Doing Better Therapy

A Blog For Mental Health Professional's

Treating Anxiety

 

By Jennifer Powell-Lunder, Psy.D

The prevalence of anxiety among tweens and teens seems to be escalating at alarming rates, as confirmed by a recent New York Times article. Toward the aim of prevention and intervention, it is important to understand why so many kids today are experiencing anxiety, and have an in depth discussion regarding the most efficacious approaches to treatment.

Different schools of thought tout different strategies and one common supposition is that the best way to treat anxiety is to face it head on. Avoidance rarely gets an individual anywhere except overwhelmed and overloaded. In ‘clinicalese’ we are referring to an exposure approach. In order to manage anxiety, it first has to be experienced. The objective of treatment becomes helping the client develop coping skills.

When treating through exposure, the initial goal is for the individual to simply be able to tolerate their anxiety. This is a completely different expectation than fixing or stopping it, which can be overwhelming or feel too far-reaching. The key to treatment is experience. When the client is able to tolerate their anxiety, even for a moment longer than he previously could, he is successful. When in doubt, he will be able to say, “I can because I already did!”

It is difficult to watch someone suffer from anxiety, but when a well-meaning parent or professional offers the opportunity to avoid anxiety rather than confront it, they inadvertently reinforce a bad habit. This is especially common if the client is a child. For example, a child who becomes overwhelmed in class might be allowed to leave. While on the surface this may sound like an empathetic response, in reality it only serves to encourage the child to avoid their anxiety. A more helpful approach is to teach the child how to use distraction and mindfulness techniques to cope.

Tweens and teens are purveyors of technology and using these tools to enhance a client’s treatment can be advantageous. There are a multitude of apps offering, among other things, Cognitive Behavior Therapy (CBT) exposure schedules, guided imagery and mindfulness, and distraction activities. Teaching a tween or teen when to use what technique is also essential. For example, it would not be good for a child to consistently avoid confronting academic stress by playing games, albeit therapeutic ones, instead of doing their work. Exposure protocol should entail asking the child to remain in the classroom in lieu of leaving, and once this is mastered, gradually raise participation expectations.

The first step toward providing a successful treatment is validation and acknowledgement that the anxiety a teen or tween might be experiencing is real. Nothing resonates better than assurance that the people trying to help you understand what you are going through. Once this is communicated, the child will most likely be far more receptive. It is important to clarify from the get-go that, while it may be arduous work, in the end, exposure to anxiety is essential to overcoming it.

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