Dr Kirsty Ross is the Senior Clinical Psychologist and Senior Lecturer at Massey University. She recently reviewed 'Rising Tide' by Sarina Dickson (Kōtuku Creative, 2016) for 'Psychology Aotearoa' Volume 9, Number 1, May 2017.
'This book beautifully sets out complex psychological processes in a way that children aged 8-12 will understand and relate to.'
This is the third book in The Worry Bug series by the Kotuku Creative group, and targets children aged 8-12 years old. It is available in English as well as in Te Reo. It is a delightful story that centres on a young ten-year-old boy (Ari) who is trying to manage some big worries. Ari lives with his parents and two sisters in a small rural town, and is having a great deal of trouble with writing, reading and spelling, which he is trying to keep a secret. The effort of trying to hide this leads him to experience physical symptoms of anxiety, negative cognitions, and feelings of shame, sadness and worry; it also results in him avoiding situations where his secret might be found out. He also avoids friends, family and his kind supportive teacher, leading to him missing out on key supports. A major event involving his beloved Koro leads to a series of events that ultimately lead to him discovering that his much-admired father and Koro also have the same difficulties, and Ari realises that sharing his problems and worries leads to him learning that they are often not as bad as he feared.
The story illustrates the five part CBT model very well, with Ari having physical, cognitive, emotional and behavioural responses to situations where his worries are triggered. His pattern of avoidance – and how it worsens the situation – is also nicely depicted, as is the loneliness of keeping his secret (and the resulting worries) to himself. The cognitive and social processes that are typical of this developmental stage are incorporated into the story in a way that I think most children this age will identify with. While the importance of family is still evident in the story, the growing desire for independence, along with an increasing awareness and emphasis of the opinions of peers that is characteristic of this age, is also included.
Rising Tide also included the therapy notes that are intended for use by teachers in schools, parents in the home, and by therapists in individual work. The therapist notes are well explained, and are designed to scaffold between home and school. They incorporate and link to competencies in the NZ curriculum so will fit in nicely with schools’ needs to demonstrate the relevance of the topics to their required teachings. The topics and tasks would be able to be delivered in a variety of settings and formats (individually as well as in groups). The activities take advantage of the cognitive and social processes of middle childhood, and mix concepts such as magical thinking with cognitive errors to create a set of tasks that will meet the needs of children across the specified age range. The emphasis for teachers and parents on managing their own emotions, and adopting and modelling the skills to children is very appropriate for this age range, and the systemic focus of identifying supports will be beneficial for all children.
The English version of the story, and the therapist notes, beautifully incorporates Maori culture, and the therapeutic notes which use the metaphor of a family Korowai (cloak) which weaves together the family values as a protective cloak is just lovely. Similarly, the idea of developing new family Kowhaiwhai builds on the idea of stories through art and that families can change their stories and commit to new ways of being.
I think this book and the resources attached to it are a wonderful addition to what we can suggest to families, schools and therapists supporting children with anxiety. If I were to offer any suggestions or constructive comments to the publishers, it would be to suggest that they highlight that the skills discussed in the therapist notes can be generalised to other emotional states, not just anxiety. When using the strategies, it would be beneficial to add in ways to encourage and teach people to calm down physical responses before they engage in cognitive strategies and accessing social supports. This is suggested in the actual story when Ari takes some deep breaths, but it would be helpful to include some specific calm breathing and relaxation techniques in the package of resources. Also, some of the language in the therapist resources is quite sophisticated – for example, ‘dominant and subjugated stories’ are terms that therapists would be very familiar with, but might be quite daunting for parents. The terms themselves are well explained; however, I would like to think that this book can be used by people with varying degrees of formal education, so I hope that some of the more ‘technical’ terms do not put people off or have them feel that they couldn’t use the strategies. Finally, the website link given on the final page of the book leads to an error message, although the resources themselves and research supporting the ideas were easy to find on The Worry Bug website, under the section “The Rising Tide”.
In conclusion, this book beautifully sets out complex psychological processes in a way that children aged 8-12 will understand and relate to. It incorporates biculturalism and key theories relevant and supported in the literature on children and anxiety – attachment theory, systems theory, narrative therapy and CBT. It also incorporates key developmental processes (both cognitive and social) in the therapeutic strategies, along with tasks that can be tailored to individual family values and beliefs. The application to both school and home would hopefully mean that children would be receiving consistent and positive messages, modelling and strategies from the key people in their lives, and if delivered in a group format, would also involve social support from peers. I will be recommending this book to people wanting to support and assist with children with mild levels of anxiety; those with distress at a higher level would benefit from having therapist coaching of the children and their parents, in order to successfully implement the strategies for children like Ari.