I think my child has anxiety. What are the treatment options?

Childhood anxiety and anxiety disorders are common among Australian children, affecting nearly 7% of those aged 4–11 years.

By Simon Byrne, The University of Queensland

Children’s fears can focus on areas such as being alone, talking to strangers or going to sleep. In small amounts these fears can be helpful for survival; in large amounts they can become overwhelming and impairing.

Childhood is the ideal time to treat these problems before they become severe, protracted or lead to other disorders.

A variety of child anxiety treatments are on offer, yet not all treatments are the same or should be considered equal. So how do you face the daunting task of deciding which is best for your anxious child?

What you need to know about childhood anxiety

The first step is to work out if your child needs treatment. It’s normal for children to experience irrational fears that pass with time. For example, many children and adults are more fearful of spiders than they should be, based on the level of danger.

The main factor that determines whether a child has “clinical anxiety” is how much the fear affects their daily life. For example, if a child who fears spiders has ongoing trouble leaving home or sleeping because of their fear, they may need extra help.

In younger children, anxiety can be seen as more cautious or avoidant behaviour, which is especially visible when they are in unfamiliar situations.

Keep in mind that anxious children often do not draw attention to themselves and can “go under the radar”. For example, anxious children are often quiet and well behaved at school, so teachers may not be aware they are struggling.

Many anxious children also experience other mental health problems, particularly depression, so it’s important to watch for additional issues as well.

What is the best treatment for childhood anxiety?

Psychotherapy (talking therapy) for child anxiety can be highly effective. A therapist should empathise with your child and assess how their anxiety began and how it effects their life.

Different health professionals may emphasise different ways to understand and treat a child’s anxiety, often using the approach they are more familiar with or trained in.

Children can respond differently to these treatments, so you need to listen to what they find helpful. For example, a family systems therapist may focus on how family dynamics and communication impact on a child’s mental health. Some therapists focus on developing mindfulness skills, teaching children to observe and accept their anxious thoughts and feelings rather than responding to them.

Different treatments offer varying levels of evidence. Keep in mind that people often report some benefit from any treatment (like a “placebo effect”), so you need to determine what works best overall. With that said, treatments that teach children skills to manage their anxiety, such as cognitive behaviour therapy (CBT), tend to be most effective.

What is cognitive behaviour therapy?

Cognitive Behaviour Therapy (CBT) covers treatments that focus on how your child’s thoughts, feelings, and behaviours interact. Therapists guide children to change their thinking, which can then affect how they behave and feel.

CBT programs have been developed and tailored for anxious children and their families, such as the Cool Kids program. These treatments have been rigorously tested and are known to work for many children.

CBT is also freely available online and this can be an easy way to access and try treatment for example, Fear-Less Triple P Online.

These treatments teach the same CBT skills, however, they are delivered and assessed using an online platform, meaning treatment can take place at home.

Does my child need medication?

Antidepressant medications can be highly effective for childhood anxiety but can also cause side effects, so they are often used when psychological therapies have not been effective. Their use should be monitored by a doctor.

What else can I do?

Simple things, such as improving your child’s diet, sleep and exercise can have a big effect on their mental health.

Support and listen to your child when they feel distressed, and encourage them to face their fears. Their fears may seem silly to you, but they feel very real to them.

Consider involving your child’s school in their treatment so that teachers and parents are aligned.

Like with most services, you may need to explore different options to find the right mental health professional and treatment for your child. A psychologist with training in CBT and child anxiety is a good starting point. Researching or getting a referral is worth the effort.

Is my child getting better?

You’ll know your child is improving when they resume their normal life. The goal of treatment isn’t to eliminate anxiety, but to help your child manage it so they can live a full life.

Childhood anxiety is tough for both your child and the whole family, but there is hope. Effective treatments exist, and these challenges often pass with time.

It may take time, but by working with your child and skilled professionals, you’ll find the support your family needs.

Simon Byrne, Lecturer in Clinical Psychology, The University of Queensland

This article is republished from The Conversation under a Creative Commons license. Read the original article.