I told them to NOT think of a white bear in the next 10 minutes, what would they be thinking of? The goal being to not focus on the fear or anxiety, but to be aware of it, be friends with it as something that is an attempt to protect them by part of their psyche, and gently let it pass. There are so many things that can work like relaxation techniques, music, exercise, etc. You just have to explore what your client would actually use and benefit from using. I also like a simple energy modality called Emotional Freedom Techniques because it is easy to learn and simple to implement. There are lots of example to be found on youtube, if one does not want to go through the formal training. Bruce Lipton, Ph.D., a cellular biologist, is an excellent resource in doing this kind of work and explaining how and why it works with clients. EFT is a form of energy work that can help in cases where the CBT and mindfulness work has stalled and the cient in open to more non-traditional (but more widely accepted) form of therapy. Hope that helps.