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Trea%ng

 Anxious  Kids  &  Teens  

Prevalence
Anxious  Kids,  
•  Anxiety is #1 mental health problem
Anxious  Parents:  
    in USA
Seven  Ways  to  Stop  the   •  An estimated 1 in 8 kids has
Worry  Cycle diagnosable anxiety disorder
•  Most frequent reason parents bring
children to mental health provider
Lynn  Lyons,  LICSW
Lynnlyonsnh.com

The  Anxiety  Disorders


Age of Onset
Separation anxiety disorder 7.5 years
What percent of children living with an
Specific phobia 8.4 years anxious parent meet the criteria for an
Generalized anxiety disorder 10.8 years anxiety disorder?
OCD 10.8 years
Social phobia 11.3 years
Panic disorder 14.1 years
PTSD

If  your  child  is  anxious,  you  


Lead researcher Golda Ginsburg reports data showing
that the children of parents diagnosed with an anxiety
probably…
disorder are up to seven times more likely to develop
an anxiety disorder themselves, and up to 65 percent
•  Accommodate •  Do your child’s
of children living with an anxious parent meet
•  Reassure problem solving
criteria for an anxiety disorder.
•  Talk too much (lots •  Avoid things as a
Ginsburg, et al., The Child Anxiety Prevention Study: Intervention of verbal preparation family
Model and Primary Outcomes. Journal of Consulting and Clinical for things) •  Get really frustrated
Psychology, 77(3), June 2009, 580-587.
and lose it
sometimes!

©  2013  Reid  Wilson  &  Lynn  Lyons   1  


Trea%ng  Anxious  Kids  &  Teens  

If  you  are  anxious,  you  might  


Teaching  skills  to  kids  and  
also  do  these…
parents  based  on  an  umbrella  
•  Accommodate •  Do your child’s process    principle  that…
•  Reassure problem solving
•  Talk too much (lots •  Avoid things as a
of verbal preparation family
for things) •  Get really frustrated
and lose it
sometimes!

Anxiety has figured out


…guides  my  interventions  more   how to be overwhelming
than  the  content  and    diagnostic  
categories On the other hand,
anxiety is not that complex

Teaching  skills  to  kids  &  parents


Anxiety  Demands  TWO  Things:
Certainty: I have to know
3 target areas
what s going to happen
next…and I want to control •  Physiological (those uncomfortable
it! bodily reactions)

Comfort: I want to feel safe •  Cognitive (those worried thoughts)


and comfortable…or else I •  Principles (beliefs)
want out!

©  2013  Reid  Wilson  &  Lynn  Lyons   2  


Trea%ng  Anxious  Kids  &  Teens  

Trigger
Event Critical  Concepts  as  we  face  anxiety…

Worried •  CONTENT is far less important than


Thoughts PROCESS

Intensified
Amygdala •  We are eliminating NOTHING
Physical
Activated
Reactions
•  We have to teach an OFFENSIVE
rather than a DEFENSIVE position

More Worried Physical


Thoughts Response

Seven  Puzzle  Pieces


Step  One   Step  Two  
Each teaches a skill that helps
kids & parents shift their response to
anxious thoughts, sensations, & beliefs

You  have  a  thought,   You  learn  to  


feeling,  sensation respond,  react  
differently  

©  2013  Reid  Wilson  &  Lynn  Lyons   3  


Trea%ng  Anxious  Kids  &  Teens  

1.  Expect  to  worry


•  stop acting startled by each new occurrence of
worry

•  expect worry to appear in certain situations

•  figure out
o when to ignore those normal, expected
worried thoughts
o when to pay attention to them

2.  Talk  to  your  worry The  Content  Trap


Content (not good) Process (good!)

•  The Content Trap •  Focus on & talk about how •  Focus on HOW worry
to fix SPECIFIC problem operates & what it’s up to
o  focusing on particulars of each worry •  Reassure about that •  Cue “worry-managing”
SPECIFIC problem strategies
o  content of worry is moving target •  Give data, stats, rational •  Be general: “That sounds
information like worry to me…”
•  Go over plans & specifics •  Prompt independent,
repeatedly internal reassurance &
•  3 ways to talk to worry problem solving

Three  Ways  Kids  Can  Talk  to  Worry


     
EXPECT  IT TAKE  CARE  OF  IT BOSS  IT  AROUND
 
 

“I know you’re just “I’m going to feel “I’ll get back to you on

trying to help.” nervous, & then it’ll that, worry.”


 

  be over.” “You’re not helping. I’m


“You usually show   going to ignore you.”
 

up at these times, so “I’m safe, even


“Knock  it  off!  Stop  
I’m not surprised by though I feel
trying  to  scare  me!”
you.”   scared.”  

©  2013  Reid  Wilson  &  Lynn  Lyons   4  


Trea%ng  Anxious  Kids  &  Teens  

3.  Be  unsure  &  uncomfortable  


on  purpose CRITICAL  ATTITUDINAL  SHIFT!
•  Worry says STOP. Worry is not a big fan of
moving forward. If  I’m  uncomfortable  or  unsure  or  nervous  
as  I’m  learning  something  new,  I’m  on  the  
•  Worry fires off your alarm system, usually way
right  track…
too much

•  Anxious kids & parents try to stay comfortable


& certain

o With certainty-seeking behaviors…

Distinguish  Worries  as    


Signals  vs.  Noise
If you will stop telling your alarm
Worry center that there’s danger,
it will learn on its own not to
push that danger button

Signal? Noise?

These  are  messages  to  try  out

§  “I’m willing to feel uncomfortable” Reassurance and anxiety:


§  “I’m willing to feel unsure & to not know what short term decrease,
will happen” long term increase
§  “I’m willing to grab onto my courage & do it”

©  2013  Reid  Wilson  &  Lynn  Lyons   5  


Trea%ng  Anxious  Kids  &  Teens  

Step  into  unknown  territory,  &… Safety  Crutches


•  Reduce, mute or prevent anxiety symptoms
•  Stop saying, “I’ve GOT to know that
•  Increase perception of personal control
everything will turn out just right”
•  Child feels more secure
•  Start saying, “I’m WILLING to NOT •  Can serve useful functions & be
KNOW how things are going to turn out” developmentally appropriate
•  Stop saying, “I’ve got to feel comfortable”
Excessive reliance
•  Start saying, “I’m WILLING to feel ―  Strengthens anxiety through avoidance
UNCOMFORTABLE” ―  Limits range of functioning

4.  Breathe!
•  Simple, brief relaxation skills to REBOOT as
brain relearns

•  Parents get to practice staying calm when


their child escalates

•  Helps with the mind/body connection

•  Creates mastery & the experience of


malleability

5.  Know  what  you  want

Reaching a goal requires finding a


“WANT-TO” & then figuring out steps
that will get you there

©  2013  Reid  Wilson  &  Lynn  Lyons   6  


Trea%ng  Anxious  Kids  &  Teens  

How  to  get  what  you  want


•  Deliberately choose to do what’s hard &
uncomfortable
Important Points:
§  Rewards are short term
•  Worry must show up if you are to learn a new
§  Rewards happen when they
way to manage it
practice and “step in”
•  Trying new things is a good way to get worry §  WHY you are rewarding is
to show up
clearly explained
•  Pick goals that you really want to accomplish §  Never “in a row”
―  you’ll feel more motivated to face your
worries



I  want    ________________________

So  I’m  willing  to  ________________

Helping  kids  connect  to  their  past  


6.  Bridge  back  to  your  successes successes:  
•  What can you do now (automatically) that you couldn’t
do a few years ago?
•  anxious children suffer from amnesia

•  learn from new experiences & create pattern •  Can you remember something that was really
challenging when you first tried it but now seems
of remembering (reminder bridges) simple?

•  Make a list of accomplishments that make you proud.


•  Learned to ride a bike?
•  Mastered your times tables?
•  Went to sleep away camp (and had fun!)?

©  2013  Reid  Wilson  &  Lynn  Lyons   7  


Trea%ng  Anxious  Kids  &  Teens  

7.  Take  Action  on  Your  Plan  


•  pieces of puzzle are assembled

•  a written, step-by-step plan

•  emphasis is on problem solving

•  movement away from CONTENT of each


worry & focus on PROCESS

A  Really  Clever  Guide  to    


Winning  over  Worries
―  Know what you want to accomplish
Parenting  Paaerns  that  
Make  Sense    
―  Remember past successes that can help you
―  Expect worry to show up
―  Talk to your worries so they can’t run the show …&  DON’T  WORK
―  Make a plan & step into that new situation
―  Be willing to feel unsure & uncomfortable along
the way
―  Let your breathing skills support you

Accommodation  is…
•  Reassuring, rescuing & overprotecting
anything done in service of avoidance,
•  Providing certainty without any teaching or skill building
•  Identifying child as “worrier” because it “runs
in the family,” overplaying genetic card DON’T…
•  Allowing “bad” behavior (yelling, swearing, •  adjust family routines or schedules
tantrums, hitting) because it’s part of anxiety •  create school accommodations with no
•  Modeling with your own anxious behavior “weaning” plan
•  Pushing too hard, becoming angry & •  allow “unacceptable” behavior & referring to it
explosive, punishing as “anxiety”
•  use medication with NO therapy/skill building

©  2013  Reid  Wilson  &  Lynn  Lyons   8  


Trea%ng  Anxious  Kids  &  Teens  

Your  words  maaer! A  few  words  about  the    


non-­‐‑anxious  parent
•  Global: never, always, no one,
everyone •  Often marginalized by anxious parent

•  Catastrophic: worst case scenario, •  Important role model

•  Will need coaching/validation if hasn’t been


•  Permanent: things won’t change involved

The  ultimate  goal  for  kids  &  parents...   Normalize and Activate
 

Psychological  Autonomy

Normal movement toward physical & psychological


independence

Parents à shift from overprotecting to promoting •  This is what I’m experiencing.


competency = decrease in childhood anxiety
•  I don’t like it, but I can handle it.
•  I can figure out what to do next.
Don’t remove hurdle, teach them to jump over it!
•  And I’m going to DO something.

Changing the reaction to Psychological  Autonomy


the anxiety…. o  Tolerate differences of opinion & feelings (esp.
anger & sadness)
Expect: When does worry show up? What o  Focus on problem-solving & negotiation of conflict
does worry say? How does it boss you around?
o  Skill of arguing & successfully managing conflict
Externalize: Create the worry part and within family = better handling peer pressure &
talk back to it. decision making

Experiment: Take action, learn about how o  “I can handle this” attitude
anxiety operates and build confidence.

©  2013  Reid  Wilson  &  Lynn  Lyons   9  


Trea%ng  Anxious  Kids  &  Teens  

Information  Stuff
•  Websites:
•  lynnlyonsnh.com
•  playingwithanxiety.com

•  Email: Lynn@lynnlyonsnh.com

•  Facebook: Lynn Lyons Psychotherapist, Anxiety and


Children

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P l ay i
ng w
ith A
Casey nxie
’s t y:
Teens Guide for
and K
ids

by
Rei
dW
ilso
n & Ly
nn
Lyo
ns

Lynnlyonsnh.com

©  2013  Reid  Wilson  &  Lynn  Lyons   10