Separation anxiety disorder is a young person's disorder and can be compared to the adult "version" of a panic disorder with agoraphobia, phobic avoidance, catastrophic interpretations and panic symptoms. Separation anxiety is a normal developmental milestone, which "appears at the age of 6 to 8 months, peaks at 10 to 18 months and subsides by 2 to 3 years old." (Ehrenreich, Santucci, & Weiner;, 2008) Along with object permanence, the child builds normal separation response levels by the age of 3 (Ehrenreich, Santucci, & Weiner;, 2008). .
Abnormal separation anxiety, also known as separation anxiety disorder, is composed of two core ingredients: excessive anxiety upon separation and a formed attachment to a primary caregiver (Carruth, 2000). The DSM-IV-TR diagnosis criteria states: recurrent excessive distress when separated, excessive worry about harm happening to major attachment figures, reluctance to be alone, reluctance to go anywhere without the attachments figures, repeated nightmares and somatic complaints when separated from major attachment figures (Carruth, 2000). The symptoms must be present for at least four weeks and the client has to have had an onset before the age of 18 (Ehrenreich, Santucci, & Weiner;, 2008). .
Formerly, SAD has been treated primarily with medication or psychodynamic, family or behavioral interventions (Dia, 2001). After the discovery that cognitive behavioral therapy could be adapted as a treatment plan for children and adolescents, cognitive techniques were added into various treatments plans for children and adolescents. The cognitive techniques allow the children and adolescents to decrease their cognitive distortions and help them reduce their attachment to their primary attachment figure, which helps maintain behavioral change (Gosch, Flannery-Schroeder, Mauro, & Compton, 2006). Cognitive behavioral therapy (CBT) for children and adolescents is composed of the same strategies exhibited in the CBT treatment for adults.