7 Strategies for helping kids with anxiety
Respect kids feelings without empowering fears
Many children experience anxiety of varying degrees on a daily basis. And although it would be unrealistic to eliminate anxiety completely, we regularly work with children and families in our practice to provide strategies and tools that help kids manage anxiety more effectively.
How does anxiety manifest in children
Before strategizing an action plan for managing anxiety in children, it’s important to understand anxiety in general. According to the American Psychological Association, anxiety is “characterized by feelings of tension, worried thoughts and physical changes like increased blood pressure. People with anxiety disorders usually have recurring intrusive thoughts or concerns. They may avoid certain situations out of worry. They may also have physical symptoms such as sweating, trembling, dizziness or a rapid heartbeat.”
In children, anxiety can look a lot more like behavioral concerns or irritability, says Dr. Adrija Chatterjee, PsyD, who works directly with Kids First patients and families in our office. Dr. Chatterjee and Dr. Alice McCutcheon both are behavioral psychologist with the Gersten Center and offer their counseling services as part of our Kids First practice.
Dr. Chatterjee adds that kids who have experienced trauma may express anxiety through tantrums, so it can be hard to distinguish regular tantrums from an anxiety-induced ones without the support of a professional.
Supporting kids with anxiety
As parents, it’s completely normal to want to reassure kids when they are fearful of something. But Dr. Kathy Shepherd explains that parents of children with anxiety have to be more aware that too much reassurance can feed the “anxiety monster.” For example, says Dr. Shepherd, if a kid is afraid to walk to school because something bad might happen, our natural reaction is to say “Oh, don’t be silly nothing bad is going to happen to you.” And then if they walk to school and they fall, you’re not acknowledging that bad things can happen. “Although you provided reassurance, you failed to address the root of their fear, and as a result the fear resets at higher level,” says Dr. Shepherd.
Instead of simply reassuring kids with anxiety, we need to encourage them to face fear and walk them through it. Try asking questions like the following instead:
- Well, let’s talk through it.
- What’s the worst case scenario?
- What would happen if you fall down, would you be okay?
For instance with an older child who is fearful about an exam, you can ask them:
What’s the worst case scenario if you fail a test?
Will you never graduate?
Obviously, the answer is no; that would be extreme.
By sharing this process with your child, you help them learn the tools to put their situation in perspective. This allows them to face fears instead of simply reassuring them that everything is going to be okay. “The reality is that we can’t promise children there are no bumps in the road. Instead, we can assure them that we will be there to help them navigate those bumps,” says Dr. Shepherd.
It’s natural to not want our children to suffer, but by not allowing them to work through their challenges, you may be exacerbating the child’s fears. The solution is to help guide them to escape the cycle of anxiety. Anxiety is a chronic condition, and it is your role as the adult to help them deal with it properly in the long-term. It would be impossible to try to avoid everything that makes your child anxious, and this avoidance only reassures them in the short term while strengthening the power of anxiety.
Helpful strategies for managing anxiety
Not a day goes by when our providers don’t see a patient with anxiety. We work with parents to support children facing anxiety and encourage those children who need more support to see a therapist–either within our practice or in another practice we recommend.
Strategies for supporting children with anxiety
Dr. Chatterjee offers parents the following strategies for supporting children with anxiety:
- Show Empathy: Your child’s fears may be realistic, so it’s important to acknowledge them, but then help your child face them. Try saying, “I get it that you’re really scared right now.” As a parent, you have to think of what evidence there is to go against this fear and use it as a tool. In this way, you are not dismissing how your child is feeling and are helping them cope. Both are equally important so your child can feel empowered beyond the feeling of fear.
- Strike a Balance: Respect and validate your child’s feelings, but don’t empower them. Try not to belittle fears, but also don’t amplify them so they can face their fears. Try saying something like, “I know you’re scared. I’m here, and we’ll get through this.”
- Reduce Anticipation Time: Try to reduce the anticipation period when you can because anxiety is highest before the stressor. Use your best judgment to give them a short time to prepare for something that may cause anxiety, so that they are not faced with thinking about the stressful event at length. In that short time, it’s best to talk through scenarios to plan for any uncertainty and diffuse anxiety.
- Diffuse Anxiety: A little bit of anxiety is helpful because it can motivate kids, but they need to have balance. Too much anxiety can be paralyzing, so it’s important to know your child and what they are equipped to handle. When your child feels physical manifestations of anxiety, like sweaty palms or a racing heart, teach them how to calm their body down or find ways to distract it, like counting backward slowly or taking deep breaths.
- Habituation: When you practice not just reassurance for dealing with anxiety and teaching your child to visualize and express their fears, your child will start learning how to self-soothe in stressful situations. Just like muscle memory, when this becomes the “go-to strategy” for your child, he or she will be better able to manage anxiety.
- Ask Open-ended Questions: If you sense your child is getting anxious, encourage them to talk about it, but try not to ask leading questions. They will feed off anxiety they sense in you.
- Model Healthy Ways of Handling Anxiety: Set an example for your kids by letting them see how you cope with anxiety yourself.
When kids need therapy
When anxiety causes dysfunction in a child, we encourage families to try behavioral therapy. It’s such an essential and common part of pediatric care that we offer therapy within our practice. Even at the preschool age, therapy can be helpful.
The first step is typically diagnosis. This is a collaborative effort of speaking to the child, the family and the school (with permission) to understand the challenges a child is having and how it manifests in different settings. If the child’s behavior affects the classroom, the therapists at Kids First will even let a teacher know this is something the student is working on so that teachers can help them on their journey. Of course, this would all be done with a family’s permission because confidentiality is so important.
Throughout the individual therapy, Dr. Chatterjee says they strive to form a relationship with the child where they trust the therapist. “The important piece is to find balance and empower them. It can feel debilitating if their fear becomes too strong, so we always do psycho-education to help them understand what’s going on because anxiety is a physical reaction,” says Dr. Chatterjee.
Teaching kids to notice the responses in their bodies when feeling anxious can be a great starting point to managing anxiety. Adrija says, “Once the child begins to notice their heart beating faster, butterflies and sweaty palms, this means their body is telling them an alarm is going off. It’s beyond the ‘it’s going to be fine’ or ‘get over it’ because it’s a physical response.”
Dr Chatterjee says she teaches children to notice this physical reaction so that the child can work on an effective response. She offers children tools they can practice and use during these times.
Working together as pediatricians, therapists, parents and schools, we can ensure the best possible outcome for children with anxiety in the Kids First practice. To schedule an appointment with one of our behavior therapists, speak to a Kids First provider or call the office at 847-676-5394.