How can I help my daugh­ter who is al­ways anx­ious?

The Irish Times - Tuesday - Health - - Family - Send your queries to health@irish­times.com

Since about the age of six, my daugh­ter (who is now eight) has be­come a bit of a wor­rier. She can be fear­ful about lots of dif­fer­ent things, such as go­ing out to a party (for ex­am­ple, be­cause none of her friends will be there) or when there is bad news on the telly. When the news cov­ered fires in Por­tu­gal re­cently, she be­came re­ally wor­ried that these could start in Ire­land.

Re­cently she has be­come wor­ried about my wife go­ing out in the evening in case some­thing “bad” hap­pens to us. My wife and I try to re­as­sure her each time she is fear­ful, and some­times we can get through to her, but then in a cou­ple of days she has a new fear. We want to get to the bot­tom of what is caus­ing her to be wor­ried like this. We want to get to the root of the prob­lem rather than just treat the symp­toms. We have asked her what has made her worry like this all the time, and she says she does not know.

We were won­der­ing about tak­ing her to get pro­fes­sional ther­apy. Who would you rec­om­mend? Lots of the web­sites rec­om­mend CBT for deal­ing with anx­i­ety. One of our friends took their son to a play ther­a­pist, and this seemed to help. We were won­der­ing about tak­ing our daugh­ter to the same per­son. Do you think play ther­apy will help her or should we go some­where else?

AAnx­i­ety and worry are very com­mon child­hood prob­lems. In­deed, there are many chil­dren like your daugh­ter who have a ten­dency to worry about ev­ery­thing. Just as as you think you have re­as­sured them about one worry, an­other can ap­pear and you have to start again. Anx­ious chil­dren re­quire a lot of re­as­sur­ance and pa­tience from their par­ents. Over time the goal is to teach them skills of self-man­ag­ing their anx­i­ety and worry.

Al­though there might be trig­gers for cer­tain wor­ries – such as bad news on the TV, in your daugh­ter’s sit­u­a­tion – fre­quently there is no one “root cause” for their anx­i­ety that can be clearly iden­ti­fied. While some chil­dren have a sen­si­tive per­son­al­ity that makes them more likely to be anx­ious, their pat­tern of worry and anx­i­ety can be best thought of as ha­bit­ual ways of think­ing that de­velop over time. Like all habits, there is a lot you can do to break this pat­tern of wor­ry­ing, and to de­velop more con­struc­tive ways of think­ing through it takes time and pa­tience.

Help­ing your daugh­ter

In help­ing your daugh­ter, con­tinue to be re­as­sur­ing and pa­tient. Lis­ten to each of her wor­ries and ac­knowl­edge her feel­ings – feel­ing un­der­stood will re­lieve a lot her dis­tress and help her cope. It is im­por­tant not to just see her ten­dency to worry as a prob­lem, but rather to take time to ap­pre­ci­ate and chan­nel the pos­i­tive strengths be­hind it. For ex­am­ple, you might say to her: “You have such a great imag­i­na­tion. The prob­lem is that you just imag­ine ev­ery­thing that can go wrong. I won­der what it would be like if you were to imag­ine things go­ing well in­stead?”

Over time it is im­por­tant to teach your daugh­ter strate­gies on how to man­age her worry and anx­i­ety, such as learn­ing to dis­tract her­self when she starts to worry, or chal­leng­ing the think­ing that un­der­pins her wor­ries, or learn­ing to prob­lem-solve when she has a spe­cific worry. For ex­am­ple, if she is wor­ried about go­ing out to a party, you can talk through how she might man­age this sit­u­a­tion step by step. You can en­cour­age her to ex­press her fears about some­thing that might hap­pen (such as that no one will talk to her at a party) and then ex­plore so­lu­tions to each of these prob­lems (for ex­am­ple, iden­ti­fy­ing some­one she knows who she can ap­proach, and/or re­hears­ing what she might say). In ad­di­tion, help­ing your daugh­ter learn re­lax­ation strate­gies ( such as count­ing breaths or vi­su­al­i­sa­tion or mindfulness) will be ben­e­fi­cial and give her strate­gies that she can use when wor­ries take over. Last year in The Ir­ish Times I wrote a six-part se­ries on all the dif­fer­ent strate­gies par­ents can use to help anx­ious chil­dren; for more de­tailed in­for­ma­tion, you can ac­cess these at irish­times.com

Pick­ing the right ther­apy for your daugh­ter

Pro­fes­sional ther­apy can be of ben­e­fit in help­ing chil­dren over­come anx­i­ety. Play ther­apy can be par­tic­u­larly help­ful in build­ing a child’s con­fi­dence and help­ing them un­der­stand and ex­press their feel­ings. With re­spect to anx­i­ety, there is more ev­i­dence for skills-fo­cused mod­els such as cog­ni­tive be­havioural ther­apy (CBT) that con­cen­trate on help­ing chil­dren de­velop new think­ing and be­hav­iours in re­sponse to their anx­i­ety.

How­ever, the most cru­cial fac­tor in suc­cess­ful ther­apy is pick­ing the right ther­a­pist and in par­tic­u­lar one who is child-cen­tred and who knows how to com­mu­ni­cate with chil­dren. More im­por­tant than choos­ing the “right” model is choos­ing a ther­a­pist who your daugh­ter is com­fort­able with and who is able to en­gage and mo­ti­vate her. In ad­di­tion, most child ther­a­pists are eclec­tic in how they ap­proach their work, draw­ing from a range of mod­els as they try to help in­di­vid­ual chil­dren. For ex­am­ple, a skilled play ther­a­pist could also use many CBT ideas in their ap­proach as they sup­port a child in man­ag­ing anx­i­ety.

Fi­nally, in pick­ing the right ther­a­pist for your daugh­ter, pick a per­son who you can work with as well. The best child ther­a­pists also know how to sup­port par­ents and to as­sist them in deal­ing with the sit­u­a­tion at home. To max­imise progress, the ideas prac­tised in the ther­apy should also be ones you can ap­ply at home with your daugh­ter. Be­fore tak­ing your daugh­ter to a ther­a­pist, I would rec­om­mend meet­ing them your­self first and tak­ing time to judge whether they could be help­ful to both of you.

Dr John Sharry is a so­cial worker and psy­chother­a­pist and code­vel­oper of the Par­ents Plus pro­grammes. His new book,

Bring­ing up Happy Con­fi­dent Chil­dren, is now avail­able. so­lu­tiontalk.ie

PHO­TO­GRAPH: IS­TOCK

The best child ther­a­pists also know how to sup­port par­ents and to as­sist them in deal­ing with the sit­u­a­tion at home.

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