Building confidence and managing anxiety in your child Grace West- - - PowerPoint PPT Presentation

Grace West-Masters, Children’s Wellbeing Practitioner Katie McDonnell, Children’s Wellbeing Practitioner Islington CAMHS 8th June 2018

Building confidence and managing anxiety in your child

Aims of the session

 Explain about anxiety in children  Explain about different factors that lead to the

development of anxiety in children

 Help you think a bit about things you can do as

parents to manage anxiety and build confidence in children

What is anxiety?

Anxiety in your child

 How does their anxiety show in their behaviour?

What do they do?

 What are their thoughts and worries?  How does it show itself physically in their bodies?

ANXIETY VIDEO

What is anxiety?

• Anxiety is a normal emotion, and in the right amounts it can be useful
• Anxiety has three characteristics:
• Physical sensations in the body



Associated with adrenalin - preparing the body for action



E.g. sweating, heart beating faster, trembling

• Anxious thoughts



Over-estimate “danger”; underestimate ability to cope



“Worry” – similar worries exist in “clinical” and “non-clinical” populations (e.g. school, health, personal harm, friendships)

• Anxious behaviour



Behaviour aimed at helping the child anticipate and/or avoid future danger, e.g. looking out for danger (hypervigilance), avoiding worrying situations N.B. Anxiety occurs in children AND parents!!!

Fears and worries are normal and tend to link in with development (Moore & Carr, 2000)

Age Developmental stage Fears and worries 0-6 months Sensory Strong sensory stimuli (e.g. loud noises); loss of support 6-12 months Sensori-motor: cause and effect; object- constancy Strangers; separation from care givers 2-4 years Pre-operational thinking: imagination, but limited distinction between fantasy and reality Imaginary creatures; potential burglars; the dark 5-7 years Concrete operational thinking: Concrete, logical thinking Natural disasters; injury/illness/death; animals; media-based fears 8-11 years Self esteem based on academic and athletic abilities Poor academic and athletic performance 12-18 years Formal operational thinking: meta-thinking and anticipation of future dangers. Self esteem based on peer relationships Peer rejection; world issues

Books to help you talk to children about death and dying:

 Michael Rosen -The Sad Book  Oliver Jeffers - Heart in a Bottle  Judith Kerr - Goodbye Mog  Marge Heegaard - When someone very special dies  Susan Varley - Badger’s parting gifts  Doris Stickney - Water Bugs and Dragonflies  Also look at the Winston’s Wish website

How can we work out whether a child’s anxiety has become “a problem” ?

Things to consider:

 When did the symptoms develop: are they a “normal” response to

something that’s happening in their lives, e.g. starting school

 How strong is their worry? Is it becoming hard for them/you to manage?  Is the anxiety stopping them from doing what they want to/should be

doing?

 In their social life (causing problems with friendships)  Academically (stopping them from doing as well as they should be)  In their mood (are they miserable/low as a result?)

 Is their anxiety stopping you from doing what you want to/should be

doing? e.g. going out/to work

Different types of anxiety problems in children

• Generalised anxiety – “a bit of a worrier”
• Anxiety in social situations
• Anxiety about being apart from parents/carers
• Phobias
• Panic attacks
• Obsessive thoughts and behaviours
• Post traumatic stress disorder

Models of the development of childhood anxiety

People have done a lot of research looking at different factors that influence the development of anxiety in children

 Things that cause it to develop in the first place  Things that keep it going  How these factors link together

e.g. Rapee (2001); Hudson and Rapee (2004); Murray, Creswell and Cooper (2008)

Understanding anxiety in children and parents

 We are designed by evolution to protect our

children!!

 If our children seem vulnerable to us, we will be on

the look out for signs that they are in danger

 We will step in to protect them at all costs  This has advantages and disadvantages ……

Things that tend to keep anxiety going:

There are a number of common maintenance cycles in anxiety:

 things that children do to look after/protect

themselves

 and things other people do to try and

help/protect them

Things that might keep a child’s anxiety going:

Genes/ temperament Learning by example Learning from

• ther people’s

reactions Coping experiences Life events ANXIETY

Things that might cause a child to develop anxiety:

• Anxious thinking: notice / remember things

that fit in with their worries; overestimate danger; underestimate coping

• Misinterpret physical symptoms of

anxiety: “something bad is happening”;

• Anxious behaviour: avoidance; “safety

behaviours”; seek reassurance from others

Things children do: Things others do:

• Demonstrate anxious behaviour
• React to the child in an anxious way
• Become very involved and protective

– maybe too much?

• Reassure them – maybe too much?
• Don’t encourage them to try/do

things

Containment as children grow …

 All children feel anxious at times – at different ages they struggle

with different anxieties.

 Sometimes these anxieties connect to life experiences; other times

they come from worries inside them that they might not recognise

• r understand.

 Sometimes there is an obvious connection between their worry and

anxious behaviour; other times the connection isn’t as clear ….

 Your job as parents is to recognise that they are struggling and try

to understand what’s going on for them. This can make them feel less alone with their difficulties; and sometimes feel more able to do the things they are worried about.

Strategies to manage anxiety and increase confidence

What can parents do to manage anxiety and build confidence in their children?

 Be aware of your own anxiety responses, and those of

• thers around them

 Try and get them on board with standing up to their

anxiety: what is their anxiety stopping them from doing? What would they like to be able to do that they can’t do at the moment?

 Physical symptoms of anxiety: teach them how and

why these physical sensations happen; explain that they are “normal” (even if they’re not pleasant); and learn ways to manage them e.g. relaxation

Strategies to manage anxiety and build confidence

 Working with anxious thoughts: “catch” them; take a

step back from them and think “are these worries realistic? Might there be another way of looking at things?”

 Learn ways of coping with worries that aren’t worth

worrying about: “it’s one of those annoying worries again”, and distract themselves

 Problem-solve situations that really might be difficult –

how will they cope? Who else can help them out?

Challenging negative thoughts THINK LIKE A JUDGE

Evidence for this thought



Someone in the family has died



People die



Bad things happen in the world



Sometimes I’m not with them so I don’t know if they’re ok

Rate e truth th of s stateme tement nt 0-10 100% 0%

70%

Thought on trial

“I worry something bad will happen to my parents”

Evidence thought might not be 100% true



My parents are still alive and well



They are healthy



They are still young



If I separate from them, they always come back



They are able to look after themselves



They can call for help if they are in trouble

Closing summary:

Although it is possible for bad things to happen to people, and people do die. My parents are young, fit and healthy, they always come back to me after separating and are able to know if they are unwell/in trouble and call for help.

Revie view w truth th of s stat ateme ement nt 0-100% 100%

30%

Key principles for building independence

 Be confident in your child – and let them know you are

confident

 Show your child how to be independent and do things for

themselves

 Encourage them to have an internal voice that says “have a go

– I can do this”

 Allow and encourage them to be independent rather than

jumping in and doing things for them

 Be tolerant of and respect their struggle, rather than criticising

them

 Slowly build up what your child can do  Give your child choices, rather than choosing for them

Encourage them to do some new things by themselves

Usual age Skill 6+ Choosing own clothes, dressing self Tying shoes 7+ Taking a bath independently Brushing teeth or combing hair without help 8+ Putting dirty clothes in the washing basket 9+ Making breakfast or a packed lunch Packing bag for school 10+ Choosing own haircut/style 11+ Getting up in the morning without a reminder (using an alarm) Being responsible for own bedroom (e.g. tidiness, decorations) 12+ Arrange own transport e.g. bike, bus

If your child gets anxious…

 Try and manage your own anxious behaviour  Model calm and coping behaviour  Don’t keep reassuring them. It’s better to help them

earn how to manage their own worry

 Don’t collude with them avoiding the thing they’re

worried about. It’s better to support them in gradually facing their fear and learning to solve problems

 Do promote “brave” behaviour, where your child stands

up to anxiety and “has a go” at doing something:

 Pay attention to it  Give clear and specific praise for it  Model brave behaviour to your child  Allow and encourage independence

What strategies do you use already use to calm down your child when they’re anxious?

Try things out with your child

Count back from 20 in 2s Imagine a big red STOP sign and stop your/their

worries

Describe something you can see in detail Spell the names of your family Make a time of the day to think about your worries or

a time to write in a worry book

Try mindfulness

Mindfulness

 Present moment  Non-judgemental: aims to creative distance between

thoughts and our cognitive reaction to them

 Practical skill  Wide evidence base

 increased sensory awareness  greater cognitive control  enhanced regulation of emotions  acceptance of transient thoughts and feelings  the capacity to regulate attention

Deep breathing exercise

Useful reading

 Creswell, C. and Willetts, L (2010). Overcoming

your child’s fears and worries: A guide for parents using cognitive behavioural techniques.

 Sitting still like a frog: Mindfulness Exercises for

Kids (and Their Parents)- Eline Snel

 Apps: HeadSpace, Smiling Mind, Sleep Meditations

for Kids, My First Yoga

 Superhero's get anxious too

A N Y Q U E S T I O N S ?

Thank you for coming.