What Parents Can Do When Their Child Is Anxious
When anxiety and avoidance behavior interfere with life activities in the family, school, or the community, a child may have an anxiety disorder. Anxiety disorders are the most common mental health condition among adolescents with close to 32% of youth experiencing an anxiety disorder at some point in their childhood or adolescence. Fortunately, anxiety disorders are treatable. This article may assist you in helping your child with anxiety.
Consider Treatment Options
Anxiety disorders tend to persist without treatment. A psychotherapist or a psychiatrist can determine if your child has an anxiety disorder and what type of treatment is needed. Psychotherapy is an effective method for treating childhood anxiety disorders. In fact, psychotherapy is a first line treatment for anxiety disorders. Family interventions that focus on changing parent behavior have been shown to be effective in treating childhood anxiety disorders even when the child is not receptive to treatment. In general, psychotherapy for anxiety disorders involves increasing exposure to anxiety-related things and situations while teaching strategies to manage anxiety.
Different types of professionals provide psychotherapy, such as licensed clinical social workers, licensed professional counselors, and licensed psychologists. The most important thing is to find a psychotherapist who is a good fit for your family. Psychotherapy is most effective when you feel understood, participate in creating therapy goals, and provide the therapist with feedback. When you begin working with a psychotherapist, it may be helpful to ask questions about therapy. Here are some examples of questions to ask a therapist.
- What is your professional background?
- What kind of therapy do you think might help my child and our family?
- What will we do in therapy to help my child and our family with this problem?
- How often will we meet and for how long?
- How will we evaluate my child’s progress?
- How likely is it that this therapy will help my child and our family?
- What should I do if my child is not getting better?
- How much will therapy cost and do you take my insurance?
Psychotropic medications are used to treat anxiety disorders. If you want to consider psychotropic medication to treat your child’s anxiety disorder, speaking with your child’s pediatrician is likely the first step. Some pediatricians prescribe psychotropic medication and others prefer that a psychiatrist prescribe the medication.
Create a Plan to Approach Anxiety-Related Things or Situations
An anxiety disorder involves anxiety and fear in reaction to a thing or situation that does not pose a real danger. Parents will often accommodate their child’s need to avoid or escape things or situations that evoke anxiety. Some of the most common ways that parents allow their children to avoid anxiety-inducing situations include speaking for the child in social settings, letting the child sleep in the parents’ bed, and permitting the child to avoid school or other social situations.
Allowing or helping your child to avoid distressing situations is a natural and well-intended reaction that provides short-term relief for your child and possibly for you. Unfortunately, in the long run, the more a child avoids anxiety-related situations the stronger the anxiety disorder becomes. By helping your child face situations that evoke anxiety, you are giving your child an opportunity to learn that his or her fears are unfounded.
Encouraging your child to face situations that evoke anxiety can be challenging. Children with anxiety often have strong, negative reactions to facing situations that they fear. Create a plan to help your child to take gradual steps toward facing fearful situations. Getting support from others such as family members, a psychotherapist, and your child’s educators will be important to help you successfully put this plan into action.
Validate Your Child’s Feelings and Communicate Confidence
Validate your child’s feelings while communicating confidence that your child can handle anxiety-provoking situations. Validation involves acknowledging your child’s feelings, but it does not mean that you agree with your child’s fears or your child’s request to avoid things or situations. You can communicate your confidence by telling your child that he or she has the strengths and resources to handle the situations that create anxiety. The validating and confident message you want to communicate is, “I hear that you are scared. I am here to support you. You can do this.”
Encourage Your Child to Learn Ways to Manage Anxiety
Experiencing anxiety is unpleasant. However, it is not harmful or dangerous to feel anxious. Children can learn ways to manage their anxiety. Help your child to find healthy strategies that work to manage anxiety. For instance, one child might benefit from using a relaxation exercise cell phone app, while another child might find physical exercise helpful. The message to communicate is, “I hear how anxious you are and how bad it feels. Even though it feels bad, it is okay to feel anxious. Let’s think of ways to manage your anxiety.”
Highlight Successes and Compliment Your Child
Anxiety ebbs and flows. Your child may seem very anxious when in certain circumstances, and at other times, your child may have less anxiety in a similar situation. Look for times when your child successfully tolerates anxiety and approaches a situation that usually evokes anxiety. When you notice these successes, highlight them in your conversation with your child and compliment your child. Pointing out successes and offering compliments builds hope, inspires confidence, and validates your child’s experience. A parent might say, “Wow! You did a great job making it to school today even though you were a little anxious. That takes courage. How did you do that?”
Manage Your Stress and Stay Calm
Parents often experience stress and anxiety in reaction to their child’s anxiety. Find ways to manage your stress and to stay calm when you are helping your child learn to manage anxiety. When you handle your own stress and anxiety in a healthy way, your child learns from your example. Remaining calm helps you to make thoughtful decisions about how best to support your child.
Collaborate with Educators
Communicate with your child’s educational team about anxiety-related issues that may affect school performance. You and your child’s educational team can develop a plan to address your child’s anxiety and behavioral avoidance in the school setting. The team may include your child’s school counselor, principal or assistant principal, teachers, and school psychologist. The plan should be designed to support your child so that he or she can participate in school activities as much as possible and learn to manage anxiety. The strategies in the plan should be based on your child’s specific anxiety-related needs. For instance, if your child benefits from periodically meeting with the school counselor, the plan may include providing your child with a permanent pass to the school counselor’s office. Talk with your child’s educational team about your child’s needs and strategies that might help.
Duncan, B. L, Miller, S. D., & Sparks, J. A. (2004). The heroic client: A revolutionary way to improve effectiveness through client-directed, outcome informed therapy (Revised Edition). New York: Jossey-Bass.
Ginsburg, G. S., Drake, K., Tein, J. Y., Teetsel, R., Riddle, M. A. (2015). Prevention onset of anxiety disorder in offspring of anxious parents: A randomized controlled trial of a family-based intervention. American Journal of Psychiatry, 172(12), 1207-1214. doi:10.1176/appi.ajp.2015.14091178
Hunsley, J., Elliot, K., Therrien, Z. (2013, October). The efficacy and effectiveness of psychological treatments. Canadian Psychological Association. Retrieved from https://cpa.ca/docs/File/Practice/TheEfficacyAndEffectivenessOfPsychologicalTreatments_web.pdf
Lebowitz, E. R., Marin, C., Martino, A., Shimshoni, Y., & Silverman, W. K. (2019). Parent-based treatment as efficacious as cognitive-behavioral therapy for childhood anxiety: A randomized noninferiority study of supportive parenting for anxious childhood emotions. Journal of the American Academy of Child and Adolescent Psychiatry. Advanced online publication. doi: https://doi.org/10.1016/j.jaac.2019.02.014
Lebowitz, E. R. & Omer, H. (2013). Treating childhood and adolescent anxiety: A guide for caregivers. Hoboken, NJ: Wiley.
Lebowitz, E. R., Omer, H., Hermes, H., & Scahill, L. (2014). Parent training for childhood anxiety disorders: The SPACE program. Cognitive and Behavioral Practice, 21(4), 456-469. doi: https://doi.org/10.1016/j.cbpra.2013.10.004
Lebowitz, E. R., Woolsten, J., Bar-Haim, Y., Calvocoressi, L., Dauser, C., Warnick, E., Scahill, L., Chakir, A. R., Shechner, T., Hermes, H., Vitulano, L. A., King, R. A., Leckman, J. F. (2013). Family accommodation in pediatric anxiety disorders. Depression and Anxiety, 30, 47-54. doi: 10.1002/da.21998
Nelson, T. S. (2019). Solution-focused brief therapy with families. New York: Routledge.
Norman, K. R., Silverman, W. K., Lebowitz, E. R. (2015). Family accommodation of child and adolescent anxiety: Mechanisms, assessment, and treatment. Journal of Child and Adolescent Psychiatric Nursing, 28, 131-140. doi: 10.1111/jcap.12116
Raftery-Helmer, J. N., Moore, P. S., Coyne, L., Palm Reed, K. (2015). Changing problematic parent-child interaction in child anxiety disorders: The promise Acceptance and Commitment Therapy (ACT). Journal of Contextual Behavioral Science, 5, 64-69. http://dx.doi.org/10.1016/j.jcbs.2015.08.002
Wang, Z., Whiteside, S. P. H., Sim, L., Farah, W; Morrow, A. S., Alsawas, M., Barrionuevo, P., Tello, M., Asi, N., Beuschel, B., Daraz, L., Almasri, J., Zaiem, F., Mantilla, L. L, Ponce, O.J., LeBlanc, A., Prokop, L. J., & Murad, M. H. (2017). Comparative effectiveness and safety of cognitive behavioral therapy and pharmacotherapy for childhood anxiety disorders: A systematic review and meta-analysis. JAMA Pediatrics, 171(11), 1049-1056. doi:10.1001/jamapediatrics.2017.3036
Whiteside, S. P. H., Gryczkowski, M., Ale, C. M., Brown-Jacobsen, A. M., McCarthy, D. M (2013). Development of child- and parent-report measures of behavioral avoidance related to childhood anxiety disorders. Behavior Therapy, 44, 325-337. https://doi.org/10.1016/j.beth.2013.02.006
Carlson, M. (2019). What Parents Can Do When Their Child Is Anxious. Psych Central. Retrieved on May 24, 2020, from https://psychcentral.com/lib/what-parents-can-do-when-their-child-is-anxious/