Psychosomatic disorders in children & Cognitive Behaviour Therapy-CBT

Psychosomatic disorders consist of clinical symptoms with no underlying organic pathology. Most common symptoms observed in children are abdominal pain, headaches, difficulty in breathing, chest pain, fatigue, excessive worry about health. Most symptoms appear to be responses to stress like school work, learning difficulties, family problems, peer pressure, bullying, chronic disease, family moves and other psychosocial factors. A thorough medical (physical examination, eye check up , hearing assessment, etc.)and physical examination by a medical practitioner to rule out any organic etiology for the symptoms should take place before making a referral to mental health professional for psychosomatic disorder. The characteristic of the psychosomatic problems are vagueness of symptoms, their inconsistent nature, pattern, varying intensity, etc. In most cases, cognitive behaviour therapy(CBT) and parent counselling is often used as treatment for psychosomatic disorders.

What is Cognitive Behaviour Therapy- CBT?

Take an  example of a child who has a fear of going to school. When a child feels anxious to go to school then he or she starts to miss school because the child learns that avoidance works in reducing the anxiety. If parents allow the child to miss school to avoid trigger of those fears than the anxiety grows and becomes more powerful. One form of CBT that works for anxiety in children is exposure and response prevention. The child is taught to unlearn avoidant behaviour. The idea is to expose the child to trigger (like going to school) that causes anxiety. A structured plan of providing safe environment in small steps will make them learn how to handle their anxiety rather than controlling it. The children should be exposed to the trigger in mildest form like starting school with the school counsellor where they feel safe for short time and then gradually adding more hours in a day and transitioning them to the classroom. The structured plan needs to be followed until the anxiety subsides. Fear like any sensations diminishes over time once children gain a mastery on how to handle it, the anxiety overtime subsides. This Exposure therapy is effective on many different kinds of anxiety, including separation anxiety, phobias, obsessive-compulsive disorder (OCD), and social anxiety. 

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