HealthFor Parents Who Are Anxious About Their Children's Anxieties: Strategies for What...

For Parents Who Are Anxious About Their Children’s Anxieties: Strategies for What to Do—and What Not to Do

Mark’s son, Billy, struggles with social anxiety disorder (SAD).1 Billy experiences fear and anxiety in social situations and frequently worries that others are negatively judging and evaluating him. He often avoids social situations, instead choosing to keep to himself on the playground at school or staying at home on the weekend. Because social situations stress out Billy, Mark goes to great lengths to find things to do with him that do not involve being around others, such as watching movies at home.

Parents Reinforce Children’s Anxiety

Lately Billy’s social anxiety has been getting worse. To address this, Mark and Billy seek support from a therapist. The therapist works with Billy to learn ways to manage his social anxiety and provides psychoeducation to Mark about the ways that parental figures reinforce or contribute to their children’s anxiety.

For example, parents often respond to their children’s anxiety with their own distress and anxiety. After all, it can be distressing to watch your anxious child struggle. Even though it’s quite natural, parental anxiety can often result in parents reacting negatively to their children’s anxiety. This results in a cycle in which the child and parent feed into each other’s fears, worries, and anxieties.2

After listening carefully, Mark considers the strategies that he uses to deal with Billy’s SAD. He admittedly feels worried and stressed, but he believes he does not react poorly; he aims only to support him and to do what is best. Sure, there are times when he gets a bit overprotective, but it’s all for Billy’s well-being…right?

How Anxious Responses Feed Anxiety

A large body of research indicates that parental influences are not the sole contributing factor to their children’s anxiety, but they are an important contributing factor.3 The specific practices and behaviors that parents use when interacting with their anxious children can significantly contribute to the development, maintenance, and exacerbation of their children’s anxiety.3 For example, greater levels of parental rejection, including criticizing or ignoring their children, are associated with higher levels of children’s anxiety.4

Other practices and behaviors can also contribute to children’s anxiety in more subtle ways: overinvolvement in a child’s daily life, overcontrol of the child’s environment, or encouraging safety and dependence over autonomy. While they may be well-intentioned, these behaviors are often responses that maintain and exacerbate anxiety. They teach and encourage children to avoid anxiety-provoking situations because they are not capable of handling them.4

For example, Billy experiences a significant amount of social anxiety. When Mark and Billy are around others in a social situation, Billy feels anxious and distressed, which causes Mark to feel anxious and distressed about Billy’s anxiety. Because Mark wants Billy to be happy and does not want to see him under distress, he tries to find activities that do not require them to be around other people.

Since Billy does not experience social anxiety during their movie nights at home, Mark does not either, so they continue to spend their weekends alone at home. This strategy is effective in removing Billy’s social anxiety and Mark’s anxiety about Billy in the moment, but it reinforces a cycle of avoidance. Since always avoiding social situations prevents Billy from learning how to handle social situations, this pattern serves to maintain or exacerbate Billy’s social anxiety in the long term.

Strategies Parents Use

It is possible for parents to prevent contributing to their children’s anxiety. The first step is awareness. It is hard to change your behavior if you don’t know you’re doing it. In a recent study conducted at the University of Lisbon, researchers interviewed parents about how they deal with their children’s anxiety.5 From that came 10 strategies—some are effective, and some are not and can contribute to greater anxiety. Below are seven strategies to try to avoid, and three that are considered effective management tools for children’s anxiety.

7 Maladaptive Strategies: What Not to Do

These strategies contribute to maintaining or exacerbating children’s anxiety in the long term:

1. Overinvolvement: Any overprotection, overcontrol, or attempts that parents made to direct their children’s behaviors. For example, Mark displays overinvolvement when he tells Billy what to say or do in anxiety-provoking situations, even though he may trying to lower Billy’s anxiety.

2. Reassurance: Any attempt to reassure children of the probability or cost of a negative outcome in an unrealistic way. For example, Mark displays reassurance when he tells Billy that no one will ever judge him, even though he knows that it is likely that somebody will judge his son negatively at some point in life.

3. Reinforcing avoidance and dependence: Anything said or done to indicate that it is OK or even good for children to avoid things that make them anxious. For example, Mark displays reinforcement when he tells Billy that he doesn’t have to socialize if it makes him anxious..

4. Anxious behavior: Anything done or said that reinforces anxiety. For example, Mark displays anxious behavior when he tells Billy that he needs to prepare more for giving a speech, even though Billy is highly anxious about it.

5. Helplessness: Anything done or said that indicates that a child cannot be helped or that a situation and anxiety cannot be controlled. For example, Mark displays helplessness if he believes nothing he does can help Billy’s anxiety. In doing so, he conveys the message that anxiety is a scary and uncontrollable thing that we cannot manage.

6. Passivity: Any withdrawal or unresponsiveness to a child’s anxiety. For example, Mark displays unresponsiveness when he does nothing because he believes that Billy will just grow out of his anxiety one day.

7. Negativity: Any criticism, negative remarks, punishment, or blaming pointed toward the child. For example, Mark displays negativity when he gets angry at Billy for being socially anxious or tells him that he is awkward and weird in social situations.

3 Effective Strategies: What to Do

These strategies contribute to managing children’s anxiety effectively.

1. Task resolution: Any development and plans made to solve an issue or cope with anxiety. For example, Mark displays task resolution when he helps Billy come up with ways to cope with his social anxiety before an event.

2. Emotional support: Any indication of empathy and support for children to express their thoughts and feelings. For example, Mark displays emotional support when he tells Billy that it’s OK to feel anxiety and that it is not something to hide, shut down, or avoid.

3. Encouraging bravery: Anything said or done to encourage approaching, instead of avoiding, fearful situations. For example, Mark displays this strategy when he encourages Billy to try going to a birthday party.

The study also indicated that the strategies parents reported using were significantly different from the strategies they were observed using: 31 percent of parents reported overinvolvement, but the researchers observed it in 83.3 percent; and 11.9 percent reported anxious behavior, but researchers observed it in 81 percent. While these results are limited, they do highlight the relative lack of awareness that parents may have about the strategies they are using. What we think we are doing may often be quite different from what we are really doing. But it is never too late to learn new strategies and change course.

Sources

1. American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.

2. Mcleod, B., Wood, J., Weisz, J. (2007). Examining the association between parenting and childhood anxiety: A meta-analysis. Clinical Psychology Review, 27, 155-172.

3. Kortlander, E., Kendall, P., Panichelli-Mindel, S. (1997). Maternal expectations and attributions about coping in anxious children. Journal of Anxiety Disorders, 11, 297-315.

4. Whaley, S., Pinto, A., Sigman, M. (1999). Characterizing interactions between anxious mothers and their children. Journal of Consulting and Clinical Psychology, 67, 826–836

5. Beato, A., Pereira, A. I., & Barros, L. (2017). Parenting strategies to deal with children’s anxiety: Do parents do what they say they do? Child Psychiatry and Human Development, 48, 423-433.

Graduate Research Assistant at University of Massachusetts Boston

Carol S. Lee is a clinical psychology doctoral student at University of Massachusetts Boston. She received her Bachelor of Arts in psychology from University of California San Diego in 2012 and her master’s in clinical psychology from UMass Boston in 2015. Carol works with Dr. Sarah A.

Hayes-Skelton to examine how and why therapeutic exposures and behavioral experiments in treatments for anxiety disorders work. In an effort to examine one piece of this, Carol’s current research draws from both social and clinical psychology to examine the process behind engaging in a behavior despite any fear or anxiety associated with that behavior. Carol and Dr. Hayes-Skelton collaborate to write articles for Anxiety.org.

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