Alison Alden recently had the chance to help her toddler overcome a potentially anxiety-provoking moment. Over the holidays, a family member brought his German Shepard to Alden’s sister-in-law’s house for a party. When Alden and her son walked over to say hi to the dog, it began barking, which made her son nervous. He hadn’t been afraid of dogs before, and Alden didn’t want him to develop a phobia based on a bad experience, so she took the opportunity to encourage him to confront a new, uncomfortable situation.
“I knew the dog that we were around. He was a nice dog, so I brought my son over to him,” Alden says. “I petted the dog. I said, ‘oh, he’s so nice, his fur is so soft, look how happy he is, look how his tail is wagging.’ You really have to model to them that those situations are safe and push them to enter them themselves.”
Alden is a clinical psychologist at the Anxiety Treatment Center of Greater Chicago, a clinic that’s nationally recognized for treating anxiety disorders in children as young as two. She says that one of the earliest risk factors for anxiety in children is behavioral inhibition, or the tendency to withdraw or become upset in unfamiliar situations. It’s a trait she had noticed in her son even before the holiday party.
Behavioral inhibition doesn’t guarantee that a child will develop an anxiety disorder, but it does increase its likelihood. Research has found that behavioral inhibition is often hereditary, though a child’s environment plays a strong role in shaping their mental health. According to the Anxiety and Depression Association of America, one in eight kids has an anxiety disorder.
Even though anxiety is common in kids, many parents struggle with how to help their children manage their anxiety. It’s important for parents to recognize that their child’s fears are real to them, says Ronald Rapee, co-author of Helping Your Anxious Child and founding director of the Centre for Emotional Health at Macquarie University in Sydney, Australia. But parents need to balance that compassion with encouraging their children to confront things that make them anxious.
“Parents need to take children’s fears and worries seriously,” Rapee says. “Children don’t make these things up and are not ‘exaggerating.’ They should not get angry or punish their child when they say they can’t do something. On the other hand, the most common response for most parents is to ‘allow’ their child to avoid. This has the effect of reinforcing the child’s anxiety.”
Alden has also found that accommodating a child’s anxiety is the most common, and most harmful, mistake parents make. She says parents often shrink from pushing their kids to face their fears because it feels cruel, when in fact it’s just the opposite.
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“The kindest, most loving thing you can do for your child is to push them to face their fears,” Alden says. “That’s how people get over anxiety. The child learns that oftentimes something they thought was dangerous is actually safe and something they can handle. Children develop a sense of confidence and competence by facing their fears.”
For young children with behavioral inhibition, Alden says parents should model appropriate fear behaviors for their kids, like she did when she approached her family member’s dog and demonstrated to her son that it was a nice dog. For older children, Alden and Rapee recommend breaking down anxiety-provoking activities into doable pieces.
“A simple, concrete example might be a child who fears sleeping in their own room in the dark and so sleeps in their parents’ room every night,” Rapee says. “The first step might simply be to get the child onto a mattress on the floor of the parents’ room for a couple of nights. Then gradual steps might involve moving the mattress closer and closer to the door of the parents’ room. Eventually, a step might involve the child in their own bed, but with the light on. Then the light might be turned down gradually each night until it is off. The process proceeds at the child’s pace, but parents will often have to gently push.”
Although parents often don’t want to “bribe” their children into good behavior, Rapee and Alden say that parents should establish small but meaningful rewards to motivate their children to accomplish their anxiety-busting goals. For the child who’s just moved into their own bed, Rapee suggests an extra bedtime story. Alden recommends parents and kids work together to draw up a prize list that the child can work toward.
“Kids, especially anxious kids, have trouble thinking about the long-term consequences of things. No seven-year-old is going to think, ‘if I only face my fears, I’m going to have a better life in the long run.’ You need to help kids along by giving them little prizes and incentives a lot of the time,” Alden says. “The more praise and external rewards you can use to get your child to do something, the better.”
Another issue that many parents of kids with anxiety face is addressing their child’s outbursts. Children with anxiety can become angry when parents encourage them to face their fears, Alden says.
“Once their child begins to make a scene or get very upset, parents are much more likely to cave in and end up accommodating the anxiety, so another thing that parents can do is develop a good way to respond when kids become angry,” she says.
Alden encourages parents to teach themselves how to ignore temper tantrums because attention feeds them. Alternately, if the child hits someone or breaks something, time-outs can be an effective form of discipline. To use time-outs correctly, Alden recommends counting to three without other commentary and then implementing the time-out immediately on three, without yelling or talking a lot about it. Taking away privileges also works well for older children as long as it’s done in a measured way and without anger.
“If parents don’t push their children to face the things they fear, they’ll never have the opportunity to develop confidence and competence in those anxiety-provoking situations,” Alden says. “A lot of times you end up with kids going off to college really feeling like they can’t handle it and still continuing to rely on their parent, as opposed to taking risks and taking charge of their lives at that time when they’re supposed to be developing as a young adult.”
Children and parents don’t have to struggle with anxiety alone. If a child is having a difficulty with anxiety, parents should seek help from a mental health professional. Research has found that cognitive-behavioral therapy (CBT) is the most effective treatment for both children and adults with anxiety disorders. For kids whose anxiety interferes with their ability to perform daily tasks, a professional may recommend pairing CBT with medication, though Alden says they typically have a higher threshold for prescribing medication for children than they do adults.
“Don’t be afraid to ask for help,” Alden says. “Oftentimes there’s a lot of shame around parenting a kid with anxiety. A lot of times parents end up blaming themselves when their child is struggling with something, and that holds back some people from seeking help. There’s really nothing to be ashamed of here. Some kids are just more predisposed to these things, and it’s important to get your child the help that they need.”
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