How do you manage anxious children who are somatically focused and do not tolerate SSRIs?  

Treatment of an anxious child ideally involves a holistic bio-psycho-sociocultural approach to understand the nature and underlying reasons for the anxiety, and importantly, the family's response and accommodations to their child's anxiety. So individual CBT-focused therapy can be very helpful, but ...

Children, like adults, are not anxious for no reason. Before giving a medication, I would refer the child for psychological evaluation to find out what is making her anxious. We all know that children are complicated people, too, and we should treat them that way.

CBT is the primary/first-line recommendation to treat Anxiety disorders in children. I am assuming that your pt is already getting CBT?  I believe that it is important for any provider who is working with anxious kids to be able to utilize CBT skills. I would also rule out OCD, as i have seen...

Psychotherapy is the obvious answer, but the problem begins when people start recommending named therapies, such as CBT, SPACE, and "the TIPP components of DBT," because that tends to discourage clinicians who may not have taken the official classes in those modalities. A famous psychotherapy resear...

I have also found useful the TIPP components of DBT, such as paced breathing, temperature modulation, progressive muscle relaxation, and intensive exercise to be helpful in modulating somatically focused anxiety.

Sharing the reality of "a little anxiety focuses the mind and too much anxiety destroys the mind" is my goal with kids, teens, adults, and parents of minors. A routine comprehensive psychiatric evaluation can help further clarify what comorbidities may exist and further help in understanding famil...