Separation Anxiety in Toddlers Scholarly Articles


The defining feature of separation anxiety disorder is excessive anxiety or fear of separation from the home or attachment people. This fear or concern is beyond what can be expected of the person given their level of development.2 If it sounds familiar, treatment can help. Treatment for separation anxiety disorder includes both the parents and the child participating in the therapy. Parents can learn to set boundaries for their children and help them explore the world on their own. Children can learn skills to deal with scary thoughts and feelings and practice separating a little at a time. Most children with separation anxiety will improve a lot with treatment, especially if their anxiety is detected early. Studies on the link between separation anxiety in mother and child are rare, and available studies are hampered by small sample sizes (Dallaire and Weinraub, 2005; Hock et al., 2004; Mayseless and Scher, 2000; Peleg et al., 2006). In addition, these studies were conducted at different stages of development, making it difficult to compare their results. Although these studies are based on theoretical claims (Blatt, 2004; Hock et al. 1989), the theory is rather unclear as to when maternal separation anxiety should affect children and for whom it may be most troubling. In the present study, we found that maternal separation anxiety is weakly related to separation anxiety in children, and we were unable to replicate previous results on a link between maternal separation anxiety and separation anxiety in children over time.

This shows that the available evidence of a link between maternal separation anxiety and separation in children is not substantiated. Although Dallaire and Weinraub (2005) found a fairly strong association between maternal separation anxiety and separation anxiety in children over time, these authors measured maternal separation anxiety during childhood at the same stage of development as the children in our study. This may be important because it may suggest that current feelings of maternal separation anxiety may not be as important as feelings of maternal separation anxiety at the beginning of development. This reasoning coincides with the theoretical thesis that the first separation-individuation process takes place hypothetically in early childhood (Mahler 2000), and with attachment research, where extensive studies have shown that early mother-child interactions influence children`s ability to regulate their emotions (e.B. Bakermans-Kranenburg et al. 2003). The BDI phase begins with a psychoeducation of the parents on the nature of anxiety and explains the reasons for the progressive exposure to anxiety-provoking separation situations. The therapist works with parents and the child to develop a hierarchy of fear, or “bravery ladder,” that lists all the situations the child is afraid of and/or currently avoids.

In addition, the family creates a list of rewards to reinforce the child`s approach behavior in the face of these feared situations. Despite the well-established effectiveness of general CBT treatment programs for anxiety disorders in children, a significant number of children do not sufficiently benefit from current treatment approaches [9]. About 30-40% of treated children will experience a return of anxiety (i.e., relapse) after successful treatment [15]. As a result, some treatment programs have attempted to improve remission and relapse rates by adding disorder-specific and family-focused treatment components to routine CBT programs. One disorder-specific, family-centered treatment program for SepAD children is the TAFF (Separation Anxiety Program For Families; English: Separation Anxiety Family Therapy) [16, 17]. TAFF contains disorder-specific material suitable for children aged 5 to 13 and includes parent training (aimed at parenting behaviour and parent-child interaction). The rationale for parental involvement is based on the intrinsic nature of separation anxiety in the family context. TAFF was found to be very effective compared to a waiting list condition in children aged 5 to 7 years [16], with a reference rate of 76.2% and large effect sizes (d = 0.98 to 1.41). In fact, the effects obtained with the specific treatment of SepAD disorder were greater than those reported in the meta-analysis of the treatment of childhood anxiety disorders [9]. A second study also showed the effectiveness of TAFF compared to CC (Coping Cat; [11, 12]) in children aged 8 to 13 years, with no significant differences between these treatment programmes [17]. When it comes to psychological control focused on children`s addiction and separation anxiety, theory and research also point to a link between these constructs. Psychological control is believed to pose a threat to the child`s emerging sense of self (Barber, 1996), as the child may not be able to develop a stable representation of the mother as a caring person.

This unstable portrayal of the mother can lead to fears of loss of love and abandonment if the child tries to separate from the parent (Blatt 2004), which can lead to difficulties in distancing, interpersonal differentiation, and boundary formation for the child (Hock and Schirtzinger, 1992). Consistent with the idea that parenting tactics to keep the child nearby are associated with fear of separation, addiction-focused mind control has been found to be associated with dependent personality traits and depressive symptoms in adolescents (Soenens et al. .