Anxiety in Children

Anxiety

This article is focusing on being aware of whether your child might be anxious and how children’s worries can sometimes keep them awake.

There is a lot of information available on children and anxiety and many useful strategies that can be used to support your children.  Anxiety can manifest as a fear of something specific, fear in certain situations or a general sense of feeling unsafe. We should always firstly assess whether there is a rational reason for the fear and to try and work out whether a child’s withdrawal for example is due to experiencing low mood or whether it is clear that it is anxiety. Whilst very anxious children and teenagers may need assessment or support from a child psychologist, there are a number of useful techniques that parents can use to help their children identify and work with anxiety and build up their confidence and sense of resilience. These include helping children recognise when they are feeling anxious and adopting strategies to help them cope.  Useful techniques include social stories, using feelings faces, worry boxes/journals (the focus of this article), transitional or special objects and using feelings thermometers, to name a few. When children experience worry, it can interfere with how they feel, their perception of themselves, their play, their relationships with others, how they manage at school and their sleep.

Signs of worry include:

  • Feeling nervous, sad or angry on a regular basis
  • Not sleeping or having difficulty falling/staying asleep
  • Perfectionism and being overly concerned about the opinion of others
  • Having irrational fears about their safety or the safety of others.

Having a child who worries does not mean your child has an anxiety disorder. We live in a stressful world, and children internalize the stress around them while trying to cope with their own experiences and worries about their world.  Sometimes simple strategies can relieve them of some of this stress.  It is however important to note when their difficulties are more entrenched and when you may need more specialist guidance and support to help them.

For children who are experiencing a mild degree of worry, it is useful to encourage them to share their feelings and concerns with you.  Young children lack the cognitive ability to effectively cope with excessive worries independently, but they do respond well to concrete strategies to help them to deal with their worries.  Having a way of putting their feelings into words diminishes the power that the anxiety has over them, and helps them to feel understood and provides them with a sense of relief.

One of the techniques to do this is by using a ‘worry box’.  This is a simple yet often effective strategy.  The Worry Box helps children put their worries in a special place (where parents can keep the worries for them) so that they can be relieved of those worries – useful during the day but also at night for children who struggle to sleep due to their worries.

Like adults, young children tend to do most of their worrying at night. They are busy and active during the day, but when the lights are off, their mind can wander and stress starts to creep in. This can lead to difficulty falling asleep and nightmares, which can lead to them waking frequently during the night.  By using the Worry Box at night, children have a chance to talk about and put away their worries so that they can get a restful sleep. Sometimes young children just need to know that someone can handle their worries for them (without becoming overwhelmed) when life becomes stressful. This simple strategy will give your child the chance to put away their worries at night and sleep a little easier.

Making a worry box:

Any box will do and an old shoe box and lid is ideal.  Cover the box and lid with wrapping paper (so that the lid can still be removed to empty the box) and make a slot in it so that the child can post letters into it.  Encourage your child to help make and decorate the box so that they feel it is their special creation.  Leave it in a convenient place for your child to access it.

Introducing the worry box:

Discuss the worry box with your child and explain that it is their own special place to put their worries every night, and that you will look after the worries for them.  In order to try and encourage a sense of control over their worries, let them help you choose a place in your room, not theirs, where you can keep the box safe for them.  Make sure that they do not keep it in their room, which is their safe space.

Children who worry a lot during the day can be encouraged to write down any worries that they have and post it in the box (younger children can draw their worries or have you write them down for them).

Using the worry box:

Once a day when you have enough time to explore it (for children who have trouble sleeping due to excessive worrying it may be useful to do it before their bedtime story, ensuring you have at least ten minutes to devote to it), open the box and review the worries.  Some children will want to write notes as a worry comes up, but for others it may work better to wait until ‘worry box time’ and take time to talk about their worries from the day.  If they are not yet able to write it themselves, help them to write each worry on a separate piece of note paper and post it in the box one at a time.  Encourage your child to talk about the worry, how they are feeling and help to empower them by discussing what they can do and strategies to cope with their worry.  Keep the worries in the box for you to ‘look after’ for them, so that they can have a night that is worry free.

The process of writing down worries helps the child to have a clearer idea of what they are worried about. It makes it easier for the child to talk about their worries later, and helps to give their anxiety a more manageable form.  Talking through what has been placed in the box on a regular basis helps the child to know that they will have a chance to talk about their worries, which then often free them up from thinking about them constantly because they know they will be discussed.  The worry box also helps children to name what is bothering them to an adult and makes the process of sharing initial worries a lot easier for them.  They also learn that adults are interested in their worries, no matter how trivial it seems to us, and they learn that it is ‘safe’ to share the worry with adults. Over time, your child may begin to learn better ways to manage his or her worries and to recognise that not all worries are overwhelming.  It is useful to end your discussion with visualising a nice, safe and relaxing place that they can imagine themselves in and use all five senses to imagine what it would be like to be there.  This helps to create a relaxing place to be before bedtime.

Worry Journal

This technique is suitable from age 3-10 and as children get much older and can express themselves well in writing, the more grown up ‘worry journal’ can be used.  Have your child choose and, if they want to, decorate a journal.  Each night encourage them to note down their top three worries/stressors for the day, and then to write down three good things that have happened.  The three good things can be as small as something that they enjoyed doing to something that they were really proud of.  The point is for them to express their stress and then find some positive thoughts to ease them to sleep. Older children can do this independently, and this tends to give them a sense of control over their anxious thoughts.

Small print:

  • Anxiety is a very complex issue.  I have tried to make a succinct summary of one technique for addressing one aspect of it.  This information should be read with this in mind.
  • Make sure that you give your child a lot of praise and attention for other areas of their life as it is important that they do not start to rely on ‘worry time’ as attention time as there will then be a vested interest for them to continue to have many worries.
  • In a small proportion of children, the worry box may exacerbate their anxiety.  If you are concerned that your child is extremely anxious and you worry that this may be the case, it may be useful to talk this through with a qualified practitioner prior to introducing it.
  • Some children will require other support such as the use of feeling (anxiety) thermometers, social stories and visualisation to help them to address their worries.
  • If you are very concerned, it is important to take your child to your GP or consult with a psychologist for further support.
  • It is important to note that anxiety can overlap with other difficulties; therefore if you are in doubt, this approach is not a substitute for talking to an appropriate mental health professional.
  • The worry box and worry journal work effectively when used consistently. If you are not able to consistently find 5-10 minutes per night to do this, then it might not be the right technique for you.

Copyright Leanne Cowan (KindleKids) 2013 (c)

 

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