On October 18 we held our second class, The Anxious Child, led by Dr. Anne Marie Albano in the offices of In Good Company. Attendees learned how to recognize the signs of normal childhood nervousness and more serious anxiety issues. They also found ways to manage serious cases of anxiety. We thank Stacey Gill, who attended the class last week, for writing up this wonderful post about the class. You can read more of Stacey’s writing at One Funny Motha.
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On the fourth floor of a cozy New York office an intimate gathering of parents assembled behind French doors to hear Dr. Anne Marie Albano, Director of the Columbia University Clinic for Anxiety and Related Disorders and associate professor of clinical psychology at Columbia University College of Physicians and Surgeons, speak about ways to identify and address anxiety and related emotions in children, adolescents and young adults. The Modern Village, a continuing education series for parents, presented the talk on Thursday night in the second of their on-going lectures and seminars.
“The big thing we work on is uncertainty,” Dr. Albano said. “Anxiety comes when we can’t predict the situation, and we don’t have control over it. We have to teach kids to deal with uncertainty and ride it out.”
Although all children face anxiety, Dr. Albano distinguished between normal levels and disruptive levels. Dr. Albano also acknowledged that while it may be difficult to parse out the child’s actions and the motivation behind them, several warning signs may help parents determine if anxiety is the root cause for their child’s behavior.
Potential Red Flags
- Child is extremely shy
- Child looks to isolate him or herself
- Child avoids social situations
- Child constantly questions what can go wrong
- Child worries about the future
- Child lacks self-confidence
- Child has trouble sleeping
- Child exhibits physical symptoms of breathlessness, sweating and dizziness
- Child experiences frequent stomachaches, headaches or nausea
- Child avoids or has trouble completing school work due to the child’s fear of making a mistake
When the anxiety level is excessive and treatment necessary, Dr. Albano asserted there is really only one therapeutic treatment.
“Cognitive Behavioral Therapy is the goal standard,” Dr. Albano explained. No other therapy is effective according to Dr. Albano who focused her presentation on psychological treatment rather medication.
Cognitive Behavioral Therapy (CBT) works by exposing the child to the things causing the anxiety and having them sit with the feelings until they subsides. Of course, every fear and discomfort isn’t thrown at the child at once. The method takes a gradual approach.
“It’s a process we are working through,” Dr. Albano noted.
The child works to build up his or her resistance to the fear. If the child has an intense fear of the dark, for example, he or she would first sit in a dim room during the day to get accustomed to the anxious feelings. Eventually the feeling diminishes and the child moves on to a more anxiety-inducing fear like sitting in his or her darkened bedroom at night. The child does this for longer and longer periods until the child is sleeping in his or her room overnight.
Recognizing the difficulties parents face in dealing with their children’s anxiety, Dr. Albano suggested several ways parents can help their child manage it. Parents, she said, need to show sensitivity to the child. Parents should explain they understand how the child feels, but that does not mean they should accommodate the fears. Parents should also provide positive reinforcement when the child copes well with his or her anxiety, and they should remain consistent in their approach, maintaining the rules put in place to help the child handle the anxiety. Dr. Albano discourages singling the child out, but promotes collaborating with the child’s therapist.
While Dr. Albano recognized how difficult it is for parents to watch their child struggle, she emphasized the usefulness of mistakes in promoting learning. She insisted parents must allow their children to experience the struggle and deal with the consequences because this allows them to learn how to problem solve. She pointed to actions on the part of the parents that can help their children cope.
Actions by Parents
- Identify their own role in child’s behavior (Do they secretly enjoy having the child sleeping their bed because it makes them feel needed and important?)
- Focus on the effort made by the child in coping with anxiety rather than focusing on the outcome and praise the child’s efforts
- Talk to the child about the situation realistically
- Focus on coping with the anxiety-producing situation; talk about ways of handling the situation rather than ways they can avoid and get out of the situation
For parents struggling with this issue Dr. Albano recommended several resources in the NYMetro area including Long Island, Staten Island, New Jersey and as far as Massschusetts:
EffectiveChildTherapy.com for general information and techniques;
The Association of Behavioral Cognitive Therapists, for help finding a therapist.
In New Jersey
The Youth Anxiety and Depression Clinic at Rutgers University, directed by Brian Chu, Ph.D
The Child Anxiety Disorders Clinic at Fairleigh Dickinson University directed by Dr. Andrew Eisen
Behavior Therapy Associates, directed by Dr. Steven B. Gordon, Ph.D., ABPP
On Long Island
On Staten Island
Freedom From Fear, directed by By Mary Guardino
Sabine Wilhelm, Ph.D., The Obsessive Compulsive Disorder (OCD) and Related Disorders Program at the Massachusetts General Hospital/Harvard Medical School
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Watch for Dr. Albano’s book, coming in Spring, 2013: You and Your Anxious Child, by Anne Marie Albano and Leslie Pepper (Avery/Penguin Books).
Stacey Gill is a freelance writer, part-time blogger and an award-winning journalist who is currently working on a memoir. She writes for several hyper-local media outlets covering towns in the New York metropolitan area. Previously, she worked as a copywriter for Saks Fifth Avenue and before that as an assistant editor in the book business. She lives outside the City with her husband, two crazy kids and a pair of hermit crabs.
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