Helping Children Tame Anxiety - PowerPoint Presentation

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Helping Children Tame Anxiety

Mary Bolger, Ph.D.Slide2

Anxiety is

An important signal “Caution” “Be Alert”

A source of motivation to take on challenges

Neurobehavioral

Physical make-up of our brain

Maintained through reinforcement

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Typical Early Childhood Worries

Separation Anxiety

New and unfamiliar situations

Real and imagined dangers (dog bites, spiders, monsters, the dark, basements)

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Typical Worries of School Aged Children

Real world dangers (fire drills, burglars, illness)

Social acceptance

Academic and athletic performance

Risk and safetySlide5

Typical Adolescent Worries

Social acceptance

Concerns about the larger world

Moral issues

Future successSlide6

When Anxiety is No Longer Protective

Your child worries immensely over insignificant situations

Your child’s automatic response is worry and avoidance

Worry response is not temporary

Worry functions not as a signal but a way of lifeSlide7

What Unhealthy Anxiety Looks Like in Children

Behavioral reaction is excessive and disproportionate to the situation

Age inappropriate clinginess, tantrums, irritability, or crying jags

Withdrawal from family, friends, peers

Excessive time spent consoling child about distress of ordinary situations, or excessive coaxing to do normal activities like homework, hygiene, meals, play dates

Avoidance or giving up are primary response to challenges

Not happy, not moving forward

Coaxing, reassurances, logical plans don’t helpSlide8

What Unhealthy Anxiety Looks Like in Children

Headaches, stomachaches, nausea, vomiting

Sleeplessness, difficulty falling asleep, frequent nightmares, unable to sleep alone

Refusal to go to school, outside the home, places in the home or unable to be without parent for appropriate time period

Poor concentration

Unrealistic, catastrophic, pessimistic thinking patterns

Seeks excessive reassurance, “what if” questionsSlide9

Reasons Not to Fear Anxiety

Interventions for anxiety work!

The brain’s capacity for “survival of the busiest”

Handling worry is a skill that can be learned

Best time to intervene is early because left alone the interference from anxiety becomes more disabling

Overcoming anxiety builds competence!Slide10

Cognitive-Behavioral Therapy

Active, skilled focused intervention that is the treatment of choice

Magic Circle Slide11

Components of Cognitive-Behavioral Treatment

Magic Circle

What you think

the inner voice inside your head

How you feel

o

ur thoughts result in many different feelings

What you DO

w

hen feelings become very strong they start to have an affect on what you do and these actions REINFORCE thoughts and feelingsSlide12

CBT for Children

Education About Worry

Worry begins in the Worry Center of the Brain

Worry Center is sending mistake messages

Get in Charge! Take Control of the Worry Center!Slide13

CBT for Children

Externalization

Anxiety can be thought of as a entity separate from the child, “The Worry Bully”

Point out the child’s competencies

Name and characterize the worry

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CBT for Children

Cognitive Restructuring

Use self-talk (inner voice) to talk back to the worry bully

The bad feeling will go away soon.

The worry bully is sending a false alarm. I don’t need to listen.Slide15

CBT for Children

Step by Step Exposure

Competing demands, the ART of DISTRACTION

Charting ProgressSlide16

Desensitization

Gradual exposure helps defeat worries

-builds a sense of competence

-creates new patterns of learning in brain

Avoidance reinforces worry behaviors

-give up, stop doing things

-avoid situations that might be difficult

-reluctant to try new thingsSlide17

Interventions for Anxiety

Healthy

Goal: promote mastery

Face the fear step by step

Answer anxious questions only once or twice

Learn to tolerate the discomfort

Make home a safe haven

Parent uses techniques to manage own anxiety

Unhealthy

Goal: temporary relief

Avoid

Repeat answers over and over

Reassure, coax, accommodate to minimize distress

Push, scold, let child know the behaviors aren’t normal and are annoying

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10 Best Parenting Practices for Fighting Anxiety

Empower your child to fight back! Fight the worry not

your child!

Make a plan with your child

Enlist the support of important people in your child’s life (teachers, school psychologist, nurse)

Target erroneous thoughts, select a new skill to practice, and monitor change

Practice containment of anxiety

Role Play

Always go forward, no matter how small the step

Recognize each small step as a victory over the Worry Bully

Be a role model for problem solving worries

Remember to make home a safe havenSlide19

How to Collaborate with Your Child’s School

Be proactive so your child is not misunderstood

Find your support contact at school

Schedule a time to talk

Set regular check-ins

Know Thyself

Encourage therapist and teacher connectionSlide20

Connecting Your Child’s Pillars of Support

Email regular updates that include parent, school, and therapist

Include outside therapists at school meetings

Look for the positive contribution of each pillar

Look for therapists who will work with the school and are flexible about how classroom plans are developed

Feedback between therapist, school and home helps guide intervention to support change for child

Remember the child is part of the team! Slide21

Classroom Environment

Potential targets that can be manipulated to help anxious children:

Classroom Seating

Following Directions

Classroom Management

Testing Conditions

Unstructured Times

Returns from long absences

Fire and Safety Drills

Curriculum ContentSlide22

Teacher Awareness About Anxiety

More than 10 percent of the kids in class are anxious and have difficulty processing risk accurately

I am here for you and will do everything I can to help you

Emphasize handling emotions versus winning or being right

Firm but understanding limits on behavior

Create a classroom atmosphere that looks for the positive