1. Understanding Anxiety in Children, Families and OurselvesBy
Meredith Hill, LCSW, MSW

2. Welcome!!

3. Training Objectives:
Objective #1: Participants will be able to identify at least two types of anxiety disorders.
Objective #2: Participants will be able to describe at least 3 symptoms of anxiety.
Objective #3: Participants will be able to describe at least 3 signs of anxiety in children.
Objective #4: Participants will be able to identify how their own thoughts, feelings and behaviors can impact their interactions with children, parents and co-workers.
Objective #5: Participants will be able to identify at least 3 strategies they can use to support themselves, the children and their families.

4. How Much Do You Know About Anxiety?

5. The Science of Anxiety

6. Signs and Symptoms of Anxiety

7. Anxiety Disorders
Specific Phobias - Is an intense fear of something that poses little or no actual danger. Some common phobias include closed in places, heights escalators, tunnels, water, flying, dogs and injuries involving blood.
Social Anxiety DIsorder - Involves overwhelming anxiety and excessive self- consciousness in everyday social situations. People with social phobia have persistent, intense, and chronic fear of being watched and judged by others and being embarrassed or humiliating by their own actions.

8. Anxiety Disorders, Cont’d.
Generalized Anxiety Disorder (GAD) - This anxiety is chronic and fills one’s day with exaggerated worry and tension, even though there is little or nothing to provoke it. Having this disorder means always anticipating disaster, often worrying excessively about health, money, family or work.Sometimes, simply the thought of getting through the day provokes anxiety.
Panic Disorder - People with panic disorder have feelings of terror that strike suddenly and repeatedly with no warning. They can’t predict when an attack will occur, and many develop intense anxiety between episodes, worrying when and where the next one will strike. You may genuinely believe you’re having a heart attack or losing your mind, or on the verge of death.

9. Anxiety Disorders, Cont’d.
Obsessive Compulsive Disorder (OCD) - involves anxious thoughts or rituals you feel you can’t control. If you have OCD, you may be plagued by persistent, unwelcome thoughts or images, or by the urgent need to engage in certain rituals.
Post-traumatic Stress Disorder (PTSD) - can develop following a terrifying event. Often, people with PTSD have persistent frightening thoughts and memories of their ordeal and feel emotionally numb, especially with people they were once close too.

10. Anxiety Disorders in Children

11. Childhood Fears and Worries
by Age

12. Separation Anxiety
Separation Anxiety - This is normal in very young children (those between 8 and 14 months old). Kids often go through a phase when they are "clingy" and afraid of unfamiliar people and places.

13. Separation Anxiety Disorder
Separation Anxiety Disorder - When fear of separation occurs in a child over age 6 years, is excessive, and lasts longer than four weeks, the child may have separation anxiety disorder.
Separation Anxiety Disorder is a condition in which a child becomes fearful and nervous when away from home or separated from a loved one - usually a parent or other caregiver -- to whom the child is attached.
Some children also develop physical symptoms such as headaches or stomachaches, at the thought of being separated. The fear of separation causes great distress to the child and may interfere with the child's normal activities, such as going to school or playing with other children.

14. Symptoms of Separation Anxiety Disorder in Children
An unrealistic and lasting worry that something bad will happen to the parent or caregiver if the child leaves
An unrealistic and lasting worry that something bad will happen to the child if he or she leaves the caregiver
Refusal to go to school in order to stay with the caregiver
Refusal to go to sleep without the caregiver being nearby or to sleepaway from home
Fear of being alone
Nightmares about being separated
Bed wetting
Complaints of physical symptoms, such as headaches and stomachaches, on school days
Repeated temper tantrums or pleading

15. Thoughts, Feelings and Behaviors: They’re all connected!

16. Anxiety and Ourselves - What we bring to school (besides our lunch!)
Break out session!! (3 groups) - Sticky/Rotate!
What thoughts, feelings or behaviors do you bring from home each day?
How might your thoughts, feelings or behaviors impact classroom relationships?
How might your thoughts, feelings or behaviors impact the classroom environment?

17. Coping Strategies Positive Thinking (vs. Negative Thinking)
Coping Self-Talk
Visualization, Deep Breathing, Exercise, Muscle Relaxation

18. Practice, Practice, Practice
**Pair Share**
Practice Cards:
The Wrong Thoughts Card
Self-Talk Card
Self-Encouragement Card
Visualization Card

19. Anxiety in the Classroom
Describe four elements

20. When Anxiety in Children Looks Like Anger, Tantrums or Meltdowns
Anxiety or Aggression?
When Anxiety in Children Looks Like Anger, Tantrums or Meltdowns
When children are under influence of an anxious brain, they are being driven by a brain in high alert.
An anxious brain is a strong, healthy brain that is a little overprotective. When it senses threat it automatically goes into fight or flight mode.
Any situation that puts expectations on them or demands that could exceed their own developing resources will have the potential to trigger anxiety.
It’s important to be open to the possibility that beneath an aggressive, disruptive child, is an anxious one looking for security and comfort.

21. Strategies to Help Children Cope
Powerful Thoughts - “Go Away Worry Bully”
Breathing buddies
Name It To Tame It - Talk about the feeling
Lift Them Up - Focus on Strengths
Give Comfort - Hugs
Safe Place

22. Strategies to try to help children relax Google Bugs Tight and Loose:

23. Palming: A strategy to help children calm

24. Helping Children Manage Feelings of Anxiety

25. PREVENTION
Practice, practice, practice Remember your triggers Exercise Visualize Exercise your rights No stinking thinking Try deep breathing Inner child work
Own your feelings
New avenues for fun

26. Handouts Anxiety Management - rate yourself!
Rational Thinking Throughout the Ages
Article: “Anxiety or Aggression: When Anxiety in Children Looks Like Anger, Tantrums, or Meltdowns”

27. Almost Done! Training Evaluation Form! Thank you!!
“Living in balance and harmony requires a freedom from anxiety about our own imperfections”

28. References
Anxiety Disorders. NIH Publication No , National Institute of Mental Health, Bethesda, Maryland
K. Young (2016). Anxiety or Aggression? When Anxiety in Children Looks Like Anger, Tantrums, or Meltdowns.