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Ask A TFI Clinician: Children & Anxiety

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Anxiety is everywhere—and adults aren’t the only people who struggle with its impact. Today, Co-Director of TFI’s new Child and Adolescent Anxiety Clinic, and leader of the mini-series for parents of anxious children,Caroline Adelman, PhD provides insights for parents as they think about their kids and anxiety.


 

Be mindful of anxious avoidance and heightened need for control.

The most common response to anxiety is some form of avoidance, aimed at either getting relief from anxiety or keeping oneself from experiencing elevated levels of anxiety in the first place. Anxious individuals may try to escape an anxiety-provoking situation, or may simply refuse to engage in any situation in which anxiety is likely to be activated. For example, a child with a dog phobia may panic and run anytime that he sees a dog, rendering him unable to enjoy going to the park or playing at certain friends’ houses. Similarly, a child with social anxiety may refuse to speak in class, for fear of saying something embarrassing in front of other children. This avoidance response can leave parents feeling confused and stressed, as their children refuse to engage in formerly enjoyable activities, from soccer practice to school to birthday parties (depending on the source of their particular form of anxiety).

Another very common behavioral manifestation of anxiety is for anxious individuals to try to exert control over other people and over situations that make them feel anxious. For example, a child with Obsessive Compulsive Disorder may demand that everyone in the home wash their hands excessively, or that they complete the bedtime routine in a rigid, prescribed fashion. Similarly, a child who is anxious about being late for school may begin every school day by yelling at her siblings to rush through getting ready for school. These behaviors are aimed at reducing anxiety by increasing a child’s sense of control and making the environment more predictable, but the behaviors can cause significant interpersonal stress for children and their families.

Because some level of anxiety is a totally normal part of the human experience, I would expect all children to display anxious behaviors from time to time. Parents should consider seeking professional help when anxiety begins interfering with a child’s day to day functioning, by affecting their schoolwork, friendships, family relationships and/or their willingness to try new things.

 

Support your child, but don’t reinforce or accommodate anxious behaviors.

I think the greatest challenge for parents of anxious children is knowing how to support their children, without accidentally reinforcing anxious behaviors. Another major challenge is knowing how to respond when children refuse to engage in required activities, such as attending school. Parents of anxious children also frequently report feeling unsure about when they should support versus discipline children who engage in negative behaviors during “episodes” of extreme anxiety. In addition, many parents of anxious children have their own histories of anxiety and feel unsure about how to model effective coping responses for their children.

Additionally, parents of clinically anxious children typically report that they spend a lot of time accommodating children’s anxiety. Accommodation refers to any change in routine or environment that is made with the specific intention of reducing or avoiding a child’s anxious behaviors. For example, a parent may call the school to say that a child is ill, when in fact the child is anxious about a school presentation and refusing to leave the house. Or a parent may answer the same “what if…” question repeatedly, despite knowing that the answer is already been provided to the child. The accommodations are usually well-intentioned efforts to reduce a child’s anxiety in the short-term. However, accommodation of anxious behaviors reinforces anxiety over time because it signals that the perceived threat is legitimate (i.e., serious enough to warrant a response from the parents) and that the child is not expected to tolerate feelings of anxiety.

 

Empower yourself.

The mini-series for parents of anxious children is intended to empower parents to respond more effectively to their children’s anxiety. Over the course of five meetings, this mini-series provides parents an understanding of childhood anxiety and its manifestations, information on therapeutic approaches, tools to better tailor their responses to the child’s anxiety, a framework for defining parents’ role in supporting the anxious child, advice on managing day-to-day dilemmas around the anxiety and ample time to ask pertinent questions regarding childhood anxiety. While it will not be therapy, this empirically-supported educational workshop series may be quite instructive and helpful to parents in knowing how to deal with children’s anxiety. This workshop also provides parents with opportunities to meet other parents experiencing similar challenges, and allows parents to benefit from each other’s experiences.

The Family Institute offers Dr. Adelman’s mini-series for parents of anxious children on Monday afternoons, beginning on July 21st, at our Evanston Location. To learn more about the mini-series, visit our website.


 

Caroline Adelman, PhD received her PhD in Clinical Psychology at the University of North Carolina at Chapel Hill. Prior to joining The Family Institute, she completed her pre-doctoral and post-doctoral fellowships at the Child Study Center at Yale University. While at Yale, Dr. Adelman specialized in the treatment of Obsessive Compulsive Disorder (OCD) and Anxiety Disorders among youth. To read Dr. Adelman’s full bio, please visit our website.

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