What is anxiety?
Anxiety is an emotion which causes children, teens, and adults to feel an overwhelming sense of fear that something terrible will happen in the future. These feelings can occur even when a child is safe and has not been hurt or threatened. Although anxiety can be experienced in many different ways, there are three basic types of symptoms: (1) physical discomfort, (2) negative thoughts, and (3) negative changes in behavior.
First, physical symptoms can include an upset stomach, headache, and dizziness. Essentially, these physical changes reflect the triggering of a “fight-or-flight” response even in the absence of an actual threat.
Second, a child with anxiety will also have negative thoughts or worries. These worries typically include fears of being harmed, embarrassed, illness, or loss. Worried thoughts cause children to believe that something terrible will happen despite reassurances and evidence that they are safe.
Finally, these persistent fears often lead to behavioral changes such as avoiding school, animals, or doctor’s appointments. In summary, anxiety can be very debilitating and creates a high level of distress which reduces a child’s ability to function in his or her normal, daily activities.
What is Cognitive Behavioral Therapy (CBT)?
Cognitive Behavioral Therapy (CBT) is an evidence-based approach that helps children (and their parents) manage the symptoms of anxiety. CBT is a practical approach that provides children with skills and strategies to reduce their symptoms. Through a series of therapy sessions, children learn to:
- Identify “triggers” to anxiety
- Remain physically calm by using relaxation techniques
- Develop positive ways of thinking to replace or minimize negative thoughts and worries
- Practice facing feared situations in a systematic and supported manner
- Problem-solve around situations that are challenging
CBT is provided within a safe, supportive, and respectful environment in which the child is viewed as a “whole person,” rather than a collection of symptoms. The child’s developmental history, family environment, academic challenges, and medical conditions are all taken into consideration when developing a behavioral treatment plan. Within this framework, therapy is tailored to meet the needs of each individual child. Additionally, CBT is a collaborative approach in which parents and children work together to recognize and manage the symptoms of anxiety effectively. Parents are considered to be active partners in the treatment process and much of the therapeutic work occurs at home (outside of the weekly clinical sessions).
What happens in a typical therapy session?
After the initial parent consultation session, and a subsequent rapport-building session with the child, therapy sessions typically unfold as follows:
I will meet with you and your child together at the beginning of the session to review the prior week. After this, you will wait in the waiting room while I work with your child individually to develop skills and strategies. A plan for the upcoming week will be discussed and developed. This is often followed by a fun activity such as drawing or playing a game. Finally, during the last several minutes of the meeting, you will rejoin us and your child and I will explain the new skill and the plan for the upcoming week. If needed, the plan will be refined so that you and your child can follow the behavioral plan successfully during the upcoming week. The behavioral plan usually involves keeping track of progress in some way so that any changes in treatment are informed by data collected at home or school.
Photo (above) by Christine S. Johnson