Anxiety

Many children, teens and adults struggle with anxiety at some point in their lives. Anxiety can be very distressing and debilitating. Extreme fear, worry, and anticipatory anxiety can lead children to begin to avoid situations and greatly limit their activities. Anxiety that is left unaddressed can also lead to poor self-esteem, poor self-confidence, and can put a child at greater risk for developing depression in future.

Fortunately, due to its high prevalence, anxiety is one of the most well researched mental health concerns. There are extremely effective short term-treatments (namely, Cognitive-Behavioral Therapy) that have been shown to yield very significant improvements in a relatively short amount of time. Cognitive-Behavioral Therapy encompasses two major components: 1. Cognitive - helping the child to change thoughts, beliefs, and ideas about the feared situation, and 2. Behavior - creating gradual and systemic changes in behavior to allow for increased habituation to what the child fears. Cognitive-Behavioral Therapy should be performed by a professional trained in the methodology who is also able to adapt strategies to the developmental level and individual needs of each child. For example, younger children may need drawings, or other visual and concrete activities to promote understanding, and maintain attention/motivation. In addition, families and parents play a crucial role in assisting younger children through the therapeutic process, supporting their gains between sessions, and reinforcing information presented in sessions in the home environment.

Certainly, treatments that also take into consideration the child's individual strengths, environment (e.g. family relationships, peer relationships, school setting), temperament, level of insight, motivation, and other factors (e.g. health or other concerns) will be the most effective. In addition, anxiety that is situational or due to a major change in a child's life (e.g. parental divorce, loss of a family member, transitioning to middle/high school, peer difficulties, coping with medical health issues) will require a less structured approach in order to tailor the therapy to the child's individual circumstances.

If your child is experiencing anxiety, here are a few tips to assist them in managing their feelings:

  1. Normalize their experience - Reassure your child that what they are experiencing is normal, and that everyone experiences anxiety. The feeling that they are 'the only one' can be very alienating and frightening in and of itself.
  2. Educate your child about anxiety - Explain to them what their body is doing when it worries and how in the right context worry or anxiety is a very healthy thing (e.g. If we are anxious about an upcoming exam, we are more likely to spend time studying!).
  3. When your child is anxious, remain calm - This sounds intuitive, however as parents we often cannot help reacting with distress when our child is distressed. Yet, in order to communicate with your child that they are truly not in danger, we need to model confidence, even in light of their anxious reaction.
  4. Attempt to challenge your child's assumptions about the probability the feared situation will occur in future. How likely is it really that when Mommy goes to the grocery store she will get in a car accident?
  5. Attempt to address the 'worst case scenario' with your child, and what they envision the consequences will be. What is the worst thing that would happen if you said the wrong thing? How would you cope with that?
  6. Whenever possible, avoid avoidance! Explain to your child that avoiding the thing they fear is only going to perpetuate their anxiety, and can even make it worse. Brainstorm with your child other ways to face the feared situation, perhaps in a way in which it is somewhat less scary. For example, if your child fears separation from you, ask him/her if you can leave for 10 mins, 20 mins, or 30 mins at a time.

For more information on anxiety or Cognitive-Behavioral approaches, please visit the Anxiety Disorder Association of America webpage at www.adaa.org