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March 9, 2007
Easing troubled young minds
Psychology program needs funding to keep helping Israeli children
affected by trauma.
EDGAR ASHER ISRANET
It probably comes as no surprise that 10-15 per cent of children
in Israel suffer from some form of anxiety problem. All too often,
the implication of sweeping the problem under the carpet is not
fully realized.
Like an infected wound or a broken bone, anxiety problems can, in
nearly all cases, be fixed. Untreated, anxiety syndrome, like an
infected wound or broken bone, can soon lead to far more serious
complications. At its worst, it can lead to suicide, and it is a
disturbing fact that each year, about 150 young people take their
own lives. This demographic represents more than a third of all
recorded annual suicides in Israel.
At the Department of Psychological Medicine at the Schneider Children's
Medical Centre in Petach Tikvah, psychiatrist Prof. Alan Apter and
clinical psychologist Danny Lotan head a team who are leaders in
the field of dealing with anxiety problems in the six-to-18-year-old
age group. "Today, we can deal with anxiety syndrome in a relatively
short space of time," said Lotan. "What's more, the treatment
has about an 80 per cent success rate and, even in most of the remaining
20 per cent, there can be seen significant improvement."
The preferred treatment Lotan is referring to is known as cognitive
behavior therapy – CBT, for short. Developed in the 1960s,
CBT is a psychotherapy based on modifying everyday thought and behavior
with the aim of positively influencing emotions. The treatment brings
the patient into direct contact with their anxiety. The negative
and irrational results of anxiety, which might make a person's self-esteem
feel very low, is faced directly. Clinical depression, which can
result from childhood anxiety, can be avoided and the patient can
take his or her place as a full and useful member of society.
"In its simplest terms, the CBT treatment consists in most
cases of cognitive therapy combined with anti-depressant drugs,
such as Prozac," said Lotan. "Our experience shows that
a combination of CBT and medication is the best formula for successful
treatment."
The success of CBT is not in question, but the future of the department
hangs in the balance. "Our department could be closed down
next year if funding dries up," said Apter. "We see about
400 children each year in our department, with a cost of $600 to
treat each child for a period of four months. We have about 20 psychologists
working part-time in the anxiety clinic, but this still means that
there is a waiting list of three to four months."
The fact that funding is drying up will mean that parents will have
to pay out of their own pocket if their child is going to be accepted
into a CBT program. "This is a big concern to me because it
will mean that children from poorer backgrounds will not be able
to avail themselves of the treatment," said Apter. "Thousands
of children in Israel live with the suffering and emotional distress
brought on by anxiety disorders."
Apter had particularly in mind the problems caused to the number
of children with anxiety syndrome who live in the north of Israel
and also those who live near to the Gaza border in towns like Sederot.
Scores of extra children have been coming to the clinic from towns
like Kiryat Shemona in the north as a result of the Lebanon war,
when they had to remain sometimes for days at a time in bomb shelters.
In the case of Sederot, these children have had to face daily rocket
attacks from Gaza. Many children from lower socio-economic families
from these areas did not have the funds to enable them to leave
for safer locations in other parts of the country.
Fund-raising efforts for the centre are already underway by the
Friends of the Schneider Children's Hospital Department of Psychological
Medicine. "I hope when potential donors become familiar with
the work that we do, they will feel that they, too, would like to
make a donation," said Lotan, "to ensure that there will
always be a place to go for children suffering from some form of
deep anxiety."
Parents of children with anxiety disorders are in touch with the
clinic on a daily basis. "These children cease living their
lives; they stop eating, studying and sleeping ... their lives at
home become a nightmare," said Lotan.
He spoke about the parents of an 11-year-old patient, Meiron, who
noticed that he began to be afraid of noises and lights. Whenever
he was outside of his home, he would rush to his parents in fear
if he heard a noise. Then they noticed he was avoiding many activities.
He didn't want to eat or swallow; he didn't want to go and play
with friends and was afraid to be left alone in the house. Sixteen-year-old
Ido is another example. He moved to a new neighborhood and tried
to meet new people. He had thoughts and fears that perhaps he would
not fit in. He had never felt like this before.
Ido, who was treated at the clinic for about 10 months, explained
his predicament. "At first, my anxiety was just in my mind,"
he said. "But later, it develops and grows within me, sending
shivers and butterflies in my stomach. I felt like I was going to
faint all the time – I felt dizzy and had pressure in my chest.
My teeth, fingers and hands felt very strange."
Ido then described his feelings after his treatment. "I have
undergone a tremendous change since the time I arrived at Schneider
as a closed, lonely person," he said. "I am now becoming
somebody who lives and enjoys his youth and his life, who respects
himself, something that didn't previously exist – I hated myself.
Now I have discovered things about myself that I didn't even realize
before coming to the clinic."
Orly, the mother of a teenaged daughter suffering from anxiety,
explained, "We're going through things we can't really talk
about and explain to people. To see your child missing out on her
childhood and youth is very frightening."
It is clear from listening to the parents and their children that
the earlier they go to the anxiety clinic, the better the long-term
result. Parents can also learn how to best help their children overcome
their anxiety and maintain the improvement.
"The changes in children once they have started CBT therapy
is incredible to see," said Lotan. "If we can reach the
children in time, our ability to influence them, help them and return
them to normal life is amazing. Children who have stopped going
to school, sometimes within a month of being treated, are back on
their feet and totally functional. On the other hand, children who
don't reach us in time, or don't receive treatment, develop overwhelming
complications. We are talking about terrible deterioration, such
as addiction to alcohol and drugs and then deep depression.
"These are children who have 'checked out' of life. They need
professional, experienced help. It is unacceptable in a country
such as Israel, with all its problems connected with the security
situation, that children who are more prone to develop anxiety disorders
are possibly being denied funds for their care."
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