If you are the parent of an anxious child, it’s very likely that your child’s anxiety negatively impacts the entire family. Anxiety often does this. It’s kind of like a contagious annoying pest that controls and bullies everyone around it. Of course, your child may be feeling it worse of all, but parents and even siblings often gets pulled into webs of anxious behaviors that can include avoidance, excessive checking and reassurance seeking, and even rituals.
Once you have identified that anxiety is the root cause of your child’s and families distress, the importance of changing anxious behavior is often shared by all family members.
Once you have met with your therapist, whether that is me of someone else if you are out of state, it will be important to recognize the key variables in anxiety. While anxiety can manifest differently among different people there are some key areas to look at and to look at as well as the relationships among these factors.
Firstly, we often look at feelings- physical symptoms and emotional feelings. I often see fear and worry as well as aches and pains.
Secondly, we identify thoughts. Anxious thoughts usually begin with”What Ifs” followed by something very bad that is definitely going to happen and there is nothing you can do about it (Yikes!).
Lastly, and most importantly in my opinion, we identify actions and behaviors. The key categories of behaviors to look for are: avoidance, checking, and reassurance seeking. These behaviors leave people feeling highly dependent, insecure, more anxious and fearful,and lacking in experience to challenge these end of the world/ worst case assumptions.
So maybe you are asking ” Now what?”
Here are some ways to get started and moving:
Next we make concrete goals and reward and reinforce the behavior that will turn around the negative cycle I just described above and allow for the creation of new behavioral patterns that will provide the experiences necessary to make changes and ultimately significantly reduce the negative impact of anxiety and give your child and your family your lives back.
List all the anxious behaviors. Here are some examples:
Child avoids sleeping in their own bed and sleeps with parents ( In my practice, I often see this in 8-12 years olds)
Child demands to know parents whereabouts during the school day, checks on parents, or refuses to go to school.
Child does not engage with peers due to fears of social embarrassment.
Child checks house excessively.
Child asks repeatedly if they are sick and dying (when otherwise healthy).
Child refuses to go to sleepovers, camps, afterschool activities independently.
Child washes excessively or checks homework or handwriting and redoes this excessively.
Next you identify what is important to your child and family (hopefully it’s the same- usually it is the same or pretty close).
Some examples of this are: Become more independent, sleep in my own bed, go to activities, not worry about parents or self dying
Then you ask child if they would be willing to be brave and face their fears? and by doing so make some behavioral changes.
You then implement a reward system where they can earn “Bravery Tickets” or “Bravery Bucks” ( yes, as in pretend dollars, credit to my colleague Jane for “bucks”) to start to change their behaviors.
Your therapist or I can also help you create a hierarchy as a ladder of least to most anxiety provoking situations that can serve as a road map. While many people may choose to start with easiest and progress to most difficult, you and your child have the choice to start wherever they would like based on what is important to them.
Then you catch your child being brave and start to track tickets earned.
For example, if your child often calls out to you in the house when you are in another room, you can reward them for increments of time that they resist calling out. The idea is to start small, build on successes and continue to take larger steps.
You and your child should create a reward list of short and long term rewards that they can then use to cash in their bravery tickets. Keep in mind that rewards do not need to be something you buy. It can be anything from a special activity with a family member, an outing, making pancakes or dinner, or picking a movie or game for family move or game night. Basically whatever your child likes, within reason. A combination of smaller short term rewards as well as larger longer term rewards can work. And yes, sometimes removal of a privilege is indicated as well, depending on unique circumstances we can discuss. Keep in mind the consequence should be short term and intended as a learning tool.
Remember, while kids can come up with ideas for rewards, parents have final say in how many tickets are required for specific rewards.
Once your child has mastered one new behavior, move on to the next and the next until a new behavioral pattern and habit is created.
Don’t get discouraged by progress and setbacks. That is still progress and consistency will be the ultimate key to success. When old behaviors return and even if they return more intense, that is simply the process of behavioral extinction. The anxiety and old anxious behavioral habits are trying to lure your child back to escape, avoidance, checking, reassurance seeking, and parents can easily get pulled back into rescue. You must remind yourself that if you get pulled back into those old habits, you will make the anxiety worse and the extinction process longer and more grueling.
You can validate your child’s feelings and continue to encourage brave choices in behaviors (resisting urges to escape, check, or seek reassurance) by for example saying “I see you are really scared and want to sleep with us, and if I thought that would help I would let you. But, we have all learned together that that will make your anxiety worse. It’s important for you to sleep in your room so that you can see for yourself that no intruder is coming to get you and your room is a safe place. And remember you are working towards that reward. I believe in you and your courage. You can do it!”
If you would like to schedule an initial phone consultation to discuss your child’s needs in more detail and see if Cognitive Behavioral Therapy is right for you, click on “Book Online Now” to schedule this phone consult.
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