Approach to managing social anxiety disorder in children

Psychosocial interventions (eg cognitive behavioural therapy [CBT]) are first-line treatment for social anxiety disorder in children. Children with social anxiety disorder rarely require pharmacotherapy but it may be used if psychosocial interventions are not available, not effective or not preferred, or if symptoms are severe. Pharmacotherapy is also recommended for children with comorbid depressive symptoms of at least moderate severity. Pharmacotherapy is ideally started by a clinician with expertise in using psychotropics in children. If a drug is required, use it concurrently with psychosocial interventions if possible.