Foreword: When to Get Help and What to Expect

By: Kristin Abbondate, Pd.D. | Boys Town Dialectical Behavioral Therapy (DBT) Team

As a child psychologist, I spend at least part of my day discussing anxiety with children, adolescents, and their families. Anxiety effects everyone; however, for some people, anxiety can cause significant impairment academically, socially, emotionally, and behaviorally. For those families, seeking professional help can be useful.

  Cause for concern?

• Your child or teen is unable to complete NEEDED or WANTED activities due to anxiety (e.g. school, driving, sports, social activities, etc.)
• Significant changes in behaviors (e.g. mood, sleep, eating habits, grades, social habits)
• Another adult has noticed concerns related to anxiety (e.g. difficulty asking questions in class, not interacting with peers in social situations, refusal to complete certain tasks, etc.)
• Sometimes anxiety can look like defiance, especially when a child has a significant amount of anxiety. Defiance may be a way of avoiding anxiety provoking situations. A professional can help you decide if noncompliance is due to anxiety as well as provide helpful strategies.
• As a parent, if you have concerns about your child’s anxiety level, it never hurts to ask a professional.

  What to expect?

• Typically, your first appointment will include you and/or your child and will consist of an interview. The goal is to address current concerns (e.g. problem, impact on life, goals, etc.) and get a history of your child (e.g. medical, school, social, behavior, etc.).
• The aim is to identify goals that will be helpful for your child and family.
• The psychologist will also give you and your child education about anxiety and helpful strategies.
• Don’t be scared to ask questions or give information. Some parents find it helpful to make notes or write down questions they have before the appointment.

  If you have not had the experience of seeing a psychologist, here is an example of child and mother’s experience seeking professional help.

The Four Things I Learned Parenting My Anxious Child

By: Boys Town Contributor

My daughter had been a worrier her whole life, but after she turned 7, her ongoing tantrums and defiance became even more frequent. The moment we realized we needed help was near the end of a family vacation. We had just ordered food from a small quick-serve restaurant and sat down at a table near the back, she refused to sit with us. She wanted to sit by herself across the restaurant. This turned into a argument, which turned into a full on embarrassing situation.

This defiance was becoming more and more frequent and I had no clue where it was coming from or why it would start.

At the restaurant, I took a deep breath, swallowed my anger and embarrassment and went to confront her. I told her she needed to explain to me calmly what her reasoning was — because, at the moment, her behavior was unacceptable and she was about to get herself into a great deal of trouble. She looked at me and started to tear up. “What if there is a fire?” she asked. “If we sit all the way back there, we will never be able to get out!” I felt. Horrible.

I made an appointment with a psychologist at Boys Town. We only met once a month, not as often as I imagined therapy sessions. However, what I learned from our meetings has enabled me to parent my anxious child more successfully, which has been immensely important for her, for us and for our entire family.

Although I learned a great deal, I can sum up my epiphanies into four key learnings:

What Works for One Child May Not Work for Another

I was a worrisome child myself; I could get her through this. I knew what to say and how to help her . . . right?

As a parent, you want to have all of the answers, and you want to be able to help your child. But what works for one person may not work for the next.

An expert has seen many anxious children, and they have developed many effective solutions. They have a much bigger pool to draw from. I was always able to reason myself out of a fear or worry; my daughter, however, cannot.

Everyone Is Anxious; You Are Not Weird or Crazy or Alone

This was a learning curve for my daughter. For a 7–year-old, telling your parents that you won’t stay in your room for timeout or bedtime because you are worried the house will start on fire and you won’t get out is embarrassing. My daughter knows that some of her fears are irrational, and that makes them embarrassing to talk about.

Meeting with an expert helped her see that everyone sometimes has irrational fears, but the fact that they are impairing her normal life means that it’s important for her to talk about them and come up with strategies to deal with them. My daughter’s realization of this ultimately turned a tantrum into a talk.

It’s Good to Set Aside Time to Talk About Your Feelings

I have three kids. WE ARE BUSY. Sports, school, activities, work… sometimes I feel like we never sit still. Having an hour to talk with my daughter about her life, her feelings, her worries and her fears changed our relationship and altered our line of communication. I thought I was the mom whose kids told her everything. I knew exactly what was going on. WRONG. When a child has other siblings and a busy schedule, it’s really hard for them to interrupt and say, “At the birthday party last month, when I was afraid to stay the night, all of the girls made fun of me, and I still feel bad about it and it makes me really sad, and I’ve been refusing to go to social events because of this.”

Hearing my daughter say that to her psychologist not only broke my heart, but it also opened my eyes to the fact that maybe she doesn’t tell me simply because she doesn’t have a chance to get a word in. I now make it a point to spend at least an hour of one-on-one time with each of my kids once a week. We don’t always talk feelings, but we do talk one on one, and I have learned so much more about the wonderful people they are.

It’s OK to Seek Help

I was so afraid that reaching out and making an appointment with a psychologist would immediately label my child. Silly, I know. A large, neon-lit sign did not fall from the sky and hang above her head everywhere she went. I was worried that her school would label her and friends would label her. But we just didn’t make a big deal out it. And guess what? Neither did she. Neither did the school. Neither did her friends. It was my own fear, my own interpretation of what might happen. When I look back, I can’t imagine my child still struggling with anxiety while she’s going through puberty AND entering junior high or high school. I’m so glad I reached out for help when I did.

Anxiety is difficult for kids, but it’s also challenging for parents and, really, the entire family. If you think your child is struggling, talk to someone. You will wish you did it sooner.