helping children tame anxiety
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Helping Children Tame Anxiety . Mary Bolger, Ph.D. 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 . Typical Early Childhood Worries. Separation Anxiety - PowerPoint PPT PresentationTRANSCRIPT
Helping Children Tame Anxiety
Mary Bolger, Ph.D.
Anxiety is An important signal “Caution” “Be Alert” A source of motivation to take on challengesNeurobehavioral
Physical make-up of our brain Maintained through reinforcement
Typical Early Childhood Worries
Separation AnxietyNew and unfamiliar situationsReal and imagined dangers (dog bites, spiders,
monsters, the dark, basements)
Typical Worries of School Aged Children
• Real world dangers (fire drills, burglars, illness)• Social acceptance• Academic and athletic performance• Risk and safety
Typical Adolescent Worries
Social acceptanceConcerns about the larger worldMoral issuesFuture success
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 temporaryWorry functions not as a signal but a way of life
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 help
What Unhealthy Anxiety Looks Like in Children
Headaches, stomachaches, nausea, vomitingSleeplessness, difficulty falling asleep, frequent
nightmares, unable to sleep aloneRefusal to go to school, outside the home, places in
the home or unable to be without parent for appropriate time period
Poor concentrationUnrealistic, catastrophic, pessimistic thinking patternsSeeks excessive reassurance, “what if” questions
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 learnedBest time to intervene is early because left
alone the interference from anxiety becomes more disabling
Overcoming anxiety builds competence!
Cognitive-Behavioral Therapy
Active, skilled focused intervention that is the treatment of choice
Magic Circle Thought
s
FeelingsBehaviors
Components of Cognitive-Behavioral Treatment
Magic Circle
What you think
the inner voice inside your head
How you feel
our thoughts result in many different feelings
What you DO
when feelings become very strong they start to have an affect on what you do and these actions REINFORCE thoughts and feelings
CBT for ChildrenEducation About Worry
Worry begins in the Worry Center of the BrainWorry Center is sending mistake messagesGet in Charge! Take Control of the Worry Center!
CBT for Children
Externalization
Anxiety can be thought of as a entity separate from the child, “The Worry Bully”
Point out the child’s competenciesName and characterize the worry
CBT for ChildrenCognitive RestructuringUse 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.
CBT for ChildrenStep by Step ExposureCompeting demands, the ART of DISTRACTIONCharting Progress
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 things
Interventions for AnxietyHealthy
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
10 Best Parenting Practices for Fighting
Anxiety1. Empower your child to fight back! Fight the worry not your child!2. Make a plan with your child3. Enlist the support of important people in your child’s life (teachers, school
psychologist, nurse)4. Target erroneous thoughts, select a new skill to practice, and monitor change5. Practice containment of anxiety6. Role Play7. Always go forward, no matter how small the step8. Recognize each small step as a victory over the Worry Bully9. Be a role model for problem solving worries10. Remember to make home a safe haven
How to Collaborate with Your Child’s School
Be proactive so your child is not misunderstoodFind your support contact at school Schedule a time to talkSet regular check-insKnow ThyselfEncourage therapist and teacher connection
Connecting Your Child’s Pillars of Support
Email regular updates that include parent, school, and therapist
Include outside therapists at school meetingsLook for the positive contribution of each pillarLook for therapists who will work with the school and
are flexible about how classroom plans are developedFeedback between therapist, school and home helps
guide intervention to support change for childRemember the child is part of the team!
Classroom EnvironmentPotential 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 Content
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 behaviorCreate a classroom atmosphere that looks for the
positive