In the absence of data, pharmacotherapy with benzodiazepines has become the mainstay of anxiety management in the elderly population. However, the use of benzodiazepines in the elderly has many problems. Elderly persons are more sensitive to anti-anxiety medications and are subject to a variety of increased risks, including cognitive impairment, falls, and respiratory depression. The "discontinuance syndrome," which consists of rebound anxiety, recurrence of original symptoms, and withdrawal, frequently accompanies attempts to taper benzodiazepine use. The consensus is that most patients would be better off on no medication if alternative treatment could control their anxiety. The approach to treating anxiety described in this conference paper includes standard cognitive-behavioral methods, such as: education, relaxation training, cognitive therapy, and exposure to anxiety-provoking situations combined with behavioral skills training. In addition, certain problems that appear to be particularly common in elderly anxiety sufferers require special attention. These are: somatic anxiety, panic symptoms, benzodiazepine withdrawal, and worry behaviors. A case study is presented to illustrate many of the problems confronted when working with this population, with data presented in four diagrams. General strategies for approaching said problems are discussed. (JBJ)