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Sonoma Family Life Magazine

Help Children Cope with Anxiety

When your child is anxious, everyday events turn into big struggles. In this interview, psychologist Dr. Jenny Yip, a clinical fellow of the Anxiety and Depression Association of America, offers help.

Question: What is your advice for parents who have kids who are struggling with anxiety?

Dr. Yip: The evidence-based treatment for anxiety disorder is exposure and response prevention therapy, which is a type of cognitive behavior therapy. Cognitive behavior therapy basically means teaching children how to behave in a way that allows them to decrease their anxiety. We teach them how to recognize the mind traps—the faulty thinking—that we all often get stuck in so that they can adjust their thought patterns to more accurately reflect reality. Exposure therapy basically means that we teach children how to confront their fears so that they no longer carry the magnitude that children imagine in their minds. The classic example: If you have a spider phobia, you are going to avoid spiders, check for spiders, and want reassurance from parents that there aren’t spiders around. However, that doesn’t allow you to correct your faulty assumption that spiders are dangerous. The only way to correct your assumption is to actually confront that fear, so that you learn, “Oh wait, there is no harm in this spider.”

Q: So when you work with kids with anxiety, do you expose them to their fears in increments?

Yip: Yes, in increments. And we resist safety behaviors [checking, avoidance, seeking reassurance] because they only reinforce the faulty assumption that the fear is real.

Obsessive Compulsive Disorder (OCD) runs rampant in my genetics. One of my sons had his first panic attack at two years and six months. All of a sudden he discovered that there was a lot of hair in his bath after he washed his hair. He turned bright red, panicked, and wanted to get out of the water. Initially, he cried uncontrollably, and I had to calm him down. I said, “Show me what you are afraid of,” and he pointed to the hair. Any parent would just drain the water and scoop their child out. However, we tried to make a game out of it. I made up a song that said, “Hair, hair, everywhere. Let’s see how many we can pick.” Then we tried to pick up the hair from the water, and I said, “Oh look at this!” The next baths we did the same thing, to the point where now he still notices the hair, but it’s not causing him stress.

Q: Do you have any other tips for helping children manage anxiety?

Yip: It’s important to acknowledge a child’s feelings. A lot of times parents will tell their kid, “There is nothing to be afraid of” or “Everything will be OK, you’ll be fine.” [These statements] actually invalidate the child’s experience. Instead, say, “I see you are feeling very uncomfortable and anxious.” Then, rather than try to fix the problem, guide the child to his or her own solution: “So what can you do to work through this?” [This approach tells] the child, “Hey, you have what it takes; I believe in you.” When anxiety is an issue, the most important traits children need are confidence and to believe in themselves.

Kids, especially the very young ones, really look to parents for information. If a tragedy occurs, the child will first look to the parents for how to respond. The most important thing to do in such a situation is to demonstrate strength. And being strong does not mean being emotionless. [Rather, it’s saying] I know that I am feeling sad right now. These are the things that I am doing to help myself feel better. [This approach shows children] that they are not helpless, that there is a solution, a way out of feeling sad.

Q: When should parents seek professional help for their kids?

Yip: Professional help is necessary if a child is spending a lot of time ruminating about worries, engaging in checking behaviors, seeking reassurance, and avoiding sports or school for whatever reason—these are some red flags. And when you are seeking professional help, don’t just go to anybody. Some professionals who are not specialists may just categorize anxiety as “general anxiety,” [a diagnosis that is] very different from school anxiety, social anxiety, phobias, OCD, or panic attacks. Kids rarely have just general anxiety. Usually there are specific triggers to a child’s anxiety. So interview therapists. Ask them: Have they worked with other children with anxiety disorders? And what kind of anxiety disorders? And ask them what their treatment approach is. If the clinician doesn’t say “cognitive behavior therapy” and, more specifically, “exposure therapy,” then keep looking. 

Dr. Jenny Yip is the founder of the Renewed Freedom Center for Rapid Anxiety Relief and the Little Thinkers Center, both in Los Angeles. Find out more at dryip.com.