How Families Can Help Their Child Manage Problems with Anxiety

By Melanie O’Neill, Ph.D.

This article was published in the Canadian Mental Health Association’s journal called “Visions”, Summer 2004 issue (Vol.2 No. 3) on pages 41 and 42 – published here with their permission.

Excessive anxiety is a dilemma faced by many kids and families. Anxiety disorders are the most common form of mental health problems with over 65,000 children and youth in BC coping with at least one anxiety disorder. Fortunately anxiety disorders are highly treatable with cognitive-behavioural therapy, select medications or a combination of both. Parents and families can play an extremely important role in helping kids manage excessive anxiety and associated problems.

There are many different causes of anxiety problems in children. Understanding the preliminary causes of a child’s anxiety is of limited value as the causes are either not directly changeable (e.g., genetic vulnerability to anxiety) or they are in the past (e.g., a traumatic or stressful event).

Fortunately, with your assistance, your child can learn to manage their anxiety without having to understand and resolve the initial cause!

The important next step in managing anxiety is identifying what maintains the anxiety or what keeps the anxiety high when the cause or trigger has passed. After years of research we now know that a child’s anxiety is maintained through several different factors including the way the child:

Thinks – anxious kids tend to see the world as dangerous and threatening
Copes – anxious kids tend to avoid and run away from scary or challenging situations
Interacts with their family – sometimes families respond in a helpful way but other times families can get drawn into unhelpful responses

Parents can help their anxious child with each of these areas. The first step is deciding to address the problem and seeking out evidence-based assessment and treatment. Both you and your child must be fully “on board” with the decision to seek treatment as many of the strategies and techniques require hard work over a number of weeks or months. Fortunately this hard work pays off with approximately 80% of kids and families experiencing benefits from an evidence-based management plan.

To increase motivation, you and your child can sit down and brainstorm the problems anxiety brings to their life and the benefits they will experience once they have mastered their anxiety.

Deciding to begin an evidence-based program such as cognitive behavioural therapy can bring both the family and child enormous rewards. The child struggling with anxiety will soon experience increased self-esteem, greater confidence and improved levels of personal happiness. The family will notice decreased conflict and worry and increased family cohesiveness.

Implementing an Evidence-Based Management Program

Some points parents may want to cover with their child:

Anxiety is a normal feeling and lots of other kids have the same difficulties (normalize, normalize, normalize!)
You will be doing this together with your child every step of the way
Your child will never be forced to do anything they do not wish to do
Challenges and new skills will be tackled at their own pace by breaking them down into manageable steps
Getting better can be fun and very rewarding

Helpful Ways of Dealing with Your Child’s Anxiety

Reward Brave, Non-Anxious Behaviour

Whenever you see your child doing something brave, make a big fuss. Set up a plan so that whenever your child faces a situation they find challenging they will receive a reward (e.g., special time with parent or friend, sticker, treat, etc).

Ignore Behaviours You Don’t Want

Don’t give your child your attention when they are engaging in anxious behaviours (e.g. having an upset stomach before a birthday party) and praise your child when the behaviour has stopped and they move on to a more helpful way of coping.

Preventing Avoidance

Running away from anxiety-provoking situations is one of the key maintaining factors in childhood anxiety problems. By avoiding a feared situation, your child never gets to learn there was nothing to fear in the first place. Encourage your child to gradually and slowly face challenging situations when you know they are capable of being successful.

Empathize and Understand

Ensure that your child knows that you understand their anxiety (you’ve felt it before) and how hard facing fears can be. They will be much more willing to follow your lead as their anxiety coach.

Encourage Constructive Coping

Prompt your child to come up with their own helpful coping options in a scary situation rather than telling them how to cope. This fosters self-esteem and shows that you have faith in their ability to manage anxiety.

Model Non-Anxious Behaviour

Your child watches how you face challenging situations. Ensure you are modelling brave coping whenever you encounter something that feels scary for you.

Parents and families often get pulled into well-intended but unhelpful responses when coping with an anxious child. These responses may lower anxiety in the short term but usually make it worse in the long term (e.g., excessive reassurance, taking over tasks, encouraging avoidance, becoming impatient, or participating in safety behaviours or rituals).

Your Child is Very Anxious or Frightened… What Can You Do?

Remember that everyone feels anxiety from time to time. The goal as parents is to help your child cope with scary situations and learn how to master excessive feelings of anxiety.

Summarize what your child has shared with you in a supportive and understanding way
Present choices and break the scary task into manageable chunks
Brainstorm strategies for dealing with the situation and let your child take the lead
Examine possible consequences of each strategy
Encourage your child to choose the strategy that works best

The above recommendations are adapted from Rapee et al. (2000). Helping your anxious child: A step-by-step guide for parents. New Harbinger: Oakland, CA.

Helping Anxious Children Checklist

Get an assessment from a trained expert
Get informed and educated about anxiety
Teach tools to relax
Teach tools to cope with worrying
Encourage child to take risks
Break down feared tasks into manageable chunks
Maintain a firm and consistent parenting style
Establish daily routines
Plan for homework and projects
Model and teach healthy self-care (diet, sleep, exercise)
Problem-solve life stressors for both you and your child

Adapted from ADABC Helping Anxious Children brochure (www.anxietybc.com).

Select Sources

March, J. S. (1995). Anxiety Disorders in Children and Adolescents. Guilford Press: New York.
Rapee, R. M., Spence, S. H., Cobham, V., & Wignall, A. (2000). Helping your anxious child: A step-by-step guide for parents. New Harbinger: Oakland, CA.
Rapee, R. M., Wignall, A., Hudson, J. L., Schniering, C. A. (2000). Treating anxious children and adolescents: An evidence-based approach. New Harbinger: Oakland, CA.

Implementing an Evidence-Based Management Program

Helpful Ways of Dealing with Your Child’s Anxiety

Reward Brave, Non-Anxious Behaviour

Ignore Behaviours You Don’t Want

Preventing Avoidance

Empathize and Understand

Encourage Constructive Coping

Model Non-Anxious Behaviour

Your Child is Very Anxious or Frightened… What Can You Do?

Helping Anxious Children Checklist

Recommended Readings and Resources

Select Sources