Troubleshooting—Dealing with Difficult Child Responses

This chapter provides a guide on how to deal with difficult child responses. Aggressive child responses to the plan not to accommodate are often a reflection of the child’s distress and anxiety. Remaining supportive and continuing with the plan can lead to a reduction in child anxiety and aggression. If not accommodating causes the child a lot of distress or discomfort, the parents can lean on a supportive friend or relative who can help them get through the tough moments. The chapter also addresses dealing with other difficult child responses, such as threats of self harm. If the parents are concerned about the child’s safety, they should seek professional help in person.

How Do You Let Your Child Know about the Plan?

This chapter highlights the importance of telling the child with anxiety about the plan. The child will be surprised and confused by the change in the parents’ behavior if they do not tell the child beforehand. Describing the plan to the child will also help the parents to stay firm and committed to implementing the plan. Moreover, telling the child about the change the parents are going to make not only respects the child as a person, one who is going to be directly affected by the change, but it also gives the child an opportunity to offer feedback and input. The child is probably going to be less opposed to the plan and the whole process may be much easier. The chapter then details how parents can let their child know about the plan in a supportive way, expressing both acceptance and confidence. The message that the parents give to the child to let them know about the plan for reducing accommodation has a few simple goals. It should let the child know why the parents are planning to reduce the accommodation, and it should let the child know the what, when, who, and how and how much of the plan.

Planning How to Reduce Accommodation

This chapter discusses the process of planning for reducing accommodation. A good plan for reducing accommodation should be as detailed as possible. This chapter presents sample plans to give parents an idea of the kind of details their plan should have. The plan that the parents make to reduce the target accommodation they provide to the child with anxiety is not going to be perfect, and that is OK. The important thing is to think through the details of the plan as much as possible, consider which things will make it challenging to implement, and then move forward with putting it into practice. The parents may need to make adjustments to their plan when they encounter a difficulty they had not considered, and this is also to be expected. The chapter then provides a guide on how parents can make a plan for reducing target accommodations, and how to think through the challenges in implementing the plan.

Is Your Child’s Anxiety Taking Over Your Family?

This chapter addresses child anxiety in the family context, starting with the myth that parents cause anxiety problems in their children. The idea that parents are responsible for children’s emotional and behavioral problems stems in large part from inaccurate assumptions about human development; outdated psychological theories; misunderstandings of research on the links between parental behavior and childhood disorders; and an incorrect interpretation of family dynamics. On the other hand, a child’s anxiety problem is likely to have an impact on the parents and on the rest of the family. The reason that childhood anxiety, more than other problems, can have such a large impact on parents is that when a child is feeling anxious, they look to their parents to help them feel better. But why are anxious children so reliant on parents? The reason has to do with the very nature of anxiety in humans. The natural tendency of the child to look to the parents for protection and reassurance when feeling worried, scared, or stressed is essentially hardwired into the human brain.

Understanding Child Anxiety

This chapter provides an overview of anxiety in general, and child anxiety in particular. A child who is anxious is typically going to overestimate the likelihood of negative events and to downplay the likelihood of positive ones. What is the ultimate outcome of these predictable patterns of thinking? If negative events seem highly probable, while positive events seem less likely, it is not surprising that anxious children tend to veer away from perceived risks and to move toward a more cautious course of action. The chapter then addresses some common questions asked by parents of children with anxiety. Multiple things can contribute to a child’s anxiety level, including internal and biological factors as well as external and environmental factors. Anxiety can also look very different in different children. It is useful to think about a child’s functioning in four separate domains: body, thoughts, behavior, and feelings. Anxiety can impact each domain in various ways.

Wrapping Up and What’s Next?

This chapter looks at some possible next steps if the parents feel that the child’s anxiety has partially improved, but that the child is still coping with significant and impairing anxiety. The parents may need to continue working to reduce their accommodation, by taking on additional targets and working through the steps of making a plan and gradually reducing accommodation in this new area. The parents also may want to consider trying additional treatments and strategies. Some of the most evidence-based treatments for childhood anxiety include cognitive behavioral therapy (CBT) and psychiatric medication. The parents should consider meeting with a capable therapist or psychiatrist in their area to discuss the possibilities. If the child’s anxiety has improved and things are returning to a more routine pattern without the need for special plans to help the child cope, it is important to keep up the supportive attitude toward the child’s anxiety. A supportive attitude expressed in words and actions can help to prevent future anxiety from escalating or growing to a point where it is again a major problem. Lastly, the parents should try to notice if they are falling back into old patterns of accommodation, or starting to develop new ones.

Mapping Accommodation

This chapter details the process of creating an accommodation map and monitoring accommodation. Most parents provide many different forms of accommodation, and it is important to make a choice about which to focus on first. If the behavior is something the parents do because of the child’s anxiety and the child becomes more anxious if the parents do not do it, it is likely that it is an accommodation. Knowing as much as possible about the various accommodations parents have been providing will mean they have the most options to choose from, and this will make it more likely that they select the best accommodation to reduce first. After completing an accommodation map, it will be much easier for parents to keep track of the accommodations they continue to provide in the coming days and weeks. Once the parents start actively reducing the accommodation, the log will be a useful way to keep track of changes in the parents’ overall accommodation, alongside the more specific focus on the accommodation they choose to reduce.

Common Pitfalls in Parenting an Anxious Child

This chapter describes some common pitfalls in parenting an anxious child and ways to avoid them. Many of these traps and pitfalls can be loosely categorized as either “protective” or “demanding,” which are broad categories of beliefs and behaviors, and each can be expressed in many different ways. The first category is that of protection, which covers thoughts and behaviors that center on the goal of protecting the child from harm or distress. Taking on the role of protector for the child, when a danger is not present, can convey to the child that they are in need of protection, making them feel less safe and more vulnerable. The second category is that of demanding. Demanding is when the parents expect the child not to feel anxious, or to be able to act as though they are not, despite the very real anxiety they are feeling. Demanding has an important limitation that makes it almost entirely unhelpful when dealing with child anxiety. When a demand the parents make is not met, they often respond with frustration or anger because they feel helpless to enforce the demand or undermined by the lack of compliance. This can lead to conflict and hostility.

Child Anxiety

This chapter discusses the main types of childhood and adolescent anxiety. There is no limit to the variety of things that can cause a child anxiety, but some fears and worries are more common than others. The most commonly diagnosed anxiety disorders include separation anxiety; social anxiety (also called social phobia); generalized anxiety; phobias; panic disorder; agoraphobia; obsessive-compulsive disorder (OCD); illness anxiety; and avoidant/restrictive food intake disorder, which is not an anxiety disorder per se, but is commonly associated with fear and anxiety. Of all the emotional and mental health problems that occur during childhood and adolescence, anxiety is the most treatable. Treatments for childhood and adolescent anxiety include cognitive behavioral therapy (CBT) and medication for anxiety. Healthy habits can also help to keep anxiety under control.

Troubleshooting—Dealing with Difficulties in Working with Your Partner

This chapter suggests some solutions for when the parents do not agree with each other or have difficulty working cooperatively together. If the parents are having a hard time talking about the child’s anxiety, they can try to set aside a time to talk about the issue when neither of them is under pressure nor feeling frustrated and upset. Talking about the problem may raise some negative feelings, but the parents have a better chance of having a productive conversation if they start out feeling calm. The parents should also try to stay away from unhelpful blaming and shaming; even self-blame can make it harder for parents to work together productively. It is best to keep the conversations about how to help the anxious child focused on the issue of the anxiety. If the parents can put other things aside and just focus on the one issue, it may be easier to come up with a plan for that one specific thing. The chapter also offers some additional tools and strategies for improving cooperation between parents. Ultimately, the parents should respect each other’s opinions and decisions.