Dealing with an anxious, distressed child can be one of the most heart-wrenching experiences for a parent. And while your instinct may be to be protective and minimize a child’s distress, doing this can actually worsen their anxiety in the long term. Helping children to understand anxiety – and encouraging them to face their fears – can be a much more effective approach, according to childhood anxiety expert Dr. Jaee Bodas. Here’s more from Dr. Bodas on childhood anxiety and this positive approach:

Break the cycle of anxiety

When a child is scared of going to school, they may exhibit anxious behaviors such as crying, screaming and pleading to stay home. When parents then allow the child to stay home, the child’s anxious behaviors are immediately rewarded by a temporary sense of relief from anxiety which, in the long term, feeds and maintains the school anxiety. As a result, parents and children often find themselves stuck in a negative cycle of anxiety and escape/avoidance behaviors.

A key aspect of helping an anxious child overcome debilitating anxiety is helping them to face rather than escape their fears. Of course, this is easier said than done, but the following strategies and information about childhood anxiety can help.

Anxiety is a survival emotion – Everyone has anxiety and anxiety is not all bad. Anxiety is actually a “survival” emotion. It alerts us to impending danger or important things in our life. It is normal, and even adaptive, to experience anxiety. If you see smoke coming out of a window, for example, or when you have an important deadline to meet, anxiety is adaptive because it prepares our bodies to “fight or flight” to tackle the stressor. The goal in helping an anxious child is not to eliminate anxiety, but to help them manage it. With this approach, the child learns to function despite the anxiety which then decreases over time.

Anxiety is like an oversensitive alarm – In anxious children, the adaptive mechanisms of anxiety can go awry. Anxiety can be an oversensitive false alarm that goes off even when there is no real danger or threat. It’s like a fire alarm that goes off when the toast is burnt. Helping your child understand that anxiety is normal, adaptive and uncomfortable but not dangerous is a necessary step in building their ability to deal with it. It is comforting for children to understand their anxiety and recognize that it can be like an oversensitive alarm system that goes off when the toast burns, even when the house is not on fire and there is no real danger. Parents may use the analogy of the oversensitive false alarm as well as statements such as “being anxious or scared is an unpleasant feeling…I understand that it does not feel good…but it is not dangerous” as parenting tools to calm their anxious child. Such statements are considered crucial cognitive restructuring strategies (thinking skills) that help modify the unhelpful ways of thinking that trigger anxiety (more on this concept below).

Anxious feelings are a result of distorted and unhelpful ways of thinking – Anxiety may have a variety of triggers. Common sources of anxiety for children include social and performance situations (tests, recitals), separation from parents (fear of harm to oneself or parents, unable to sleep in own bed) and phobias (animals, needles, doctors, dark). Anxiety can be expressed in many different forms, ranging from worrying (cognitive) and physical problems (increased heart rate, shortness of breath, headaches, stomach aches, etc.) to behavioral issues (avoidance and oppositional behaviors). Regardless of the trigger or the form, anxiety is always a result of a combination of two errors in thinking – overestimation of threat and underestimation of coping abilities. A child who is anxious about a stage performance, for example, may worry that they will absolutely forget their lines and everyone will laugh and when that happens they will feel mortified and unable to show their face. Likewise, a test-anxious child may habitually feel 100 percent sure they will fail a test despite preparation and when that happens future prospects will be ruined because they will never be successful at anything!

Children can learn adaptive thinking by using “detective thinking” – The thinking errors underlying anxiety are not usually corrected by reassurance and positive thinking. For example, telling your child “don’t worry, you will do a stellar job in your test” is not likely to make them less anxious. However, teaching a test-anxious child to identify and examine their thinking about their fears can help. They can be taught to challenge and change their beliefs to more realistic or accurate thinking. This will go a long way in decreasing their anxiety. When a child says “I am nervous about this test. I am certain I am going to fail it,” instead of reassuring them, try helping them understand that they are unlikely to fail given that they have prepared/studied and if they end up performing below expectations, it’s not the end of the world but rather a problem to be solved. Parents can help children question and challenge their negative thoughts by asking them to consider evidence for and against their beliefs that they will “certainly fail” and by challenging their erroneous thinking.

Coach your child in taking baby steps to face their fears and reduce their anxiety – You can help your child take small steps in practicing brave or confident behaviors that serve to diminish their fears/anxieties. For example, a child who is afraid of dogs may start by watching pictures and videos of dogs. Then gradually, they may try to be in the same room as a calm, gentle dog held by the leash by an adult and then the child may practice gradually approaching the dog to be able to pet it. A child who is afraid of performing on stage could practice performing in front of family members and close friends prior to the stage performance. It’s important to note, however, that children need more repetitions and practice, not less, of the brave behaviors that involve facing their fears. This helps them build confidence and self-efficacy (their belief in their ability to succeed in specific situations or accomplish a task) and the anxiety subsequently diminishes. With each success, it is important to celebrate your child’s brave behaviors. Rewards such as verbal praise, extra play or TV time or a special treat may provide the encouragement and motivation to practice these brave behaviors.

Parents of anxious children may struggle with their own anxiety – Anxious children often have an anxious parent or parents. One of the reasons for this is that anxiety runs in the family; another is that parents may model anxiety to their children with their own anxious or avoidant behaviors. Parents who are anxious themselves may also be more likely to overprotect or “rescue” their children by accommodating their fearful behaviors. It is important for parents to be aware of how their own anxiety is triggered when a child is anxious and to find ways to manage it which may include learning (and practicing!) their own coping strategies or seeking professional help.

When is anxiety a serious concern?

Anxiety is a normal aspect of growing up. Most children outgrow developmental fears such as separation anxiety or the fear of the dark. Children may also experience normal situational anxiety while studying for tests or after dealing with a stressful life experience. A professional mental health clinician ought to be consulted when anxiety is out of proportion to the situation and it is persistentdespite support and reassurance given by parents and teachers.  In such cases, anxiety significantly impacts how children and families function and causes distress. For example, children may experience headaches, sleep difficulties, avoid enjoyable activities like sleepovers, refuse to go to school or exhibit excessive crying when separating from a parent. Fortunately, research shows that anxiety is one of the most readily treatable psychological disorders. Psychotherapy or counseling can help kids build their competence in anxiety management. Medications are also an option if talk therapy is not fruitful in decreasing anxiety. Together, these interventions can effectively help many children overcome their anxiety and live a happy life.

Helpful resources

Anxiety Disorders Association of America
Association for Behavioral and Cognitive Therapies
The Child Anxiety Network

Virginia Treatment Center for Children Update

The new Virginia Treatment Center for Children will open in 2017 on our Brook Road Campus. This new mental health facility will have inpatient rooms; outpatient treatment rooms; occupational, recreation, art and music therapy; inpatient school programs; and centers for family resources and research. VTCC serves children with anxiety, depression, ADD/ADHD, autism, behavioral problems and other mental health issues.