Defining Anxiety Disorder
A little anxiety can be a good thing — prompting a child to study for his big test or practice for her piano recital — but a lot of anxiety can be a problem.
“The dividing line is when the fear becomes so great that it causes a lot of distress and/or it makes the person not able to do certain things,” Walker says.
Anxiety disorders among children are very common and are not something kids grow out of.
“Untreated or inadequately treated anxiety issues in children are associated with greater and more severe mental health issues in adulthood,” she says. “So it’s really important to address them.”
Avoidance and Safety Behaviors
When faced with anxiety, kids engage in what Walker calls “avoidance and safety behaviors.” The boy who’s afraid of dogs won’t go to soccer practice because there might be a lot of dogs at the park. The girl who is a perfectionist over-prepares for tests to an excessive degree.
“What we know is that those behaviors in the short run will calm your fears, but in the long run, each time you do that you teach your brain to be afraid,” Walker says. “It’s like you’re telling your brain you can’t handle it.”
Unfortunately, parents inadvertently feed their children’s anxiety by enabling it. For example, a parent will pick up a child when a dog comes near — even though the dog is on a leash and not at all aggressive.
The cognitive behavioral therapy approach is the opposite of avoidance. First, the counselor figures out exactly what the child fears in a particular situation (the fear structure). Then he or she develops a series of exposures that allow the child to face fear in controlled doses.
It’s essential, Walker says, to figure out an accurate fear structure before planning exposures. In Anxiety Relief for Kids, she describes two girls who both get good grades but are afraid to speak up in class. Camilla has perfectionistic tendencies, so an exposure for her might be to try answering a teacher’s question when she’s only 50 percent sure of the answer. Haley has social anxiety — she worries about what other kids think of her — so an exposure for her might be to drop her books in the hallway and see if other kids react the way she fears they will — by laughing at her or shunning her in the future.
Walker encourages parents who are worried about their kids to seek out counselors experienced in cognitive behavioral therapy. Several professional organizations have locator services on their websites, including the Anxiety and Depression Association of America (adaa.org), the International OCD Foundation (iocdf.org), and the Association for Behavioral and Cognitive Therapies (abct.org).
Don’t just go with the first counselor you find, though. Instead, ask them to describe in detail a treatment plan they’ve used.
“I think it’s important for parents not to be intimidated,” Walker says. “Just ask the questions.”