What derails child anxiety treatment?

This week’s question comes out of several different versions of people who contact me and say they’ve tried to get their child help and it isn’t working or it hasn’t worked and they’re asking me what to do next. So I’m squishing all of these questions together into one to talk about the things that get in the way of child anxiety treatment. 

There are five things we’re going to talk about. OK? Are you ready? Here they are: The five things that get in the way of child anxiety treatment are:

  • Information
  • Time
  • Trust
  • Fear
  • And
  • Bandwidth

Let’s go through these one by one.

The first is information or lack thereof. And that speaks to the misunderstanding that the child should be the target of anxiety treatment. There are lots of studies about child anxiety because it is one of the most common if not the most common reason why parents seek out mental health help for their kids. And those studies tell us that we should be targeting the parents because, as you know, if you are a listener to this podcast, the parents are the ones who are capable of shifting the way the family is supporting the child. The parents are the ones who can create exposures, which is to say can find ways to help their child face their fears. The parents are the ones who will be passing on and encouraging skill acquisition on the part of the kids. And parents generally are more motivated. When we target children, we are expecting them to be able to interrupt the patterns that we know become ingrained in families with anxious kids. That’s not realistic. And we’re expecting them to remember and use pretty complicated skills. But these skills are ones that they not only need to learn but they need to practice and relearn over time. If we teach those skills to the parents, they can remind their children and reteach them at each new developmental stage. Finally anxiety is a tricky beast that teaches us that to be safe, we need to listen to it. While parents may be ready for the child to do things on their own, the child may be perfect happy with the status quo. That doesn’t mean that kids like being anxious but it does mean they may be less motivated to deal with their anxiety and more interested in continuing to avoid the things that scare them. Parents on the other hand, are more likely to want the children to gain more independence and so are better placed to encourage their children towards that goal.

The second reason child anxiety treatment gets derailed is time. It does take time to unpack and examine family patterns and create a plan to address those patterns. It takes time to follow through with that plan. Anxiety treatment is not a one and done intervention, it’s something that unfolds over weeks. So there’s learning how to make the plan, making the plan, and executing the plan. A way to cut back on the time needed for this, is to get direction. A program like mine, where I’m available to answer your questions and give you feedback, can cut back on the time it takes to figure things out and then get the things done.

Third reason why child anxiety treatment can get derailed is Trust. Namely parents need to trust the plan, children need to trust their parents. The parents I work with tend to be gentle parents, supportive parents, parents who are in tune with their kids. It’s their super power and also the thing that gets them stuck. I know this because we didn’t call it gentle parenting back when I was raising my kids — we called it attachment parenting — but when you are so close to your children, it can be difficult to trust anxiety treatment because it does require us to put our kids in uncomfortable situations. So if we have an anxious child who is struggling to order for themselves in a restaurant and we see their tears and know they’re hungry and scared and here’s this nice evening out with the family and they are suffering instead of enjoying being at their favorite restaurant, we may so identify with them that we just go ahead and order. It’s hard to trust that making them do it is good for them when they’re telling us it’s not. Like, who do we trust? Our child who is telling us they’re not capable? Or this plan? No matter how much research is behind it, in the moment it can be hard to follow. This is why I think ongoing support is so important, which the research bears out. Parents do better when they have someone to help guide them, reassure them, remind them of the plan and help them figure out how to dial it back if needed or when to push even though it’s hard. 

Ok, next barrier, next thing that can derail treatment is Fear. Not the child’s fear but the parents’. Lots of parents have tried to manage the anxiety and then have pulled back because they’re concerned that they are further harming their child. This is another reason why I like working directly with parents. I have found that if we expect parents to be the target of the intervention then we have a terrific opportunity to work with their parent on their own anxiety about their child’s anxiety. Just as we’re working with the child on exposures, on helping them confront the things they’ve been avoiding, so we need to do that with parents. And I think this is really exciting — this is the part of the work that I love the most, I think — because there is so much healing to be had in supporting parents who are anxious about their kids. Processing their own worries has such great lessons in figuring out how to help their children process their worries. I know that’s been incredibly helpful for me as a formerly anxious child who has an anxious kid. Anyway, our fear can derail child anxiety treatment but it can also be such an important key to progress.

Final barrier! That would be bandwidth. Parents are by definition busy and often overwhelmed with lots on their plates and I can appreciate that even if anxiety treatment feels urgent that it’s also difficult to find the bandwidth or the spoons or the mindspace to devote to addressing it. Am I going to explain how my program address this? I sure am. Let me explain how it works. The central workshop is Strong Kids, Strong families and that’s based on the Supportive Parenting for Anxious Childhood Emotions or SPACE program developed by Dr. Eli Lebowitz of the Yale Child Study Center. That’s a six week program — one lesson drops each week. SPACE is fairly straightforward. You do the things and you get results. That’s the information piece, the first barrier in this list is addressed via Strong Kids, Strong Families. The rest are addressed by the other parts of the Child anxiety Support membership. Now you can get in there, do your six weeks, solve the anxiety issue. But most of us have other barriers. I address the Time by making the site so accessible. It’s better than a weekly group because it happens on your time, at your convenience. You can get to the site on your computer’s browser but it’s even better in the phone app so it’s easy to find time to take the lessons, check in, talk to me, etc. The Trust piece and the Fear piece, those are addressed through the live components. Whether that’s watching the live webinars, or by coming to the live chats or office hours to speak directly to me in real time, or by private messaging me because I answer really quickly. Again, better than a weekly support group because the virtual piece of it means you can reach out to me whenever and I’m super available. The app makes that easy for me, too. I get a notification on my phone and check in to respond. 

But bandwidth, how do I address that in the program? Well, I’ll tell you, it’s by using a membership model so that people can drop in, can go at whatever speed they want. You can rush through, you can go slow. You can start slow and speed up or vice versa. You can take a break and process what you’re learning, you can dip into other courses or resources that can help you figure out what you need to do next. You can tread water for awhile and then dive back in. You can hang in there and lean on the community supports. I’m there to encourage you even when you need to take a step back. You can drop in to Eve Hermann’s Stress Reset practices to give yourself some bandwidth, that’s why she’s there, to help parents take care of themselves so they can do this big work.

Yes, I’m obviously a fan of my program. And remember, if you’re listening to this in the last week of March 2023, we will be starting our spring cohort next week on April 3rd. If you join that week, you will join me in walking through the program. Child Anxiety Support is always available — you can enroll at any time — and the Strong Kids Strong Families piece is asynchronous. But twice a year — spring and fall — I’ll be offering it cohort style, meaning if you join then you’ll get the first week lesson at the same time as I go offer extra supports around that lesson, and the second week I’ll be talking about the second week and so on and so forth. 

Just head to my site to join me and know that I’m here and the program is here whenever you need it.  

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