Treatment of Anxiety for Children and Teens

Anxiety in children and teens is a common concern and can manifest in a variety of ways, including excessive worry, fears, avoidance behaviors, and physical symptoms (e.g., stomachaches, headaches). Fortunately, anxiety can be effectively managed and treated through psychological interventions. The most common and evidence-based treatments include Exposure Therapy.

1. Exposure Therapy

Exposure Therapy involves gradually and systematically exposing a child or teen to the situations, places, or objects that trigger their anxiety. The goal is to help them confront their fears in a safe, controlled way so that over time, they learn that their anxiety diminishes as they face feared situations. Relearning is also important; through exposures, children and teens learn that:

  • What they’re worried about might not happen.

  • If it does happen, it might happen less often than worries tell them it will.

  • They can handle anxiety and stress.

How Exposure Therapy Works:

  • Gradual Exposure: The therapist works with the child to create a hierarchy of feared situations, from least anxiety-provoking to most anxiety-provoking. For example, a child with social anxiety might start by imagining speaking to a peer, then gradually move up to making small talk with a classmate, and finally, attending a party.

  • Repetition: Exposure to the feared situation is repeated, in different situations and with different people, until the child’s anxiety decreases. Over time, this process teaches the child that they can handle their anxiety and that the feared situation is often less dangerous than anticipated.

Benefits of Exposure Therapy:

  • Reduces avoidance behavior, which makes anxiety worse.

  • Increases confidence and self-efficacy in facing difficult situations.

  • Effective for specific phobias, social anxiety, health anxiety, generalized anxiety, and separation anxiety.

2. Cognitive Behavioral Therapy (CBT)

A secondary component of anxiety treatment involves focusing on identifying and changing unhelpful thinking patterns, behaviors, and emotional responses that contribute to anxiety. This component is not as essential as exposure, which is the main tenet of evidence-based anxiety treatment for children and teens.

Key Components of CBT for Anxiety:

  • Cognitive Restructuring: Helping children and teens identify and challenge distorted or irrational thoughts that fuel anxiety. For example, if a child is afraid of failing a test, they might be taught to identify the thought "I’m going to fail no matter what I do" and replace it with more balanced thinking like, "I might feel nervous, but I can study and do my best."

Benefits of CBT:

  • Helps children understand the connection between thoughts, feelings, and behaviors.

  • Reduces rumination and "what if" thinking that can fuel anxiety.

3. Parental Involvement in Treatment

Parental involvement is a crucial aspect of treating anxiety in children and teens. Anxiety often affects the whole family, and parents play an active role in the treatment process.

How Parents Can Help:

  • Modeling Calm Behavior: Parents can demonstrate how to remain calm during stressful situations and use coping strategies in front of their child.

  • Reinforcing Positive Behavior: Parents can help reinforce progress made in therapy, praising their child for facing fears and using coping strategies.

  • Collaborative Approach: Parents and therapists can work together to ensure that techniques learned in therapy are practiced at home and that the family environment supports the child's emotional growth.

  • Managing Avoidance: While it’s natural to want to protect a child from anxiety-provoking situations, parents may need to be educated on how to gradually allow their child to face feared situations, rather than inadvertently reinforcing avoidance behaviors.

Conclusion:

Psychological treatments for anxiety in children and teens, particularly Exposure Therapy with Parental Involvement, have been shown to be highly effective. These therapies help children and adolescents develop skills to recognize and challenge their anxious thoughts, face their fears gradually, and manage the physical symptoms of anxiety. The involvement of parents, along with a tailored treatment plan, can significantly improve outcomes and empower children to lead more confident and lives free of problematic anxiety.

If you think your child or teen may be struggling with problematic anxiety, seeking the help of a child psychologist, such as Dr. Bastien, trained in these gold-standard approaches can be a transformative step toward improving their well-being.