Managing Anxiety in Teenagers

First-Line Treatments

The American Academy of Child and Adolescent Psychiatry recommends cognitive-behavioral therapy (CBT) and selective serotonin reuptake inhibitors (SSRIs) as first-line treatments for anxiety disorders in teenagers, with combined treatment offering the greatest efficacy for most adolescents with anxiety 1
CBT approaches typically include components such as exposure to anxiety-provoking situations, which has substantial empirical support as a safe and effective treatment for adolescent anxiety disorders 2, 3
SSRIs have considerable empirical support as safe and effective treatments for adolescent anxiety, and are recommended as first-line pharmacological treatment for anxiety disorders in teenagers 1

Comprehensive assessment should include evaluation of specific anxiety disorder diagnosis, assessment of symptom severity using validated measures, and evaluation of functional impairment across domains, as recommended by the Journal of Child Psychology and Psychiatry and Allied Disciplines 1, 2, 3, 4, 5, 6, 7
Regular monitoring of treatment response using standardized measures is recommended, with measures such as symptom severity and functional impairment assessed regularly 4, 5

Treatment selection should be guided by severity of anxiety symptoms and functional impairment, presence of comorbid conditions, and patient/family preference regarding treatment modality, according to the American Academy of Child and Adolescent Psychiatry 1

Monitor for potential adverse effects, particularly during initial weeks of treatment, and discuss potential risks and benefits with adolescents and their families, as recommended by the American Academy of Child and Adolescent Psychiatry 1

The combination of CBT and SSRI medication has shown superior outcomes compared to either treatment alone in several trials, according to the American Academy of Child and Adolescent Psychiatry 1

Anxiety disorders often have a chronic course requiring ongoing management, and relapse prevention strategies should be incorporated into treatment plans, with regular follow-up to monitor symptoms and adjust treatment as needed 1, 4