By Melanie O’Neill, Ph.D.
This article was published in the Canadian Mental Health Association’s journal called “Visions”, Summer 2004 issue (Vol.2 No. 3) on pages 41 and 42 – published here with their permission.
Excessive anxiety is a dilemma faced by many kids and families. Anxiety disorders are the most common form of mental health problems with over 65,000 children and youth in BC coping with at least one anxiety disorder. Fortunately anxiety disorders are highly treatable with cognitive-behavioural therapy, select medications or a combination of both. Parents and families can play an extremely important role in helping kids manage excessive anxiety and associated problems.
There are many different causes of anxiety problems in children. Understanding the preliminary causes of a child’s anxiety is of limited value as the causes are either not directly changeable (e.g., genetic vulnerability to anxiety) or they are in the past (e.g., a traumatic or stressful event).
Fortunately, with your assistance, your child can learn to manage their anxiety without having to understand and resolve the initial cause!
The important next step in managing anxiety is identifying what maintains the anxiety or what keeps the anxiety high when the cause or trigger has passed. After years of research we now know that a child’s anxiety is maintained through several different factors including the way the child:
1. thinks – anxious kids tend to see the world as dangerous and threatening
2. copes – anxious kids tend to avoid and run away from scary or challenging situations
3. interacts with their family – sometimes families respond in a helpful way but other times families can get drawn into unhelpful responses
Parents can help their anxious child with each of these areas. The first step is deciding to address the problem and seeking out evidence based assessment and treatment. Both you and your child must be fully ‘on board’ with the decision to seek treatment as many of the strategies and techniques require hard work over a number of week or months. Fortunately this hard work pays off with approximately 80% of kids and families experiencing benefits from an evidence-based management plan.
- To increase motivation, you and your child can sit down and brainstorm the problems anxiety brings to their life and the benefits they will experience once they have mastered their anxiety.
Deciding to begin an evidence based program such as cognitive behavioural therapy can bring both the family and child enormous rewards. The child struggling with anxiety will soon experience increased self-esteem, greater confidence and improved levels of personal happiness. The family will notice decreased conflict and worry and increased family cohesiveness.
Implementing an Evidence-Based Management Program
Some points parents may want to cover with their child:
- Anxiety is a normal feeling and lots of other kids have the same difficulties (normalize, normalize, normalize!)
- You will be doing this together with your child every step of the way (studies show kids do best when their parents are able to provide encouragement and coach them in the use of helpful anxiety management strategies)
- Your child will never be forced to do anything they do not wish to do
- Challenges and new skills will be tackled at their own pace by breaking them down into manageable steps
- Getting better can be fun and very rewarding
Helpful Ways of Dealing with Your Child’s Anxiety
- Reward Brave, Non-anxious Behaviour
Whenever you see your child doing something brave, make a big fuss. Set up a plan so that whenever your child faces a situation s/he finds challenging they will receive a reward (e.g., special time with parent or friend, sticker, treat, etc).
- Ignore Behaviours You Don’t Want
Don’t give your child your attention when they are engaging in anxious behaviours (e.g. having an upset stomach before a birthday party) and praise your child when the behaviour has stopped and they move on to a more helpful way of coping (e.g., brainstorming what they will do to cope at the birthday party).
- Preventing Avoidance
We now know that running away from anxiety provoking situations is one of the key maintaining factors in childhood anxiety problems. By avoiding a feared situation, your child never gets to learn there was nothing to fear in the first place. Encourage your child to gradually and slowly face challenging situations when you know they are really capable of being successful in that situation.
- Empathize and Understand
Ensure that your child knows that you understand their anxiety (you’ve felt it before!) and how hard facing your fear can be (provide an example from your own life). They will be much more willing to follow your lead as their anxiety coach!
- Encourage Constructive Coping
Prompting your child to come up with their own helpful coping options in a scary situation (rather than telling them how to cope) is a great way to foster self-esteem in your child. This also shows your child that you have faith in their ability to manage their anxiety!
- Model Non-Anxious Behaviour
Your child watches you face challenging situations. Ensure you are modelling brave coping whenever you enter a situations that scary for you.
Parents and families often get pulled into well-intended but unhelpful responses when coping with an anxious child. These responses may help lower the child’s anxiety in the short-term but usually make anxiety worse in the long-term (e.g., providing excessive reassurance, taking over or being too directive, encouraging avoidance, becoming impatient, or participating in the child’s safety behaviours or rituals).
Your Child is Very Anxious or Frightened…What Can You Do?
Remember we all feel anxiety from time to time. The goal as parents is to help your child cope with scary situations and learn how to master excessive feelings of anxiety.
- Summarize what your child has shared with you in a supportive and understanding way. Make sure you really know what they’re concerned about.
- Present some choices and break down the scary task into manageable chunks. This sets up kids for success and allows them to discover they can choose to do something active to cope with their anxiety.
- Brainstorm potential strategies (e.g. problem-solve) for dealing with their situation. Let your child take the lead in this exercise.
- Examine each strategy and their most likely consequences. “What would happen if you go to school today? What would happen if you stay home and miss class?” etc.
- Encourage your child to select a strategy that works best for the current situation.
The above recommendations are adapted from Rapee et al. (2000). Helping your anxious child: A step-by-step guide for parents. New Harbinger: Oakland, CA.
Helping Anxious Children Checklist
Get an assessment from a trained expert
Get informed and educated about anxiety
Teach tools to relax
Teach tools to cope with worrying
Encourage child to take risks
Break down feared tasks into manageable chunks
Firm and consistent parenting style
Establish daily routines
Plan for homework and projects
Model and teach healthy self-care (e.g. diet, sleep, exercise)
Problem-solve life stressors (both yours and your child)
Adapted from ADABC Helping Anxious Children brochure (www.anxietybc.com).
For more information about ways families can help their child manage excessive anxiety please see the resources listed below.
Recommended Readings and Resources
“Taming the Worry Dragon” Series (Includes workbooks and videos for kids and families). Available at Odin Books in Vancouver: Call 1-800-223-6346or visit www.odinbooks.ca.
Rapee, R. M., Spence, S. H., Cobham, V., & Wignall, A. (2000). Helping your
anxious child: A step-by-step guide for parents. New Harbinger: Oakland, CA.
Anxiety Disorders in Children & Youth. Special Issue of Visions (No. 14 Spring 2002).
For a free printable copy visit www.cmha-bc.org/content/resources/visions/issues/14.pdf
March, J. S. (1995). Anxiety Disorders in Children and Adolescents. Guilford Press: New York.
Rapee, R. M., Spence, S. H., Cobham, V., & Wignall, A. (2000). Helping your anxious child: A step-by-step guide for parents. New Harbinger: Oakland, CA.
Rapee, R. M., Wignall, A., Hudson, J. L., Schniering, C. A. (2000). Treating anxious children and adolescents: An evidence-based approach. New Harbinger: Oakland, CA