Need to know: How to support a child with anxiety

Parents are hardwired to protect their kids from dangers and to attend to them when they are physically hurt, but mental health conditions like anxiety can leave parents feeling completely unprepared and helpless. 

Anxiety when picked up early in kids can be treated with positive outcomes. The treatment plan will depend on the severity of your child’s condition and may include a combination of therapy and medication. Cognitive Behavioural Therapy (CBT) is usually the most recommended therapy because of its efficacy in treating childhood anxiety. Other emerging psychotherapies with promising results include Mindfulness-Based Stress Reduction (MBSR), Mindfulness-Based Cognitive Behavioural Therapy (MBCT), and Psychoanalytic Child Therapy (PaCT).  Depending on the severity of your child’s anxiety, your paediatrician may suggest medication.

Why it’s important

Mounting research shows that family members, particularly parents, who make accommodations to help diminish or avoid the distress caused by their child’s anxiety, are inadvertently making things worse. 

Seeing our child in distress triggers our protective instinct, which reduces child anxiety in the short term but does not promote coping or self-regulation. Changing the approach to be supportive rather than accommodating, conveys to a child an acceptance and validation of their distress, along with confidence in the child’s ability to manage and tolerate discomfort.

Although some accommodations are inevitable, parents/carers need to be aware of the impact of their responses to their child’s anxiety.

Supportive Parenting for Anxious Childhood Emotions Program (SPACE) is a parent-based intervention for childhood anxiety and OCD specifically for parents, and can be delivered as a stand-alone treatment or in conjunction with child treatment. The primary focus in SPACE is on parent education, skills, and tools rather than on direct child change. This is especially useful because the treatment can be implemented even in cases where the child is reluctant to engage in therapy directly.

Tips and strategies

Before you embrace the strategies listed below, it’s important to ensure your child doesn’t have any underlying conditions that may be presenting as anxious behaviour. Undiagnosed sensory hypersensitivities can sometimes be the cause of overwhelm, pain, and avoidant behaviour.

First things first

• Check-in with yourself – if you struggle with anxiety yourself (or suspect that you might), it’s important you seek help so that you can be the best role model for your child.

• Teach your child about how the brain functions – knowledge about how our brains work can help kids understand why they feel a certain way. “Did you know that your brain has a cool part called the amygdala, and its job is to warn you of danger and to protect you? This is called the fight-or-flight response and it happens without you even realising it. This is why feelings can sometimes feel like they just sneak up on you really quickly.” 

• Explain that the brain can change – reassurance that things can change for the better will help your child keep a positive attitude. “Sometimes, your brain can be overprotective even when there’s no threat. You have the power to teach it to recognise real danger and to keep calm at other times. I’ll make sure you have lots of tools to help you.”

• Teach your child to recognise signs of anxiety – you might need to ask them various questions to help them find the clues that anxiety is creeping in. “Are there butterflies in your tummy?” or “Do you feel like your heart is beating really fast?”

• Be supportive rather than accommodating – acknowledge your child’s feelings as valid but help them face their anxieties. By accommodating or stepping in for them you are allowing your child to avoid facing their fears and doing so actually reinforces the anxiety.

• Embrace laddering – take your child’s fears/worries and break them down into manageable steps (like a ladder) to reach a final goal. Each step can be conquered gradually and it moves you closer to the end result. For example, if your child is scared of dogs – you can start by watching a show with dogs, then move on to the next step of watching them from afar at the dog park and when you think your child is ready, try walking past a dog on the footpath.

• Predict and prepare – if you know your child has difficulty with certain activities or events, plan ahead by agreeing on what they can do if things don’t go according to plan.

• Model and narrate – take the opportunity to describe your feelings and verbalise the self-talk that shows your child that everyone has worries and you can work through them.