Strategies for Helping Anxious Children

Strategies for Helping
Anxious Children
Greenwich Public Schools SES Workshop
Krystina Dawson, M.S.Ed.
Nancy McGraw, NCSP
1/7/15
Your brain is built to deal with stress that lasts about 30
seconds. The brain is not designed for long term stress when
you feel like you have no control.
The saber-toothed tiger ate you or you ran away but it was all
over in less than a minute.
If you have a bad boss, the saber-toothed tiger can be at your
door for years, and you begin to deregulate.
If you are in a bad marriage, the saber-toothed tiger can be in
your bed for years, and the same thing occurs.
Types of Anxiety
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GAD
OCD
Panic Disorder
Separation Anxiety
Social Anxiety
Specific Phobias
PTSD
Generalized
Anxiety Disorder
(GAD)
Definition: when a person worries
excessively about a variety of
everyday problems for at least 6
months.
Women 2x as likely as men to be
affected; GAD affects 6/8 million
adults (3.1% of the U.S. pop.)
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Muscle tension
Fatigue
Restlessness
Difficulty sleeping
Irritability
Edginess
Chronic,
unsubstantiated worry
Disorder comes on gradually; risk is
highest between childhood and
middle age
http://www.nimh.nih.gov/health/publications/anxiety-disorders/index.shtml?rf=53414
and
http://www.adaa.org/understanding-anxiety/generalized-anxiety-disorder-gad
ObsessiveCompulsive
Disorder
Affects about 2.2 million American
adults
Both men and women impacted
equally; usually appears in
childhood, adolescence, or early
adulthood
● Obsessions
● Frequent thoughts of
violence
● Thoughts of harming
loved ones
● Thoughts prohibited by
religious beliefs
● Preoccupation with order
and symmetry
Panic Disorder
Characterized by sudden attacks of
terror
Usually produce a sense of
unreality, fear of losing control
Twice as common in women as
men; attacks often begin in late
adolescence or early adulthood
Panic attacks
≠ Panic Disorder
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Pounding heart
Sweatiness
Faintness
Dizziness
Weakness
Chilled feeling
Tingling hands/numbness
Nausea
Chest pain
Smothering sensations
Fear of these previously
experienced symptoms
from reoccurring
http://www.nimh.nih.gov/health/publications/anxiety-disorders/index.shtml?rf=53414
Post Traumatic
Stress Disorder
(PTSD)
Develops after a terrifying
occurrence that involved physical
harm or the threat of physical harm
● May startle easily
● Emotionally numb
● Lose interest in things
they used to enjoy
● Difficulty feeling affection
Traumatized person ≠ PTSD
● Irritability
Symptoms must last >1 month
● Aggressive/violent
Women are more likely to develop
PTSD than men; affect approx. 7.7
million American adults
behaviors
● Avoid reminders of the
original incident
http://www.nimh.nih.gov/health/publications/anxiety-disorders/index.shtml?rf=53414
Types of Phobias
● Agoraphobia (open spaces
Specific Phobias
Intense, irrational fear of something
that poses little to no actual danger
● Claustrophobia (tight
spaces)
● Bibliophobia (books)
2x more common in women than
men; 19.2 million adult Americans
affected
● Germophobia (sicks)
● Isolophobia (being alone)
● Enochlophobia (crowds)
● Laliophobia (speaking)
● Polyphobia (many things)
● Scolionophobia (school)
http://www.nimh.nih.gov/health/publications/anxiety-disorders/index.shtml?
rf=53414
For children with normal separation anxiety, there are steps you
Separation
Anxiety
Characterized by extreme anxiety
and distress upon separation from
parents or from other familiar
people.
can take to make the process of separation anxiety easier.
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Practice separation. Leave your child with a caregiver
for brief periods and short distances at first.
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Schedule separations after naps or feedings. Babies
are more susceptible to separation anxiety when they’re
tired or hungry.
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Develop a “goodbye” ritual. Rituals are reassuring and
can be as simple as a special wave through the window
or a goodbye kiss.
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Keep familiar surroundings when possible and make
new surroundings familiar.Have the sitter come to your
Exaggerated worries about
something bad happening to their
parents, or their loved ones or they
might worry about being lost or
kidnapped- they might refuse to be
alone or go to school.
house. When your child is away from home, let him or
her bring a familiar object.
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Have a consistent primary caregiver. If you hire a
caregiver, try to keep him or her on the job.
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Leave without fanfare. Tell your child you are leaving
and that you will return, then go —don’t stall.
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Minimize scary television. Your child is less likely to be
fearful if the shows you watch are not frightening.
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Try not to give in. Reassure your child that he or she
will be just fine—setting limits will help the adjustment to
separation.
http://www.helpguide.org/articles/anxiety/separation-anxiety-in-children.htm
● Blushing
Social Phobia
● Profuse sweating
(Social Anxiety Disorder)
Overwhelming anxiety and excessive
self-consciousness in everyday social
situations
Chronic fear of being watched and
judged by others
● Trembling
● Nausea
● Difficulty talking
Can be limited to one situation or
generalized and broad
Both men and women affected equally;
approx. 15 million American adults
affected
http://www.nimh.nih.gov/health/publications/anxiety-disorders/index.shtml?rf=53414
Treatment Approaches
PSYCHOLOGICAL INTERVENTIONS (individual and groupbased)
● Psychoeducation – learning about it, shaping parental
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responses, normalize the problem.
Somatic management skills
Exposure – gradual, repeated prolonged
Cognitive restructuring – identify automatic anxious thoughts,
challenge accuracy, formulate alternative cognitions
Emotional regulation using humor, competing emotions, using
imagery.
Cognitive Behavior Therapy (CBT)
Eli Lebowitz –Yale Child Study Center presentation April 2013
Relaxation Strategies
● progressive muscle relaxation
● diaphragmatic breathing
● guided imagery
PHARMACOLOGICAL INTERVENTIONS
● Be Informed
● Benefits and risks should be evaluated
● Careful monitoring is recommended via ongoing
communication with others
http://www.massgeneral.org/schoolpsychiatry/info_anxiety.asp
What can parents do?
● ongoing communication and collaboration with school
and community-based professionals
● acknowledgment and reassurance
● praise and positive reinforcement
● routine and structure; plan for transitions
● anticipate triggers and have a plan … be proactive
http://www.phobics-awareness.org/schoolphoia.htm
http://www.massgeneral.org/schoolpsychiatry/info_anxiety.asp
What can parents do? (continued)
● Modeling
● Encourage “Feeling good” activities
● Teach Problem-Solving strategies
● Challenge unhelpful thoughts
Anxiety in Children: How Parents Can Help – Kathy Eugster- Vancouver, BC
School-based interventions
● Establish check-ins on arrival
● Identify a “safe” place
● Relaxation techniques/self-regulation strategies
● Journaling to build independence
● Praise and reinforcement
References
Anxiety in Children: How Parents Can Help – Kathy Eugster- Vancouver, BC www.kathyeugster.
com/articles/article004.htm
Eli Lebowitz – Yale Child Study Center Speaker Series: Anxiety – April 2013
http://www.massgeneral.org/schoolpsychiatry/info_anxiety.asp
http://www.phobics-awareness.org/schoolphobia.htm
Anxiety Disorders. (n.d.). Retrieved December 5, 2015, from http://www.nimh.nih.gov/health/publications/anxietydisorders/index.shtml?rf=53414
Resources/Agencies
● Anxiety Treatment Center of Greenwich www.
atcgreenwich.com 203-769-1365
● Child Guidance Center of Southern Connecticut www.
childguidancect.org 203-324-6127
● Family Centers www.familycenters.org 203-869-4848