As a family therapist and psychologist, I have seen many children and adolescents struggle withanxiety. My take on treatment comes from a mixture of frameworks and evidence that I have applied, made mistakes with and had some success.
Firstly; anxiety sits within systems of behaviour and relationships. We cannot not communicate, so when a child communicates something they are worried about to a parent, there will inevitably be some kind of response and this response can become part of a relationship pattern. For instance, if my child is worried about monsters under the bed, I cannot help but have a response to that. My response becomes part of the anxiety system around her. That system can determine whether anxiety is maintained or extinguished. So when I see anxiety in a child, I also look at the systems of relationships and behaviour that are around the symptom. How do people in the family respond to anxious behaviours? How is the anxiety maintained? How is it extinguished? Who else in the family exhibits anxiety? Is there an acceptable level of anxiety in this family?
Secondly; young children cannot manage anxiety alone. It is not “their anxiety”. As with any difficulty, parents need to be in charge of how anxiety is managed. Involving parents or caregivers in the management of anxiety is critical in my opinion, and much research would support this. Even if a parent has some anxiety themselves, having them in the room means that the effects that they may have on their child re modelling or through relationships, may be mitigated directly by the therapist. (See Negreiros and Miller 2014 for a thorough discussion of the role of parenting in childhood anxiety.
Firstly; anxiety sits within systems of behaviour and relationships. We cannot not communicate, so when a child communicates something they are worried about to a parent, there will inevitably be some kind of response and this response can become part of a relationship pattern. For instance, if my child is worried about monsters under the bed, I cannot help but have a response to that. My response becomes part of the anxiety system around her. That system can determine whether anxiety is maintained or extinguished. So when I see anxiety in a child, I also look at the systems of relationships and behaviour that are around the symptom. How do people in the family respond to anxious behaviours? How is the anxiety maintained? How is it extinguished? Who else in the family exhibits anxiety? Is there an acceptable level of anxiety in this family?
Secondly; young children cannot manage anxiety alone. It is not “their anxiety”. As with any difficulty, parents need to be in charge of how anxiety is managed. Involving parents or caregivers in the management of anxiety is critical in my opinion, and much research would support this. Even if a parent has some anxiety themselves, having them in the room means that the effects that they may have on their child re modelling or through relationships, may be mitigated directly by the therapist. (See Negreiros and Miller 2014 for a thorough discussion of the role of parenting in childhood anxiety.
In Rising Tide, Sarina and I have used a cognitive behavioural therapy framework, paired with ideas from social constructionism, specifically round dominant stories - or schemas. We have stepped up the level from the Worry Bug material, to be more appropriate to this age group. We envisage this resource being used firstly at school and then going home to the family. In this way, the resource is supported by two important systems of relationship for the child. As with any therapy, the relationship is a critical part of success.
The therapist support resources for Rising Tide will be available online for free. Please use it as you see fit - it will obviously be changed by your own context, by the family and children that you see, by cultural and gender factors and many other influences. That is how it is meant to work - clinical judgement is a valid and useful part of our practice - we cannot just apply manualised treatments for example, without thought as to how the family will receive them, and how best to adjust them to suit. So, have fun with it and please, let us know how you have used it, what works and what doesn’t.
The therapist support resources for Rising Tide will be available online for free. Please use it as you see fit - it will obviously be changed by your own context, by the family and children that you see, by cultural and gender factors and many other influences. That is how it is meant to work - clinical judgement is a valid and useful part of our practice - we cannot just apply manualised treatments for example, without thought as to how the family will receive them, and how best to adjust them to suit. So, have fun with it and please, let us know how you have used it, what works and what doesn’t.
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Rising Tide and He Tai Pari will be available for purchase via our website from early December for $19.90. The web based version with english and te reo audio and professional development resources will be available in the new year.
Written by Julie Burgess-Manning. Get in touch julie@kotukucreative.co.nz
Written by Julie Burgess-Manning. Get in touch julie@kotukucreative.co.nz
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