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Childhood Anxiety Shelley Boswell What does anxiety look like? Signs and symptoms may include: Behavior Cognitive Physical (Pledge, 2004; Prabhu, 2016, Beidel & Alfano, 2011, Merrell, 2008; Swearer, Givens, & Frerichs, 2010)) What are some common types of anxiety? Separation anxiety disorder Generalized Anxiety Disorder Social Phobia • Extreme reactions and panic around separation from attachment figure. • Free-floating worry • Fear of new situations, people or circumstances Panic Disorder • Fear of having an extreme sudden and unexpected onset of anxiety Specific Phobia • Persistent fear of objects or situations that evoke an immediate anxious response (Pledge, 2004; Swearer, Givens, & Frerichs, 2010; Auger, 2011) What causes anxiety? Biological/ Genetic Temperament Behavioral Learned behavior/modeling Family Insecure attachment style Stressful and Difficult Life Events Cognitive (thoughts) Unrealistic/Distorted thinking (Pledge, 2004, Prochaska, Norcross, 2014; Merrell, 2008; Auger, 2011) Why is it important to address? Family • Feeling unsafe to do daily activity • Affect daily routines Community School • Can lead to other mental and physical health problems • Social withdrawal • Substance abuse • School refusal • Greater risk of underachievement • Impacts motivation and engagement (Pledge, 2004 ; Rucco, Gordon & McLean, 2016 ; Beidel & Alfano, 2011; Fletcher & Cassady, 2010; Swearer, Givens, & Frerichs, 2010; Merrell, 2008; Cooley, 2007) When should parents and teachers seek help? Periods of worry and anxiety are not necessarily a cause for concern. Fear can be - Survival instinct - Powerful motivator - Part of child development Seek professional help when anxiety - lasts for several weeks and months, - is severe and out of proportion to the situation, - interferes significantly with academic, emotional and social development, - has not improved with class-based or home-based interventions - leads to avoidance of situations , and - is not appropriate for child’s developmental stage. (Titov, Anderws, & McEvoy, 2010 ; Cooley, 2007; Merrel, 2008; Auger, 2011; Prabhu, 2016) What can adults do to help? Family Be predictable Community Physicians • Medication may be effective in combination with therapy in some cases. Mental health therapists • Cognitive-behaviour therapy, mindfulness therapy, behavior therapy can be effective • Focus on routines • Have firm and clear expectations Acknowledge and prevent • Empathize with the anxiety • Limit exposure to newscasts or realistic disaster movies Teach positive coping strategies • Teach your child self-talk (I can do this…, How likely is that too happened?, Would that be the end of the world? • Practice relaxation strategies (deep breathing) • Develop a plan to cope with “worst case scenario” fear • Be a model by managing your own anxiety Reward, Reward, Reward • Reward positive coping behaviors • Be careful not to reward negative coping behaviors/ anxiety Get the team involved • School Be predictable • Primary message - child will continue to attend school • Clear routines and expectations Acknowledge and prevent • Build support network • Social Emotional Learning • Empathize with anxiety Possible academic supports • Modify academic workload if necessary • Provide check-ins during projects and learning Supportive environment • Provide safe and caring environment • Provide a safe space Talk to your child’s teacher, counselor and family physician (Pledge, 2004 ; Prabhu, 2016; Auger, 2011; Swearer, Givens, & Frerichs, 2010; Cooley, 2007) Bibliography Auger, R. (2011). The school counselor’ mental health sourcebook: Strategies to help students succeed. Thousand Oaks, CA: Corwin. Beidel, D. C., & Alfano, C. A. (2011). Child anxiety disorders: A guide to research and Routledge. treatment (2nd ed.). New York, NY: Cooley, M. (2007). Teaching kids with mental health & learning disorders in the regular classroom : How to recognize, understand, and help challenged (and challenging) students succeed. Minneapolis, MN: Free Spirit Publishing Inc. Fletcher, K., & Cassady, J. (2010). Overcoming academic anxieties: Promoting effective coping and self-regulation strategies. In J. Cassady (Ed.), Anxiety in schools: The causes, consequences, and solutions for academic anxieties (pp. 177-200). New York, NY: Peter Lang Publishing. Merrell, K. (2008). Helping students overcome depression and anxiety: A practical guide (2nd ed.). New York, NY: The Guilford Press. Pledge, D. (2004). Counseling Adolescents and Children. Developing your Clinical Style. Belmont, CA: Brooks/Cole. Prabhu, A. (2016). Helping children cope with fear and anxiety. Retrieved from http://www.cheo.on.ca/En/anxiety Prochaska, J., & Norcross, J. (2014). Systems of psychotherapy: A transtheoretical analysis (8th ed.). Stamford, CT: Cengage Learning. Swearer, S., Givens, J., & Frerichs, L. (2010). Cognitive-behavioral interventions for depression and anxiety. In G. Peacock, R. Ervin, E. Daly III & K. Merrell (Eds.), Practical handbook of school psychology: Effective practices for the 21st century (pp. 440-458). New York, NY: The Guilford Press Titov, N., Andrews, G., & McEvoy, P. (2010). Using low intensity interventions in the treatment of anxiety disorders. In J. Bennett-Levy, D. Richards, P. Farrand, K. Griffiths, D. Kavanagh, B. Klein, . . . H. Christensen (Eds.), Oxford guide to low intensity CBT interventions (pp. 169176). Oxford, NY: Oxford University Press.