2Anxiety is An important signal “Caution” “Be Alert” A source of motivation to take on challengesNeurobehavioralPhysical make-up of our brainMaintained through reinforcement
3Typical Early Childhood Worries Separation AnxietyNew and unfamiliar situationsReal and imagined dangers (dog bites, spiders, monsters, the dark, basements)
4Typical Worries of School Aged Children Real world dangers (fire drills, burglars, illness)Social acceptanceAcademic and athletic performanceRisk and safety
5Typical Adolescent Worries Social acceptanceConcerns about the larger worldMoral issuesFuture success
6When Anxiety is No Longer Protective Your child worries immensely over insignificant situationsYour child’s automatic response is worry and avoidanceWorry response is not temporaryWorry functions not as a signal but a way of life
7What Unhealthy Anxiety Looks Like in Children Behavioral reaction is excessive and disproportionate to the situationAge inappropriate clinginess, tantrums, irritability, or crying jagsWithdrawal from family, friends, peersExcessive time spent consoling child about distress of ordinary situations, or excessive coaxing to do normal activities like homework, hygiene, meals, play datesAvoidance or giving up are primary response to challengesNot happy, not moving forwardCoaxing, reassurances, logical plans don’t helpAnxiety becomes a problem when it causes problems. It affects the way your child is leading their life. Is your child using mainly avoidance and hesitationAnxiety may happen periodically as your child grows, like when going through a developmental change or a new experience –new school, birth of a sibling. Can generally learn how to manage the situation. On the other hand, if the level of anxiety is so strong that it interferes with your child’s ability to function in a social or classroom situation at an age-appropriate level for an extended period of time, then it is time to get help.
8What 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 periodPoor concentrationUnrealistic, catastrophic, pessimistic thinking patternsSeeks excessive reassurance, “what if” questions
9Reasons 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 disablingOvercoming anxiety builds competence!Advances in neurosciences are documenting the great capacity of the brain to change or rewire connections given the right kind of practice. The brain Circuitry operates on the principle of “Survival of the Busiest.” Whichever brain circuits we engage the most enlist the greatest numbers of neurons or brain cells.This concept has application to functions after stroke, working on OCD and managing Anxiety.The more we engage in worry, the more, the faster, and the more easily the brain will be mapped to make those anxious connection.
10Cognitive-Behavioral Therapy Active, skilled focused intervention that is the treatment of choiceMagic CircleThoughtsFeelingsBehaviors
11Components 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
12CBT for Children Education About Worry Worry begins in the Worry Center of the BrainWorry Center is sending mistake messagesGet in Charge! Take Control of the Worry Center!
13CBT for ChildrenExternalization Anxiety can be thought of as a entity separate from the child, “The Worry Bully” Point out the child’s competencies Name and characterize the worry
14CBT for Children Cognitive Restructuring Use self-talk (inner voice) to talk back to the worry bullyThe worry bully is sending a false alarm. I don’t need to listen.The bad feeling will go away soon.
15CBT for Children Step by Step Exposure Competing demands, the ART of DISTRACTIONCharting Progress
16DesensitizationGradual 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
17Interventions for Anxiety HealthyGoal: promote masteryUnhealthyGoal: temporary reliefFace the fear step by stepAnswer anxious questions only once or twiceLearn to tolerate the discomfortMake home a safe havenParent uses techniques to manage own anxietyAvoidRepeat answers over and overReassure, coax, accommodate to minimize distressPush, scold, let child know the behaviors aren’t normal and are annoying
1810 Best Parenting Practices for Fighting Anxiety Empower your child to fight back! Fight the worry not your child!Make a plan with your childEnlist the support of important people in your child’s life (teachers, school psychologist, nurse)Target erroneous thoughts, select a new skill to practice, and monitor changePractice containment of anxietyRole PlayAlways go forward, no matter how small the stepRecognize each small step as a victory over the Worry BullyBe a role model for problem solving worriesRemember to make home a safe haven
19How to Collaborate with Your Child’s School Be proactive so your child is not misunderstoodFind your support contact at schoolSchedule a time to talkSet regular check-insKnow ThyselfEncourage therapist and teacher connection
20Connecting Your Child’s Pillars of Support regular updates that include parent, school, and therapistInclude 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!
21Classroom Environment Potential targets that can be manipulated to help anxious children:Classroom SeatingFollowing DirectionsClassroom ManagementTesting ConditionsUnstructured TimesReturns from long absencesFire and Safety DrillsCurriculum Content
22Teacher Awareness About Anxiety More than 10 percent of the kids in class are anxious and have difficulty processing risk accuratelyI am here for you and will do everything I can to help youEmphasize handling emotions versus winning or being rightFirm but understanding limits on behaviorCreate a classroom atmosphere that looks for the positive