The Carlat Psychiatry Podcast Treating Anxiety and Sleep Issues in Children and Adolescents
Feb 2, 2026
They compare adult and pediatric anxiety treatments and explain why some adult medications are not appropriate for children. They outline when cognitive behavioral therapy should come first and when medications may be needed. They discuss why benzodiazepines are discouraged in youth and how to talk to families about those risks. They cover sleep strategies, melatonin timing, and household medication safety.
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Prevalence And Combined Treatment Benefits
- Pediatric anxiety affects about 10% of children and includes generalized, separation, and social anxiety that often impair functioning later in childhood and adolescence.
- Combining CBT and SSRIs produces better outcomes than either alone when anxiety interferes with development or daily life.
Start With CBT For Mild To Moderate Anxiety
- For mild to moderate pediatric anxiety, start with cognitive behavioral therapy because families prefer therapy and engagement stays higher than medication-only approaches.
- Find a skilled CBT therapist and prioritize the therapeutic relationship to support exposure and tolerating anxiety.
Therapy Is About Tolerating Anxiety
- Effective CBT relies heavily on a trusting therapeutic relationship that supports gradual exposure and tolerating distress rather than removing anxiety entirely.
- The goal is to experience anxiety while doing valued activities, not to eliminate anxious feelings.
