As a child and adolescent therapist with experience working with anxious children and teens, I have seen my fair share of anxious kiddos and their frustrated parents. What seems to be most frustrating for parents and families of anxious youths is the reality that the behavior often associated with the anxiety, including avoidance, denial, temper tantrums, opposition, manipulation, aggression, and outright refusal to comply, is not always easy to remedy. In many cases, caregivers and authority figures believe the youngster is exhibiting oppositional defiant behaviors that can be instantly altered by threats and/or punishment.
As a result, anxious kids either do not learn the skills needed to cope or are forced to face their fears without understanding how to truly cope. And sometimes parents and teachers both may feel like giving up because of multiple failed attempts at trying to understand and help the youngster.
That’s why Kathleen Trainor’s book, Calming Your Anxious Child: Words to Say and Things to Do, is so helpful. In her book, Trainor highlights the efficacy and usefulness of Cognitive Behavior Therapy (CBT) and her self-titled “TRAINOR Method” in working with anxious youngsters.
The TRAINOR method includes the following steps:
- Target the anxious thoughts and behaviors
- Rate the anxious behavior (using a scale-like formula)
- Agree on the challenges to work on (making sure that everyone involved is aware of an in agreement with the steps needing to be taken to overcome the anxiety)
- Identify and teach strategies to practice (using positive reinforcement, sticker charts, incentives, etc)
- Note & chart progress made
- Offer incentives to motivate
- Reinforce and increase the challenge
Trainor makes it clear that her method, when integrated with traditional CBT, is easy to implement and follow. Often, parents of anxious children or teens have little patience as it is and truly need a manual or book that makes sense and is easy to follow in daily life. Throughout the text, Trainor attempts to highlight the thoughts and emotions of the anxious child to help readers understand their thought processes and associated behaviors. She also focuses on providing detailed examples of various case studies of youngsters with anxiety to help readers understand how to implement CBT and her TRAINOR method with individual cases or families. This is very helpful for mental health professionals who can benefit from concrete examples of how to implement her techniques.
Some readers may question the fact that Trainor waits until Chapter 10 to mention the usefulness of medication, which can be helpful to children or adolescents suffering from severe forms of anxiety. In some cases, a child or adolescent may find commitment to CBT principles and the TRAINOR method difficult if the anxiety is moderate to severe and is difficult to control. Personally, I appreciate the non-pharmaceutical approach to mental health treatment, but I certainly agree that if the disorder is difficult to control, medication may be necessary (even if used temporarily) to help the individual learn techniques and skills. Once the techniques and skills are mastered, medication may be stopped.
Trainor does include a brief discussion of other methods and approaches that may be helpful, such as alternative therapy, 504 plans and IEPs (to help kids cope in school settings), neuropsychological evaluations, and advocacy to help the child survive in school and to educate teachers, but I think it would have been more useful to parents if this chapter were more thorough.
Overall, Trainor does a good job explaining how to use CBT and the TRAINOR method. The book is also explanatory for parents who may want to learn more about CBT-based methods for youths with anxiety. The book is not written in a fashion that is intimidating or complicated. It is an easy-to-read book with practical steps that are easy to follow.
Calming Your Anxious Child: Words to Say and Things to Do
Johns Hopkins University Press, May 2016
Paperback, 264 pages