ANXIOUS CHILDREN
What To Do!
PARENT INFORMATION
Sandra L. Clark, Ph.D., R. Psych.
Psychologist
B.C. Children’s Hospital
P.A.C. Talk January 29, 2013
About Anxiety
• Survival system.
• Instinctive way to respond.
• It’s Developmental: different anxieties
depending on age of child.
• Anxiety is physical, psychological, and
behavioural.
Typical Issues
•
•
•
•
•
•
Sleeping problems
Refusals and avoidance
Physical complaints
Irritability
Perfectionism and procrastination
Pessimism
Anxiety Management
is a Life Skill
• Review your own temperament.
• Review your own stress coping style.
• Are you modeling effective relaxation, time
management and problem-solving?
• Consider some family-wide/school-wide
strategies: exercise, more sleep, “screens-off”
time to relax other ways, tune up the routine,
stop to breathe -- and to listen to each other.
Helping Anxious Children & Teens
•
•
•
•
•
•
•
•
•
•
•
•
•
•
Know temperament (theirs and yours)
Consistent routines
Feed often (graze)
Exercise & Physical Relaxation
Sleep routines
Anticipate (transition planning)
Promote self-soothing & problem-solving
TAKE TIME!
Compartmentalizing
Distraction
Organizational skills
Psychological Relaxation/Self-talk
Modeling
Training self-awareness & self-management
TAMING AND TRAPPING WORRY
DRAGONS
• Imaginative Reconceptualization
• Externalizes the Problem
• Reframes Anxiety Problems
• Allows Child to Talk About Worries
• Encourages a Playful, Humorous State of Mind
Externalizing Anxiety
• Externalizing anxiety by identifying it as separate
and naming it.
• Child and parent find a name such as “Mr.
Worry”, “The Dragon,” “Tricky” or for older
children “Angst”, “Worry” or “Freak-out.”
• With this comes the identification of the child as
the “Tamer”, or “Boss” etc.
• The dragon can be seen as trying to trick the
child into believing mistruths and creating doubt.
Engaging the Reluctant Child: Motivating
• Appeal to your child’s pride. E.g. Worriers tend to be bright and
imaginative. This has lead to an ability to see the most unexpected
dangers. Need to turn this into a talent for taming/trapping the
worries.
• Make a list with your child about the ways anxiety is interfering with
her life. Anxiety causes fear, sadness, crying and fighting. It stops
her from participating in school, parties, sleepovers, sports etc.
• Then make a positive list of the feelings and things she can do when
she is the boss of anxiety.
• Be Playful.
Relaxation Training
• Breathing – Very useful as easy to learn.
• Slowly Inhaling through the nose and
exhaling through the mouth.
• Blowing Bubbles
• Make a time to practice each day for at
least 2 weeks to become an expert.
• Go on to experiment with relaxation and
visualization exercises.
Helping Children with Self-Talk
• Worried thoughts result in increasing anxiety.
Calm thoughts bring on a more relaxed mood.
• Substitute positive self talk for negative worried
thoughts.
• Use coping tools: e.g. schedule, thought stopping
• Visualize trapping/shrinking/deleting the worry
dragon.
• Generating alternative thoughts: eg instead of “I
can’t do this work”, “I’ll start with an outline…”
Building Tolerance
• Encouraging Brave Behavior
• Need to experience and tolerate anxiety in order
to build ‘coping muscles’.
• Build a Fear Hierarchy with child and rate
according to level of Fear from 1 to 10.
• Gradual exposure to feared situations.
• Spend at least 20 minutes in challenging
situation to bring down anxiety.
Facing the Fear
• Encourage self reliance with ‘detective thinking’.
“What would Sherlock Holmes say about this?”
• Gradually withdraw. Let your child know that you
will be doing this so they can develop their
expertise in detective thinking.
• Don’t forget to reward successful self reliance.
Rewards for Brave Behavior
• Make sure rewards are valued by child
• Material rewards-money, food, stickers, & toys.
• Non material rewards- praise, attention & interest from
parent. Can be very powerful.
• Keep rewards varied.
• Need to be specific. E.g. ‘David you were able to stay in
the room with Susan’s dog for half an hour. That is
brave. Well done.’
• Given soon after the child has been brave.
• Be in proportion to the level of fear faced.
• Establish rewards for other children in family to avoid
resentments.
Expectations for Change
• Go slow, give strategies and tools a fair try
– remember that negativity and resistance
are natural (at first).
• Combinations of strategies will be most
effective.
• Change should be measured in very, very
small increments.
• Coping rather than cure model.
• Anxiety tends to wax and wane.
Summary: Tools & Challenges
• Take child’s concerns seriously, while
expressing confidence in ability to overcome
anxious feelings. Avoid anger.
• Gentle encouragement with gradual
approach to face worries.
• Coping tools take time to learn and require
practice and modelling.
• Don’t’ forget common sense: food, exercise,
sleep, downtime, etc.
• Notice and focus on successes and brave
behaviour.
• Praise is the best reward.
RESOURCES
• Taming Worry Dragons
• Worry Taming for Teens
• Keys to Parenting Your Anxious
Child. K. Manassis
• www.heretohelp.bc.ca
• www.anxietybc.com
• www.keltymentalhealth.ca