1. Anxiety in Young People How it Works, How it Looks, and How to Help
Emily introduces self
Emily Johnson, M.S.W., LGSW, Youth & Family Therapist
Youth Service Bureau

2. What is the Youth Service Bureau?
Youth Service Bureau helps youth and families learn the skills they need to be more successful at home, in school and throughout their community.
Services
Youth-Focused Family Counseling
Diversion Services, including Awareness Classes
Parent Education
Chemical Health Support
Locations
Cottage Grove
Stillwater
Woodbury
Contact Us!
Emily

3. Objectives Gain an understanding of how anxiety works
causes
contributing factors
Gain an understanding of how anxiety looks
signs
Symptoms
Gain an understanding of how to help
supporting kids
supporting yourself
Emily

4. Emily
Brainstorm pressures on kids

5. What is stress?
Any situation (positive or negative) that requires adjustment or change
Comes from pressures we experience in life
Adrenal gland releases adrenaline
There’s not always an extreme reaction
Some appear to thrive under stressful situations
Chronic stress can lead to anxiety – too much, for too long, with too little help
Emily

6. Some stress is normal Lots of pressures on kids today
The majority of stress stems from external situations
Able to be prioritized and handled one at a time
Associated with frustration and nervousness
What is stressful to one person might not be stressful to another
Common fears in children/adolescents handout
Emily

7. Life is stressful! Review handout: Sources of Stress in Children
With a partner:
Identify and put in order the top 10 stressors for kids
Emily
Discussion points:
-What is stressful to some might be more stressful or less stressful to others
-Think of your kids: what is the most stressful for them?
Some stressors are more likely to lead to anxiety: Seeing a gun or weapon, Seeing violence on TV or in movies, Divorce of parents, Violence in home (often associated with alcoholism), Theft of personal property, Becoming sick and vomiting, A serious or painful injury, Illness or death of a parent, Sexual, physical, emotional abuse, Being bullied in school, Natural disaster (tornado, flood, fire), Terrorism or war
You don’t have to figure it all out alone. What resources are available to kids who might be struggling?

8. Anxiety and Stress: The Difference
“With stress, we know what’s worrying us, but with anxiety you become less aware of what you’re anxious about [in the moment] and the reaction comes the problem. You start to feel anxious about being anxious”
Comes from a place of fear, unease, and worry

9. What is Anxiety?
A state of apprehension or worry about a danger or threat that might occur
Brain based-fight/flight system is activated
Sense of helplessness
Many children know they are anxious
Most common mental health problem of childhood and adolescence
More girls than boys
Kay

10. Why it happens
Environmental – witnessing a traumatic event/having a traumatic experience/watching another child be scared
During life changes/transitions-death in the family, illness, recent move, new school, birth of sibling, etc.
Biological-genetic predisposition- studies have shown children are more likely to develop an anxiety disorder if their parents have anxiety disorders
Kay

11. What anxiety can look like
Increase in crying
Sleep issues, Increase in fatigue/easily tired
Unwillingness to try/do activities, go to school, unwillingness to talk
Nervous movements/twitches
Increase in frustration
Impatience
Changes in eating patterns
Child becomes clingy, impulsive, or distracted
A meltdown!
Kay

12. What anxiety can look like
Kay
There are also somatic symptoms – ask kids where they feel it in their body

13. Anxiety can be difficult to detect
Anxiety personality style
Anxious children in school
High developed sense of responsibility
Well-behaved
Sensitive
Perfectionism
Perfectionistic
High Expectations
Motivated
Oversensitivity to criticism or rejection
High-Achieving
Strong control needs
Intelligent
Difficulty relaxing
Self-Conscious
Tendency to please
“Pleaser”
Difficulty with assertiveness
Frequent worry
May also have (but not always):
Many “shoulds”
All-or-nothing thinking
Somatic complaints
Attention problems
Social isolation
Kay
I’m going to challenge you a little – some kids fall under the radar. Behavioral kids – that is, kids that are acting out, are able to tell us that something isn’t right. But with the anxious personality – why do you think these children fall under the radar?
-these characteristics are desirable in a classroom
-they are compliant
-but inside they are “in knots”
-people who are anxious can be very successful because of their personal characteristics, but may still be struggling
Case: Marina (Emily)

14. Anxiety Disorders
A certain amount of anxiety is normal and is to be expected
Anxiety is a problem when it becomes a problem: too often, too strong, out of proportion
It consistently interferes with daily life (school, grades, social activities, sleep, eating)
Excessive amounts of anxiety, fear, nervousness, worry, dread
Most common mental health condition
Impacts people of all ages
Kay
Parents need to pay attention to clues and behavior, often, looking for patterns
Many kids don’t want to go to school or ride the bus and it DOES NOT trigger inappropriate behavior

15. How anxiety feels to a child
Preoccupied
Distracted
Tense
Always on alert, on guard
Confused
Scared, unprotected
Overwhelmed – even by little things
Lonley
Embarrassed, ashamed, misunderstood
Kay

16. A few notes about anxiety in kids
Kids may not have the language to talk about their experience
Kids and teens may act out emotions because they cannot hold them in
Some show aggression/hostility due to agitation
Others show depressive symptoms or exhibit attention (connection) seeking behaviors
Stress/anxiety are frequently mistaken for defiance
Kay

17. Sources of stress & anxiety related to school
Unfamiliar situations
Pressure to perform
Different learning styles/intelligences
Social life
Bullying, teasing, violence
Busyness
Amount of homework
The future
Test anxiety
School avoidance
Kay
Unfamiliar situations: new school/teachers, elementary to middle school or middle school to high school, difficult transitions
Pressure to perform- high expectations from parents, teachers, themselves. Not to mention extra curricular activities
Different learning styles – multiple intelligences, may lack social skills. Kids who are very high in their language skills and logical/math skills do very well in school. Are there enough opportunities for kinesthetic learners? Interpersonally strong kids who learn best through relating and cooperating?
Social stress: cliques, sexuality, acceptance/rejection, relationships
Homework – 3-4 hours of homework is common for high schoolers. Parents also become stressed . Cuts in to time for sleep, rest, quiet time, and family time
The future – College stress starts many years before kids actually go. Good grades, ACT/SAT scores, developing a “competitive edge” with extra curricular and special accomplishments
Tests
School avoidance (Courtney)

18. How To Talk to Your Children About Anxiety
Talk privately and tell them you notice something is bothering him/her
Listen attentively/calmly to what is wrong
Validate feelings & label them if appropriate
Involve the child in the solution – help them brainstorm things that might help
Be patient – just being there helps
Emily

19. Strategies to support anxious children
Create a safe place to go with calming activities
Teach relaxation techniques
Have realistic expectations: reward effort, not outcome
Consistent, daily routines (post them)
Play soothing music during downtime, homework, etc
Incorporate exercise, stretching
Sleep hygiene and eating habits
Encourage connection with others (limits to screen time)
Help find a hobby/outlet
Challenge kids to think about what they can and cannot control
When is therapy helpful?
Emily
Safe place –Bring examples of calming activities
Relaxation techniques – deep breathing, yoga, guided meditations (Kay will do one with us in a little bit)
Sleep hygiene – kids should be getting 8-10 hours of sleep per day (even teenagers!)
When is therapy helpful? (Mady)

20. Advocacy Communicate with teachers and counselors Encourage attendance
Consider making modifications
Schedules
Breaks
Opportunities for movement
Emily
Modifications – allowing extra time to do work, reducing workloads, modify assignments (ie: presentation in front of the class)
Breaks - in it a nurses’ office? Social workers’ office? How many are allowed? Do they need to inform the teacher? Is there a time limit?

21. Unhealthy coping strategies
Smoking/drinking/drugs
Bingeing on junk/comfort food
Zoning out through computer, TV
Procrastinating
Taking it out on others
Other avoidant behavior - withdrawing from friends/family, sleeping, skipping school
Using caffeine can make anxiety worse
Emily

22. Parent Do’s……. Encourage communication Listen and be available
Collaborate together to develop solutions
Validate their experience
Don’t minimize
Make it important
Be mindful of actions when dealing with your own stress
Emily

23. Food for thought…
Kids & Teens learn to handle stress from parents/adults in their lives.
What are we teaching them about healthy and successful ways to handle stress?
How do we schedule our lives and take care of ourselves?
Emily
Activity – turn to your table and each take turns letting each other know one way you handle your stress that you’d like to get away from, one one way you handle stress that you’d like to do more of

24. Review The difference between anxiety and stress
Sources of stress for children
Signs and symptoms of anxiety
Anxiety disorders
School stress
Coping strategies
Talking with your child
Advocacy in the schools
When additional support may be needed
Emily

25. Questions? Youth Service Bureau www.ysb.net
Explain resources
EVALUATIONS