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Top Tips for a Child Who Has Anxiety by Clinical Psychologist Dr. Susan Wimshurst

calm childMy son Oliver, 8, can be a worrier like me so I’ll be taking the advice of Dr. Susan Wimshurst below, a Clinical Psychologist who specialises in working with children and adolescents with mental health issues.

She has 13 years experience working for the NHS and also works privately for Everlief, a child psychology clinic in West Wycombe.

Dr. Wimshurst is one of authors of Brighter Futures: A Parents’ Guide to Raising Happy, Confident Children in The Primary School Years. This book tackles some of the challenges that face children between 4-11 years old in the modern world. She also has two boys of her own at primary school.

Dr. Wimshurst’s chapter focuses on anxiety and this is an area she specialises in. Children are increasingly suffering with worries and anxieties about a whole range of issues and anxiety is the most common problem reported by children of all ages.

Here, Dr. Wimshurst shares her top tips for supporting a child with anxiety:

As a parent, you know your child better than anybody else and so you are in a good position to be able to notice and help your child act on their worries before the worries get too big and start to take control. Explain to your child that anxiety is a normal, healthy emotion that we all feel throughout our lives. We all need a certain amount of anxiety to motivate us but sometimes the worries can get out of control and feel like they are bossing us around. This is when we need to take action and explain you will be working together with your child to ‘beat’ the worries.

A good place to start is helping your child understand and ‘tune in’ to their own experiences of the fight or flight response (our primitive defense system which is triggered when we feel a strong emotion like fear or anger) and describe what they actually feel inside their bodies. You can do this by drawing an outline of a body on a piece of paper (a gingerbread man style outline is fine!) Then ask your child to use colours and arrows to illustrate where in their body they feel different sensations. As they become more aware of the symptoms of anxiety they can see them for what they really are.

Once your child has recognized how anxiety affects their own bodies they are much better placed to identify times that they feel more anxious (they might not have made the association between that, ‘funny feeling in their tummy’ and school tests for example). To help identify possible triggers, it can be useful to keep a Mood Diary for a couple of weeks to help make connections between what happened that day and your child’s mood/level of worry.

It is helpful for both you and your child to be able to measure your child’s level of worry and this can be done using rating scales. Being able to distinguish different levels of worry is important not only to recognise that anxiety levels change depending on the situation and how long you have been in the situation, but also to monitor success over time. Using a rating scale, encourage your child to give their anxiety ratings (0-10) in different situations and at the beginning, middle and end of certain situations. This helps children to see that often our anxiety may start high but the longer we stay with the situation, it starts to come down naturally.

Help your child explore their thoughts and beliefs. Feelings are strongly connected to how we think about things. Feelings of worry often go hand in hand with thoughts about danger and threat. Encourage your child to tune into their thoughts, jot them down, and then you can support them to gently challenge their thoughts and look for ‘evidence’ that goes against their worry.

Avoid avoidance! It is important to help your child gradually face their fears and stay with the situation long enough to see that their anxiety levels come down naturally rather than giving into the urge to escape and avoid. I know this is easier said than done, but the best way to do this is to develop a graded exposure hierarchy or stepladder approach, which breaks the fear down into small steps. It is important to also give rewards to your child for each level successfully completed.

Encourage relaxation – controlled breathing is a quick way to reduce the ‘fight or flight’ response. The key is to breathe in through your nose and out through your mouth and by placing one hand on their tummy, they can watch their hand rise slightly as they breathe in. This shows they are breathing correctly from their diaphragm, rather than chest breathing which is what we tend to do when stressed.

We know that children learn by observing and imitation and therefore the behaviour you model as a parent is another important factor. If a parent deals with anxiety by avoiding situations then it is fair to expect the child to copy this and internalize the view that this is the best way to deal with fear. Model how you problem solve and manage anxiety in a positive, calm way.

It is important not to overlook the importance of the basics such as sleep, diet and exercise. Exercise is a very effective way to improve mental health and can have a profoundly positive effect on anxiety (amongst other mental health concerns). Diet – ensuring your child has three balanced meals a day is another helpful way to limit the power of anxiety. Sleep Getting enough sleep is important for both you as the parent and your child who may have heightened worries.

Worries and fears will not go away over night and it really is a case of being consistent and persevering. It can be useful to review your strategies every 6-8 weeks and reflect on successes/challenges.

More details on anxiety and other challenges facing children can be found in the Brighter Futures book on Amazon.

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