Help for Parenting an Anxious Child: A Guide for Families

As we head back to school this fall, I wanted to share some information that might be helpful to parents navigating life with an anxious child. As a therapist who specializes in treating anxiety disorders, I've seen firsthand the impact anxiety can have on children and their families. Parenting an anxious child is a unique challenge, and it's one that requires patience, understanding, and the right strategies to help your child thrive.  Sometimes doing the things that make sense to us in these situations are actually totally wrong and end up prolonging the problem. This certainly doesn’t mean you are to blame, but you can add to the problem by responding in certain ways. 

In this post, we'll explore effective ways to support an anxious child, discuss various anxiety disorders, and highlight treatments like cognitive behavioral therapy (CBT), exposure and response prevention (ERP), acceptance and commitment therapy (ACT), and SPACE treatment.

Understanding Anxiety Disorders in Children

Children can experience various anxiety disorders, each with its own set of challenges and symptoms. Understanding these disorders is the first step in helping your child and in recognizing the problem.

1. Generalized Anxiety Disorder (GAD):  Children with GAD worry excessively about everyday activities and events. They may worry about school, health, safety, or family issues, often without a specific reason. This constant worry can interfere with their daily life and lead to physical symptoms like headaches and stomachaches.

2. Separation Anxiety Disorder:  This disorder is characterized by an intense fear of being away from home or loved ones. Children with separation anxiety may refuse to go to school or sleepovers, fearing that something bad will happen while they're apart from their caregivers.

3. Specific Phobias: These are intense fears of specific objects or situations, such as animals, heights, or flying. A child with a specific phobia may go to great lengths to avoid the feared object or situation, which can limit their activities and experiences.

4. Emetophobia: This is the fear of vomiting, which can lead to avoidance of certain foods, places, or activities that a child associates with the risk of vomiting. Emetophobia can be particularly challenging because it affects a child's eating habits and social interactions.

5. Selective Mutism: Children with selective mutism are unable to speak in certain social situations despite being able to speak comfortably at home. This can affect their ability to participate in school and other social activities.

6. Obsessive-Compulsive Disorder (OCD):  OCD involves unwanted, intrusive thoughts (obsessions) and repetitive behaviors (compulsions) performed to reduce anxiety. A child with OCD might wash their hands excessively or check things repeatedly.

7. Panic Disorder:  Children with panic disorder experience recurrent, unexpected panic attacks—intense periods of fear accompanied by physical symptoms like a racing heart, sweating, and shortness of breath. The fear of having another panic attack can lead to avoidance behaviors.

Strategies for Parenting an Anxious Child

Now that we have a better understanding of anxiety disorders, let's dive into some effective strategies for helping your child manage their anxiety.

1. Reducing Accommodation

One of the most common but unhelpful behaviors parents engage in is accommodating their child's anxiety. Accommodation refers to changing your behavior to help your child avoid anxiety-provoking situations. While this can provide immediate relief, it reinforces the anxiety in the long run. Here are some ways to reduce accommodation:

Gradual Exposure: Encourage your child to face their fears in a gradual and supportive manner. For example, if your child has a specific phobia of dogs, start by looking at pictures of dogs, then progress to watching videos, and eventually, visiting a dog park from a distance.

Set Limits: It's important to set boundaries and limits around anxiety-related behaviors. For instance, if your child has separation anxiety, work on establishing a consistent drop-off routine for school and stick to it, even if it's difficult at first.

Provide Encouragement: Celebrate your child's efforts to face their fears, no matter how small. Positive reinforcement can boost their confidence and motivation to continue.

Encouragement and Support

Providing encouragement and support in a nurturing way can make a significant difference for an anxious child. Here are some tips:

Validate Their Feelings: Let your child know that it's okay to feel anxious and that their feelings are valid. Use statements like, "I understand you're feeling scared right now, and that's okay."

Encourage Brave Behavior:  Praise your child's bravery when they face their fears. For example, say, "I saw how brave you were when you walked past the dog today. That was a big step!"

Teach Relaxation Techniques: Help your child learn relaxation techniques such as deep breathing, progressive muscle relaxation, or mindfulness. These tools can help when practiced on a regular basis.

3. Cognitive Behavioral Therapy (CBT)

CBT is a highly effective treatment for anxiety disorders. It helps children identify and change negative thought patterns and behaviors that contribute to their anxiety. As a parent, you can support your child by:

Practicing CBT Techniques at Home: Work with your child's therapist to learn CBT techniques that you can practice together at home. This might include challenging negative thoughts or engaging in exposure exercises.

Modeling Positive Thinking and a Growth Mindset: Demonstrate positive thinking and coping strategies in your own life. Share a growth mindset. Children learn a lot by observing their parents, so showing them how you handle stress can be very powerful.

4. Exposure and Response Prevention (ERP)

ERP is a specific type of CBT used to treat OCD and other anxiety disorders. It involves exposing the child to anxiety-provoking situations and preventing the accompanying compulsive behaviors. Here's how you can help:

Support Exposures: Work with your child's therapist to create a plan for exposure exercises. Be supportive and encouraging as your child works through these exercises.

Limit Reassurance: Reassurance can reinforce anxiety, so try to avoid constantly reassuring your child. Instead, encourage them to use the coping strategies they've learned.

5. Acceptance and Commitment Therapy (ACT)

ACT helps children accept their anxiety and commit to actions that align with their values, despite their fears. As a parent, you can:

Promote Acceptance: Encourage your child to accept their anxious thoughts and feelings without judgment. Use language like, "It's okay to feel anxious. Let's see what we can do even if we feel this way."

Identify Values: Help your child identify their values and set goals that align with those values. For example, if they value friendship, encourage them to engage in social activities even if they're anxious.

6. SPACE Treatment

SPACE (Supportive Parenting for Anxious Childhood Emotions) is a parent-based treatment that focuses on changing how parents respond to their child's anxiety. 

Key components include:

Reducing Accommodation: As mentioned earlier, gradually reduce the ways you accommodate your child's anxiety.

Increased Support: Increase supportive responses that encourage independence and resilience. This might involve praising brave behaviors or providing emotional support without accommodating the anxiety.

Common Unhelpful Behaviors to Avoid

While it's natural to want to protect your child from anxiety, some behaviors can be unhelpful in the long run. Here are a few to watch out for:

Overprotectiveness: Shielding your child from all potential anxiety triggers can prevent them from developing coping skills. Instead, allow them to face challenges with your support.

Reassurance Seeking: Constantly providing reassurance can reinforce anxiety and make your child dependent on you for comfort. Encourage them to use coping strategies instead.

Avoidance: Avoiding anxiety-provoking situations can provide temporary relief but reinforces the anxiety over time. Gradual exposure is more effective for long-term improvement.

Supporting an anxious child is a team effort, and professional help can be invaluable. Encourage families to reach out to a therapist who specializes in anxiety disorders. Therapy can provide children and parents with the tools they need to manage anxiety effectively and improve their overall well-being. Be open-minded about doing work on yourself as well as your child engaging in treatment. Parenting an anxious child comes with its challenges, but with the right strategies and support, you can help your child manage their anxiety and thrive. By reducing accommodation, providing encouragement, and utilizing treatments like CBT, ERP, ACT, and SPACE, you can make a significant difference in your child's life. Remember, you're not alone on this journey—reach out for professional help and support from other families who understand what you're going through. Together, we can create a brighter, less anxious future for our children.

~ Shannon