Parenting in itself is a challange, and can be more challangeing if your child suffers from any of the anxiety disorders. This is a part of the fellow lecture series delivered by the author on 3/9/12. This presentation discusses the strategies for parenting an anxious child.

1. Parenting an
Anxious Child
What parents should know
Fellow Lecture Series
March 9th 2011
Pallav Pareek M.D.

2. Freeing Your Child From Anxiety by
Tamar E Chansky Ph.D
Helping Your Anxious Child (A step by
step guide for parents) Rapee et.al
Your Anxious Child : John S Dacey
Handbook of Clinical Family Therapy

3.  Anxiety is an expected, normal and
transient response to stress; it may be a
necessary cue for adaptation, and
coping
 What makes it pathological?
a) Autonomy: No/minimal recognizable
trigger
b) Intensity: exceeds pt’s capacity to bear
c) Duration: persistent rather than
transient
d) Behavior: avoidance or withdrawal

4.  NO !!!!
 Anxiety (abnormal) results
from unknown internal
stimulus or excessive
response to the external
stimulus
 While Fear is sense of
dread and foreboding that
occurs in response to an
external threatening
event.

5. Simple Phobia, Social Phobia, Agoraphobia
Panic Disorder, Generalized Anxiety Disorder
Separation Anxiety Disorder
Post Traumatic Stress Disorder, OCD

6.  Harder to calm
themselves
 Usually above average
creativity, they can’t use
this creativity in coping
 Even with a good plan:
get discouraged/quit
easily
 Fail to recognize their
success

8.  Reassurance is a natural parental response to
a child’s distress
 No reassurance » alone & insecure
 Children with anxiety: ask for reassurance far
more often » VICIOUS cycle
 If the heavens are falling: no amount of kisses
and hugs are too much, but for an excessive
unjustified fear » child learns a wrong
message

9.  Often it feels: “They could do it only if they
tried a little harder” & it’s not easy NOT to
become angry or frustrated on your anxious
child
 Anger More fright & anxiety

10.  COPE method
 Calming the nervous
system
 Originating an
imaginative plan
 Persisting in the face
of obstacles
 Evaluating and
adjusting the plan

11.  Stressful Situation Fight/Flight
 Hard wired human response
 We should not elicit the FF response for every
trivial situation
 Ways to calm the nervous sytem
a) Abdominal Breath Control
b) Sensory awareness :know your orange
c) Personal Punching Pillow: Vent
d) Know your heart Rate
e) Paradoxical Paradigm (witch hairy, scary witch)
f) Scale the fears
g) Link it to an ouch (rubber-band around wrist)

12.  Vertical vs. lateral thinking
 Writing stories (completion)
 Functional freedom (uses of
brick)
 Mindless activities (don’t use
in OCD)
 You be me
 Empty Chair
 Successive approximation

13.  Identify the problems
 It’s not scary after all.
 Glorify well intentioned
mistakes
 Model moderate risk taking
 Negative vs Positive
thoughts (write them down)
 We got your back…

14.  Plans are fluid
 Let them have feedback on
their own (photos/videos)
 Charting success
 Pretest vs post test

15.  Pass on your own fears. Letting them face
challenges is better than overprotection
 Leave perfectionism for your own self
 ALWAYS REMEMBER
Reflective listening is the key !!!!

16.  Based on the Cool Kids Program, developed
by Ronald Rapee Ph.D. and group at
Macquarie University Sydney AUS.

17.  Based on Cognitive therapy principles
 Event “Iam waiting to be picked up from
school, mom is late”
 Thought : She could be dead
 Evidence: its been only 10 minutes, (?) traffic,
she was late twice before (never died), other
kids are still there (not all parents could be
dead)
 Reorganized Realistic thought: She is running
late, and will arrive soon

18.  Rewarding Brave, non anxious behavior (no
matter how small a bravery: start from there)
 Ignoring behaviors you don’t want
 Modeling brave, non-anxious behavior

19.  Be Consistent (more so for an anxious child)
 Keep your emotions in check
 Distinguish between anxious and naughty:
even if anxious some behaviors are not
pardonable
 Removal of privileges
 Natural consequences are sometimes the
best teachers

21.  The MASTERPLAN
1) Empathize what your child is feeling
2) Re-label the problems (anxieties) as the
worry brain
3) Rewire, act with smarts not with fears
4) Get body on board: deactivate alarms
5) Refocus: on what we need to do
6) Reinforce your child’s efforts at fighting

22.  Anxiety Disorders Association of America
http://www.adaa.org/
 Worry Wise Kids :
http://www.worrywisekids.org/parents/paren
ting_child.html
 The Child Anxiety Network
http://www.childanxiety.net/
 Cool Kids Program Sydney Australia:
http://www.kidsmatter.edu.au/primary/progr
ams-guide/cool-kids-school-version/

23.  St. Louis Behavioral medicine
Institute : 1129 Macklind Ave.
Phone: 314-534-0200
http://www.slbmi.com/
 Dr. Jennifer L Abel (Psychologist
specializing in Anxiety disorders)
314 -721-7201
http://www.anxietystlouispsycholog
ist.com/
 Family Resource center 3rd floor in
St. Louis Children’s Hospital : 314-
454-2350
http://www.stlouischildrens.org/con
tent/familyresourcecenter.htm
 Center for Cognitive Behavioral
Therapy, St. Louis, Inc 314-576-
4900 http://site.cbt-stl.com/

25. When I was
young, I
admired clever
people. Now
that I am old, I
admire kind
people.
~Abraham
Joshua Heschel