Anxiety management techniques - Milton Keynes



Anxiety Management Facts & Strategies for Parents

1. Teaching children to manage their anxiety fear and worry is like teaching them to ride a bike or to read. It’s progressive and will improve as their confidence does over time. Unfortunately there is no quick fix but it will get better with support.

2. Most importantly, remember the 3C’s when communicating with your child. Try and stay Calm, Clear and Consistent in your Communication regardless of how panicky they get. Appearing confident about what you’re saying will also to reassure them.

3. Remember anxiety is part of normal development. Just in the same way children test behavioural boundaries they will test how safe and stable their world is as well. Anxiety related symptoms are just a sign and their way of communicating this.

4. Remember what you see on the outside is generally a mirror of what’s going on in the inside. It’s very real for them.

5. Children, like adults will have their good and bad days, their strong days and their off days and generally relates to feeling unsettled, uncertain or worried about something. Allocate time to try and find out what might be bothering them; let them know you’re there if they want to talk but there is no need to force the issue before they are ready to talk.

6. Make sure the key adults are using the same approach, this is important for the message you are giving your child to appear authentic and therefore believable. Confusing or conflictual information can often confuse them and increase anxiety.

7. Acknowledge their fear or worry. It’s real for them and has its purpose for them. Showing understanding will automatically reduce their initial panic. It’s important and reassuring knowing someone is listening and understands.

8. Model Calm approaches to situations so your child can see how best to manage situations themselves in the future. Remember Children can acquire dysfunctional anxiety related behaviours with no direct experience or observation themselves, for example, a parent’s reaction or behaviour or a child overhearing a parent’s explanation of a situation can create a level of anxiety in the child.

9. Where appropriate grant age-appropriate amounts of autonomy, remember to be aware of your own worries as a parent with a growing child.

10. Parents with children experiencing anxiety often feel the need to hide newspapers or the news on TV that relates to particular fears. E.g. fear of natural disasters. The idea is that it does not provide the child with an accurate picture of the world and limits the amount of exposure needed to the feared situation for the child to learn and practice the skills to tackle the problem. Avoidance is symptomatic of the overall impact of anxiety. It is important to tackle this every opportunity you get. Life should carry on as normal as far as possible with your focus more on how best to support your child through the anxiety episode. This forms part of exposure work and the sooner it is tackled the sooner the condition with improve. Please note it may not be appropriate to force of drag a child into a situation that is highly anxiety-provoking and can often have a negative effect on the treatment of the anxiety.

11. Parents report some cases of anxiety in children have been triggered by things such as children watching inappropriate films or TV programmes without supervision. Without parents there to guide children’s thinking, inappropriate incoming information can be difficult and overwhelming to process and sift through. Think practically, even if your child appears mature are they cognitively developed enough to be able to sift out reality from fantasy, despite the certificate is it appropriate material?

12. Encourage your child to problem-solve with you there to offer gentle suggestions to get them started and in the right direction increasing their skills and ability to solve future situations as they arise. Do not say they are wrong but gently redirect their way of thinking if necessary. E.g. “…may be this way would work?”

13. Teach your child to think things through first. Making sense of things and give them an example. E.g. If you went to bed one night on your own and heard loud banging coming from downstairs what would your brain think? What would your body do? Now what if I add the wind is blowing outside and before I went to bed I meant to close the back window but forgot? What do you think now? Putting things into context helps us calm our systems down quicker and will help your child realise their thought and feelings are connected.

14. Remember ‘worry talk’ leads to ‘worry walk’. It’s addictive. So keep worry conversations to a minimum and allocate a specific time to discuss worries with your child. Clearly and consistently redirect the child if they keep talking about anxiety-related issues. You can say “ok we will eat now and talk about it after lunch”. It will also help the child contain worries for short periods, slowly increasing the duration and ability to cope and mange their worries over time.

15. Give the child permission not to worry all the time. They are allowed to relax and have fun.

16. Introducing a worry box for younger children, or a diary for older children, can often help children contain their worry and can be used for discussion to work through worry at specific allocated times.

17. Introduce the fact that everyone worries about something at some point in their lives and these usually go away after a few days or a few months.

18. Give an example to your child of something they perhaps are not scared of but that they know others are to show its normal to an extent and they show bravery in other areas. Remind them it’s a normal in some situations to worry as anyone would, this teaches the child to assess for danger where appropriate.

19. Do not be put off by slow progress. Genuinely praise and reward the child for trying to tackle their fears, it is real for them and it will make them feel you care, believe in them and are on their side.

20. We encourage being honest with your child within reason and as long is the information is age-appropriate and shared in a child-friendly way. Avoid confiding in children with adult information if not age–approriate. Even if you feel your child is mature for their age. Excessive or inappropriate adult information can overwhelm their system and increase anxiety. Be honest but make sure this information is age-appropriate; this is very much a judgement call.

21. Avoid criticism as it can lead to tension or worry as children will anticipate this.

22. Show acceptance if your child is worried about something. Acknowledge it. Do not criticise for being foolish or upset.

23. Don’t be afraid of your child’s anxiety or them talking about it, it won’t significantly harm them or you but it will help you have a better understanding to be able to help.

24. Give only minimal key information to support your child. When children are anxious they won’t take it all in anyway. Excessive explanations or questions or arguments or justifications will just overload them and increase anxiety regardless of how many questions they ask.

25. Remember blips in progress are a normal part of things getting better. Don’t be surprised or disappointed in set-backs just be reassuring and accepting of them and don’t make too big a deal of them. Share this concept with the child if they appear down about it.

26. Remember change starts with very small successes and it takes time and patience. Remind the child that at least they’ve started the process so they’re on their way!

27. Encourage a child to do the best they can but that you don’t expect perfection as no one is.

28. Do your best not to lose your temper or enter into an argument with your child this just increases anxiety and stress for you both. Talk to your partner or a friend for support.

29. Remember anxiety is a normal and natural reaction for children and adults and is easily transferred from child to parent and from parent to child. Be aware of your own anxiety and the reaction on them. Be aware of your verbal, non-verbal and subliminal messages you share with them, however unintentional on your part.

30. Remember your belief and approach to this is vital. It’s natural to feel helpless with children who experience high levels of anxiety, but remember it will get better and share this hope and belief with your child often.

31. Work on areas of self (self-belief/self-esteem/self-confidence) with your child. (refer to Self-esteem strategies handout) Children who experience high levels of anxiety for a period often impacts on these areas and it helps to work to repair and heal.

32. Really listen and empathise - Allow your child to speak of their fears, be supportive and ask them if they need you to do anything else to help them onto the next step.

33. Confidence to tackle fears is gradually built over time through repeated experiences of exposure and success to the feared situation. Do not expect overnight success or change. Depending on the age of the child allow the child to gradually expose themselves to what they fear. Do not put them into an environment which will be highly distressing for them before they are ready. This can make things worse. For younger children bring them in slowly, breaking steps down to tackle the fear gauging their reactions along the way. For older children prepare them by discussing it to gauge their feeling about it. Ask them what they feel they are ready to tackle. Allow them the opportunity to opt out but reassure them you feel they can do it. It is more effective to try and get the child on board or motivated to want to make change. Suggest what the benefits of targeting the fear and ‘bossing it back’ will be. If you have problems motivating your child in this process it may be that your child needs more time. If the situation continues to deteriorate contact your local CAMHS team to discuss ways forward.

34. For older children educating a child in anxiety is often very powerful and allows them to understand and take control of what’s happening to them.

35. Remember anxiety is your survival response and is incredibly clever. The anxiety may make your child appear hysterical, emotional and aggressive. This is normal and will calm over time depending on your approach. This is not normally intentional on the Childs part and younger children especially have little awareness to explain this to you.

36. You can support and encourage by using your Broken-record approach to allow the child to feel heard, reassured and then distracted. This will also teach them positive affirmations to substitute the negative thinking. Be prepared children may challenge this, that is normal and is a good thing; it means they’re listening and hearing the new message. Prepare the outline of your broken-record statement so you’re prepared and all the adults who care for the child are using the same approach.

37. Introducing the concept of a ‘worry bug’ for younger children or a ‘worry tape’ for older children. Referring to the worrying thoughts as something that can be challenged and separate from the child (not who the child is) is helpful. Introduce the fact that they can ‘boss worry back’ and take control.

38. Assess worrying situations with them on the first time they occur and introduce the concept of it being a ‘false alarm’ if there is no reasonable reason to worry in the future. Remember fears are often realistic but overestimated by the anxious individual. You can work through the worries with your child through minimal discussion to calm themselves down.

39. Ask the child what they really think will happen. Introduce the concept of a third person’s perspective. “What do you think mum would say about this if she were here?”

40. The power of suggestion is really powerful; saying things like “I know it still may be a bit worrying for you but I know you’ll be able to manage” can be very helpful and plant the seed of belief and change.

41. Evidence works really well for children, so ask if any of the other children that went to the party said anything bad happened. Or what happened last time you tried?

42. Non-competitive play and exercise can be helpful in relieving the physical symptoms of anxiety in the body.

43. Anxiety is held in the body. For younger children tension can be relieved through baby massage for other children this can work too. Although we cannot recommend alternative therapies there is evidence to suggest effective outcomes.

44. Distraction can work well. If tension builds encourage the child to read a book, listen to music, play with a friend, do some artwork or something else creative they enjoy. This redirects and distracts the brain and can teach them healthy ways of coping.

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