by Angela Zaffer, MA, NCC, LPCC August 8, 2016
With children going back to school after the summer break, stress associated with homework, taking a test and or social relationships, maybe something some parents are thinking about. This article should help guide parents on how to help their child cope with these overwhelming feelings.
What is Anxiety? Anxiety is a thought that causes someone to worry or feel nervous or upset. Stressed out is a word people often use to describe anxiety. Everyone feels anxious from time to time. It’s a normal emotion. Many people feel nervous when faced with a problem at school or work, before taking a test or going to the doctor. But for children with anxiety, worry and fear are constant and can be overwhelming. For some it can be disabling and lead to feelings of panic. But with simple interventions, children can learn to manage these feelings.
One in eight children has an anxiety disorder. Parents whose children show symptoms of anxiety want to help but don’t always know what to do or where to turn. This guide can help you make sense of the available treatment options and includes some easy tips you can start using right away.
Recommended Treatments for Children With Anxiety
Recommended forms of Treatment
- Cognitive Behavioral Therapy (CBT) is the most recommended treatment technique for anxiety in children.
- Acceptance and commitment therapy, or ACT, uses strategies of acceptance and mindfulness (living in the moment and experiencing things without judgment) as a way to cope with unwanted thoughts, feelings, and sensations.
- Dialectical behavioral therapy, or DBT, emphasizes taking responsibility for one’s problems and helps children examine how they deal with conflict and intense negative emotions.
Cognitive Behavioral Therapy (CBT)
- Cognitive therapy examines how negative thoughts, or Cognitions, contribute to anxiety.
- Behavior therapy examines how you behave and react in situations that trigger anxiety.
Cognitive Behavioral Therapy (CBT) is a type of therapy that can be used with children to teach interventions to identify and replace negative thoughts. In cognitive behavioral therapy, children can learn different ways to calm themselves and learn to worry less. CBT is effective in children as young as 6. Most children need between 5 and 20 therapy sessions. Depending on the age of the child, a session typically last about 30 to 55 minutes
According to some studies, CBT is as effective as medication in treating anxiety. Unlike medication, CBT has no physical side effects. CBT does require practicing the interventions taught in each session. Most counselors will teach the parent the interventions as well. A parent can be quickly oriented in the last five or ten minutes of each session on what the child worked on learning in the session. Also, having the child teach the parent the interventions is also a good way for the child to remember the interventions taught.
Some Typical CBT Interventions include:
- What is Anxiety
- How Anxiety gets started
- Physical Symptoms
- Breathing techniques
- Relaxation techniques
- Using logic to fight worry thoughts
- Thought stopping
- Redirecting thoughts-Distraction
Interventions to Use at Home
- Help the child to recognize the physical symptoms of anxiety. A few physical symptoms of anxiety are—upset stomach, racing heart, out of breath, crying, sweaty hands, headache. Sometimes children with anxiety visit the school nurse for these symptoms. Teach your child to use coping strategies, such as deep breathing when these symptoms occur.
- Listen and Validate Let your child know you hear their worries and are empathetic to what that the child is feeling. Let the child know they can share their worries for one time a day for fifteen minutes. The late afternoon or early evening is usually in the best time. After they have shared the worries, the child needs to know you will not discuss their worries again until the next day. This helps the brain learn to re-wire itself from a worry brain to a non-worry brain. The brain has to be trained to worry less.
- Worry Box: Create a worry container The child can write down the worries on a piece of paper and put them in a box or other container. If they are worrying at school, a worry folder made to hold these worry notes works really well. The child can also write positive notes and coping skills on the front outside of the worry folder.
- Breathing Techniques: Deep breathing can help decrease the stress response in the body. Take a deep breathe with your child and breath the air out slowly. Pretend you are breathing out through a straw. You can also have the child blow the air out slowly on their hand.
- Excercise: Go for a walk together. Your child can use this time to discuss what they are worrying about during the walk. Also, excercise is a great way to get ride of the stress chemicals that build up in the body.
- Modeling ways to cope with stress: A child who sees his parents take some deep breaths to calm down may learn to do the same.
- Should Medication be Used?
- The medications that are commonly used to treat anxiety in children are antidepressants. However, because all medications have side effects, medication is rarely prescribed as a first treatment for anxiety. Medication is most often used when other interventions have not been successful, or as a complement to therapy.Depending on your child’s level of anxiety, professional counseling may be needed to find the treatment and coping strategies that work best for your child and your family.
Your doctor or counselor may recommend one or a combination of treatments.
Selective Serotonin Reuptake Inhibitors (SSRIs) and Serotonin Norepinephrine Reuptake Inhibitors (SNRIs): These are commonly known as second generation antidepressants.
Another antidepressant that is commonly used is bupropion. Bupropion ,or Wellbutrin, is a third type of antidepressant which works differently than either SSRIs or SNRIs. Bupropion affects the dopamine neurotransmitters whereas SSRIs affect serotonin nerotransmitters.
SSRIs, SNRIs, and Bupropion are popular because they do not cause as many side effects as older classes of antidepressants, and seem to help a broader group of depressive and anxiety disorders. These medications are thought to work by targeting chemicals in the brain called neurotransmitters. These chemicals affect mood and emotion. Experts have traditionally thought that they restore a chemical imbalance. But new research suggests that stress may actually destroy the connections between nerve cells — and even the cells themselves. They believe that antidepressants work by restoring these nerve pathways. These medications take 4 to 6 weeks to reach their full effectiveness. Anyone taking an antidepressant should be closely monitored, especially children, in the first few weeks.
Medication may allow your child to participate in activities he or she would otherwise avoid. Medication can help get symptoms under control while a child is learning new coping techniques in therapy. Ask your child’s doctor about the risks and benefits of any suggested medication. Also ask about follow-up appointments and medication monitoring.
Like other medical conditions, anxiety disorders tend to be chronic unless properly treated. Most kids find that they need professional guidance to successfully manage and overcome their anxiety.
Written by Angela Zaffer MA, NCC, LPCC
Angela Zaffer is a nationaly certified (NBCC) and Licensed Professional Clincal Mental Health Counselor in Rio Rancho, New Mexico. She specializes in treating anxiety disorders in children. Angela also treats children, teenagers and adults with depression, low self esteem, grief and trauma/PTSD. She is the CEO and Clinical Director of Counseling Solutions. Angela can be contacted at: firstname.lastname@example.org