PSYC 345 Week 6 DB Forum 5 Example

Discussion Board Forum 5: Thread and Reply

PSYC 345 Exceptional Child, Discussion Board Forum 5 (thread and one reply)

Thread by [Student Name]

The prompt, the composite child and the classmate's post are composites standing in for the course's own forum; the textbook, Scripture and published trial are real; the requirements follow Liberty's public course guide for PSYC 345.

Thread

Every school morning, ten-year-old Grace tells her mother she has a stomachache. Some days she cries at the car door. She no longer sleeps at friends' houses, and at night she asks her parents again and again whether a burglar could get in. Her pediatrician found nothing physically wrong. Her parents, worried and tired, have started letting her stay home when the stomachaches are bad, which makes the next morning even harder. Her teacher says that once Grace is in the classroom she settles within twenty minutes, a detail that suggests the fear is about getting there, not about school itself.

Parritz and Troy (2018) describe anxiety disorders as among the most common problems of childhood and note that they often appear as physical complaints, avoidance and repeated requests for reassurance. Avoidance brings immediate relief, which reinforces it, so the child never learns that the feared situation can be faced. Well-meaning parents can be drawn into this cycle, as Grace's parents have been. The chapters also note that anxiety often runs in families and that anxious children tend to interpret ambiguous situations as threatening, which makes everyday events feel dangerous.

The best-known treatment comparison is the Child/Adolescent Anxiety Multimodal Study. In the trial reported by Walkup et al. (2008), nearly five hundred young people between 7 and 17, each referred for one of the fear-driven conditions most often seen in school-age children, were randomly given one of four twelve-week treatments: fourteen therapy sessions, daily sertraline, the two together, or a sugar pill. By the end, independent evaluators judged roughly four of every five children on the combined treatment to be substantially better, against six in ten on therapy, a little over half on sertraline and fewer than one in four on the pill. All three active treatments beat placebo, and the combination beat each single treatment.

The therapy in such trials is not general talk. It teaches children to recognize anxious thoughts and body signals and then to face feared situations step by step, from short separations to a full school day, while parents learn to praise brave behavior instead of rescuing. For Grace, that might mean going to school even with a stomachache, practicing a sleepover at a relative's house first and limiting the nighttime questions to one answer. Each step is planned in advance, rated for difficulty and rewarded when completed, so courage becomes something she can see herself building.

Philippians 4:6-7 invites believers to bring their anxieties to God in prayer and promises a peace that guards the heart (English Standard Version Bible, 2001/2016). For a Christian family, prayer can sit alongside treatment, giving Grace a way to name her fears without implying that her anxiety is a failure of faith.

Classmates: how would you help parents stop rescuing an anxious child without seeming harsh?

Reply to Elena

Elena, you wrote that you would never want a child on medication for anxiety and that therapy alone should always be tried first. Your instinct to start with the least intrusive option is understandable, and many families feel the same, especially when they worry about side effects or about a child coming to see herself as needing pills to cope. The CAMS results actually give some support to that approach: Walkup et al. (2008) found that cognitive behavioral therapy alone helped nearly 60% of children, about the same as sertraline alone, so therapy is a reasonable first step for many families.

At the same time, the trial found that combining therapy and medication helped the most children, about four in five, a difference large enough to matter for families facing severe symptoms. For a child whose anxiety is severe, keeps her out of school for weeks or does not improve with therapy, medication discussed carefully with a physician may be part of a responsible plan. Parritz and Troy (2018) emphasize that untreated anxiety in childhood can interfere with friendships, learning and later adjustment, so delay has costs too. The decision is not between a natural and an unnatural choice but between different ways of reducing suffering, each with benefits and risks that families must weigh with their doctor.

It also matters that the trial lasted twelve weeks. Families should ask about longer-term effects and side effects, and therapy skills may last after treatment ends in a way that medication benefits may not. A family might reasonably begin with therapy, set a date to review progress, and consider adding medication if the child is still missing school by then.

The wisdom saying in Proverbs 15:22 about plans failing without counsel and succeeding with many counselors (English Standard Version Bible, 2001/2016) fits here: parents, therapists and physicians together are more likely to choose well than any one alone. In what situation, if any, would you consider medication appropriate for a child, and who should make the final decision?

References

English Standard Version Bible. (2016). Crossway. (Original work published 2001)

Parritz, R. H., & Troy, M. F. (2018). Disorders of childhood: Development and psychopathology (3rd ed.). Cengage Learning.

Walkup, J. T., Albano, A. M., Piacentini, J., Birmaher, B., Compton, S. N., Sherrill, J. T., Ginsburg, G. S., Rynn, M. A., McCracken, J., Waslick, B., Iyengar, S., March, J. S., & Kendall, P. C. (2008). Cognitive behavioral therapy, sertraline, or a combination in childhood anxiety. The New England Journal of Medicine, 359(26), 2753-2766. https://doi.org/10.1056/NEJMoa0804633