I am a clinical child psychologist at Children’s Hospital Medical Center in C…………., and I discover that I am one of the few people in this area treating SM. I began getting referrals because I see many children with other anxiety disorders. I have become comfortable with the CBT, and use the conception of a SID involving social hypersensitivity. I find that parents are very resistant to the idea of medication, and I am less confident in recommending psychiatric consult, since I have little knowledge base regarding the use of medication with SM. I have reviewed some or the resources on the bib. on this web site, but wonder if you can provide me with a model to help parents see medication as a treatment option in addition to therapy?

Sincerely, R………… K…………, Ph.D. Clinical Psychologist


Dr. K…………

I am thrilled to hear you treat SM children! We are desperately trying to find professionals that truly understand this anxiety disorder. Your question is an excellent one and is important because in many of the children with SM behavioral approaches are not always completely effective. In fact, I am convinced that the majority of children have true biochemical imbalances and medication to restore the ‘lowered neurotransmitter(s)’ is often necessary.

My approach to parents is this: Depending on the severity of SM, I recommend a trial of behavioral modification. If after an agreed amount of time, I tell the parents that I believe combining behavioral techniques with medication will enable the child to progress more rapidly and more effectively. My logic to the parents is that the reason behavioral techniques are not working is the child’s anxiety level is too high to enable an adequate response. We use medication to lower the child’s internal anxiety level enough to enable the behavioral techniques to be instituted

I often use a ‘barometer’ as a means of explaining. I show them that children with anxiety, specifically SM in our case, have a certain level…and we need to lower their internal anxiety level in order to effectively treat SM. I hope this has helped you. Thank you for your efforts and willingness to learn and further your knowledge of SM.

Dr. Elisa Shipon-Blum