Category: Children

Anxiety Disorders in Children: A Family Affair

Written by Regine Galanti

When a child has anxiety, it often becomes a family rather than individual problem. While an adult with anxiety might suffer alone with racing thoughts of danger, or avoidance of anxiety provoking situations, children with anxiety are best viewed from a perspective that incorporates the whole family. This family-perspective is often true of adults with anxiety and OCD, but in the case of anxious children, it is the norm rather than the exception.

Take the case of Emma, an 11 year old who begins to have panic attacks. When she had her first panic attack, she was alone in her room, and felt her heart pounding, her breathing quickened, and her body began to shake. She was sure she was having a heart attack, and felt terrified, helpless and alone. When she felt better, she was determined to avoid those feelings of being alone and helpless forever. In order to feel safe, she refused to stay alone in her house, despite the fact that she used to do so easily. She demanded that her parents drive her to and from school, despite having taken the bus for years. Her father had to rearrange his work schedule to go in late every day, and her mother had to leave work early to pick her up. She was also incredibly fearful of being the last one awake in the house, and would constantly check on her parents to make sure they weren’t sleeping before she did. Her parents took to sitting in the living room to “prove” to Emma that they were awake, despite previously reading in bed, and sometimes going to sleep before their pre-teen daughter. She also asked her parents an endless string of health related questions, which she demanded the answers to, even though she challenged every answer. Emma’s mother and father were distressed by the effects of her anxiety on her own life, but recognized it was taking over their lives as well.

The term family accommodation is used to describe the ways in which family members of individuals with anxiety disorders adapt or modify their own behaviors to reduce their child’s anxiety. Accommodation in families most frequently involves parents – over 90% of parents of anxious children report that they change their own behavior to reduce their child’s anxiety in some way — but sometimes incorporate siblings as well. On its face, this may seem like a positive, as the family members are changing their behavior in order to reduce anxiety to help a child function better. Higher degrees of accommodation, however, are related to many negative factors in childhood anxiety, including a higher level of impairment in anxious children, and more severe symptoms. Accommodation sends the message to a child that their anxiety actually IS dangerous. In the case of Emma, her parents modifying their behavior to reduce her anxiety tells her that if she does stay home alone, something bad might actually happen, and that would be dangerous. Her parents are protecting her from something that isn’t actually dangerous, thereby sending her the message that she needs protecting. Instead, our goal when helping families with anxious children is to help parents support their anxious children – teaching parents how to tell their children that anxiety is a normal emotional experience, and that the best way to handle it is to face those fears even though it’s difficult rather than avoid them. The important factor to keep in mind here is that, though the child might be the one in treatment, often parents can play a role in reducing anxiety as well – though not in the way that you might think. By stripping away the layers of accommodation, parents can teach children how to face their fears in a healthy, adaptive way, and improve their long term functioning.

Consistency: The Key to Discipline

Written by Regine Galanti

Discipline. It’s a topic on every parent’s mind – what’s the best way to get my child to listen? To obey? To become a healthy adult with self-control? How does a parent raise these obedient, independent, self-disciplined children without using excessive punishment, control, or other methods that might hurt my child’s self esteem, or our relationship?

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Encouraging Positive Behavior in Children

Written by Regine Galanti

Picture this: You are playing Legos with your 6-year-old son, and he’s having trouble putting two pieces together. He begins to get frustrated, throws the pieces on the floor, and stomps, “this is the stupidest game EVER!” As a parent, what do you do?

Most people will respond to and address this misbehavior in some way. After all, what better way to teach acceptable behavior than to correct misbehavior? This tendency to address misbehavior is normal, but even if done well, this method is only one piece of the parenting puzzle.

I’ve previously blogged about the power of positive attention, but I’d like to take this a step further and focus on the power of praise. Parents tend to spend a lot of time thinking about what they’d like their children to stop doing. Instead, spend a few minutes thinking about what you’d like to see your children doing. One way to accomplish this goal is to think about the positive opposite of the behavior that you’d like your child to stop exhibiting. For example, if a parent would like to see less Lego throwing, they might choose to focus on playing gently with the Legos and/or keeping the Legos on the table. Focusing on praising this positive opposite allows parents the opportunity to teach a child what they should do, rather than only providing information about what not to do. Further, providing praise allows a parent to increase their child’s self esteem, and maintain the warmth of an interaction rather than engage in a cycle of negativity around the misbehavior.

To praise the positive opposite, first pay attention to your child’s behavior. Think about what the behavior you would like to see looks like and how you would describe it. Then, catch your child exhibiting that positive opposite using specific praise of that behavior. If your child kicks his or her feet at the dinner table and it drives you bonkers, “catch them” sitting with their feet on the floor, and jump in with a labeled praise, like, “thank you so much for keeping your feet on the floor!” Telling a child specifically what you like about their behavior using labeled praises lets them know what to expect, and encourages them to repeat it.

Here’s a bonus tip: ignoring is another powerful tool in the parenting toolbox. If misbehavior is minor and isn’t hurting anyone or breaking anything, a parent can safely ignore it. Withhold attention by turning away, avoiding eye contact, and not talking about it, and then use a labeled praise immediately when you see any positive behavior. This shows a child that good behavior is a reliable way to get parental attention, and highlights the difference between misbehavior (which is ignored) and positive behavior (which is praised, specifically, with warmth and enthusiasm). Ignoring negative behavior also avoids that power struggle that often occurs when parents focus on misbehavior but don’t have the time or stamina to follow through. In practice, this means ignoring your toddler when he throws food on the floor by turning away and avoiding eye contact, but showering him with praise for eating nicely and keeping the food on his plate as soon as the throwing stops.

Using labeled praises strategically, in combination with ignoring, can drastically reduce the amount of time a parent spends on discipline, as well as allow for a more positive parent-child relationship.