1. Supporting Children with Anxiety
Donna Jo Hewitt
Calvary Christian School

2. What is Anxiety?
Definition:
Anxiety is an apprehension or fear about real or imagined characteristics. Symptoms may be reflected in a child’s thinking, behaviour, or physical reactions.
(Hubert, 2004)

3. What is Anxiety? When children experience anxiety for short durations it represents an “emotional response”. When these emotions/responses last for a long duration it represents an “emotional disorder”.
Anxiety is:
A normal response, created for our survival and protection
Includes flight, fight, and freeze response
A fear response, out of proportion to a real threat
Note: may be because of a past experience with a similar (real) threat
A future oriented response (based on “what if” thinking

4. Types of Anxiety Generalized Anxiety:
Generally characterized by worrying that is excessive, chronic, and/or difficult to control for a significant number of days over a period of time. Associated symptoms may include restlessness, fatigue, difficulty concentrating, and trouble sleeping, which in turn may impair daily functioning at school, in social situations, and with family.

5. Types of Anxiety 2. Separation Anxiety:
Begins before age eighteen and is generally characterized by extreme anxiety or worry about separation from the home or caregiver that interferes with the child’s ability to function.

6. Types of Anxiety 3. Panic Attacks:
Generally characterized by repeated unprovoked episodes of intense fear of danger associated with symptoms such as rapid heart rate, shortness of breath, choking sensation, sweating, or feelings of depersonalization.
Individual panic attacks may develop into panic disorder. Panic disorder typically has its onset in late adolescence/early adulthood.

7. Types of Anxiety 4. Specific Phobia:
Generally characterized by excessive fear of such things as a specific object, animal, activity, or situation that causes extreme distress or avoidance that affects functioning. Phobic disorders typically begin in childhood.

8. Types of Anxiety 5. Obsessive Compulsive:
Generally characterized by recurrent, persistent, intrusive thoughts (obsessions) or repetitive acts (compulsions) that the person feels he or she must do. Examples in children include cleaning or checking routines that take up a significant amount of time.

9. Types of Anxiety 6. Selective Mutism:
An anxiety disorder in which a person who is normally capable of speech cannot speak in specific situations or to specific people.
Selective mutism usually co-exists with shyness or social anxiety.

10. Types of Anxiety 7. Post Traumatic Stress:
A condition of persistent mental and emotional stress occurring as a result of injury or severe psychological shock, typically involving disturbance of sleep and constant vivid recall of the experience, with dulled responses to others and to the outside world.

11. Symptoms and Effects of Anxiety

12. Signs of Anxiety in Children Flight/Fight/Freeze
Frequent crying
Excessive worry
Excessive seeking of reassurance
Avoidance
Clinginess
Stomach aches, headaches
Restlessness
Extreme shyness
Perfectionism or rigidity
Distractibility or irritability
Angry behaviours

13. Protective Factors and Strategies
Strong, healthy attachments
Predictability and routines
Affection and Emotional Safety
Social and Emotional Learning

14. Protective Factors and Strategies Emotional Intelligence
Perceiving Emotions
What do I feel?
Understanding Emotions?
Why do I feel this way
Managing Emotions
How do I change this emotion? (if negative)
Using Emotions
What do I do with this emotion?

15. Protective Factors and Strategies Emotional Intelligence
Children learn by modelling
talk your emotions through and let them know what you are feeling and doing
use stories, movies, or pictures to help them see and understand emotions and different responses to situations
Encourage empathy in others

16. Protective Factors and Strategies Emotional Intelligence

17. Emotional Training What skills do we need to train?
Self-awareness: detecting and managing emotions, recognize your mood and its effect on others
Self-regulation: control and redirect disruptive impulses and moods, think before acting
Internal motivation: work with energy and persistence, be optimistic, be happy
Empathy: recognizing emotions in others
Social skills: build and maintain positive relationships

18. Emotional Training What skills do we need to train?
Giving children words to describe how they are feeling
Teaching facial expressions that connect with feelings
Teaching recognition of body reactions to emotion (e.g. heart rate/ breathing increase)
Teaching that emotions are normal, necessary, and needed.
Intentionally teaching children to recognize when they feel happy, sad, angry, afraid)
Being honest about their own feelings and talking through what they are doing to calm themselves (e.g. “I feel angry! I am going to take deep breathe and count to three. I feel calmer now.”)
Using books, videos, etc. to talk/teach about emotion and self-regulation

19. What to do when anxiety strikes
Important: Nobody has ever been able to calm down by being told, “Calm Down!”
Key Phrases:
“You are safe. I am here with you. I am not leaving you.”
“Let’s go for a walk and find a strong breath.”
“Your brain is thinking that it needs to protect you, but you are safe. Breathe with me. We will let your brain know that you’ve got this and you are okay.”
“I know how I feel when I am worried. Can you teach me what you are feeling?”
“You don’t have to do this by yourself. I am here to help you. Is there something I can do for you?”
“If you saw someone going through what you are feeling, what would you say to comfort them?”

20. What to do when anxiety strikes
The best medicine for anxiety and stress-relief is proper breathing. This is most effective if it includes connection to a safe person or object (e.g. stuffed animal) to help ground the child. If we can teach children to slow their breathing it will immediately bring down their heart rate, calm their body, and help them to regulate their emotions back to an even level.

21. What to do when anxiety strikes
Children can also learn to “take every thought captive” (2 Corinthians 10:5). This technique is used in secular settings where children envision the thought being burned up or destroyed. As Christians, we know that Christ is able to cleanse our minds and we can take our thoughts captive in His name. Young children can visualize this as the thought being trapped and destroyed by Jesus.

22. What to do when anxiety strikes
Take children’s mind off the situation and help them focus on something other than their anxiety and fear. Help them to understand all that they are experiencing.

23. When They are Calm Key Phrases:
“I know how it feels when I feel anxious or worried about things, but I’d like to understand how you feel. Can you teach me?”
“You don’t have to do it by yourself. Is there something I can do to help you?”
“How would you comfort someone who is going through what you are feeling?”
“I love you! I really love you just the way you are!”

24. Conclusion: What to Avoid
Minimizing their concerns/issues or ignoring the problem, hoping it will go away
Telling the child to “toughen up”
Pressuring the child to do more than he/she can handle
Having unrealistic expectations
Making it easy for the child to avoid doing anything that scares them
Expressing frustration/agitation about their struggles

25. Conclusion: What to Do Be patient, calm, and reassuring
Be positive about their ability to handle the situation
Help the child succeed by taking “small steps”
Reward and praise efforts toward success
Be a model for the child – manage your emotions well
Help the child “avoid avoidance” with planned gradual exposure to the things they fear
Teach positive self-talk, “I’m okay!” “I can do this!” “I am safe!”

26. And remember: All we do is done for Jesus and He loves them more than we ever could! We cannot be their Saviour, but they have a Saviour! And Jesus is His Name!