QUESTION
I have a nine-year-old daughter who is a gentle, empathic child but can be a real worrier. She gets herself into a state over just about everything. With the recent bad weather she was worried that we were going to have a flood or that something was going to be blown off the house in the wind. She also gets really worried about school. She will worry that her homework is not perfect (even though it is), and will get into a real fit of anxiety if she feels she is missing something.

Last week she was really worried when she forgot to bring back a reading book and was in a panic that the teacher was going to give out to her. (The teacher was surprised when I told her and it wasn’t a big deal at all – she is seen as very well behaved in school).

She also takes on other people’s worries: her elder brother was taking a piano exam and she couldn’t sleep for worrying how he would get on (even though he slept soundly). We are very patient with her but I don’t know if we are doing enough for her.

ANSWER
Though excessive anxiety and worry in children is one of the most common childhood problems, often it does not receive as much attention as more externalised problems such as tantrums and disruptive behavior. Despite this, anxiety can have a negative impact on children’s lives.

However, the good news is that children with anxiety can often be more easily helped to manage. They are often good at expressing their worries and fears, have good imaginations that can be used to think of solutions and are motivated to change. Below are some tips for how to help your daughter.

Listen and encourage her to express her anxiety
When helping an anxious child, it is important to encourage them to express their fears. Repressing or denying worries or getting frustrated and angry with them generally does not work and can make children feel worse and increase their anxiety.

When your daughter expresses a worry, try to listen and acknowledge her feelings. You can be gentle and reassuring – “I know you are worried, but trust me I think it will be fine” – but make sure to acknowledge her worry first. Being listened to is usually a great relief to children and is the first step to helping them.

Solve problems when possible
Sometimes you can solve a problem with a child about the worry they have. For example, you can ask “How can we make you feel a bit better about going to school?” “What can I say to your teacher that will help?” and so on.

Sometimes you can reason with them about the worry they have: “How likely is that to happen?” Or “I know that you worry that there is a ghost upstairs, but do you think that is real?” When challenging worries and solving problems it works best if you can help your child to take charge of the process herself.

Set a boundary around worries
A great technique is to set a clear boundary around “worry talk” in the house. For example, you agree that you will solve problems and talk about worries only at a certain time such as for 20 minutes after tea (before the bedtime routine).

At other times you move the subject on gently with “We will talk about that later, during our problem-solving time” or “Remember our rule, we won’t talk about that until later”. You can also bring up other subjects and talk about nicer things – “Let’s talk about what we see on the way to school”.

Help your child to avoid avoidance
One of the biggest ways anxiety interferes in a child’s life is that it leads to them avoiding participating in important things. For example, they might avoid a social event because they are socially anxious or avoid going to school because they are worried.

The key to keeping anxiety at bay is to help your child not to give in to anxiety but to complete some of the things she fears. Although she is anxious about school, she still goes.

The central maxim in overcoming anxiety is: feel the fear and do it anyway. You want your child to learn to experience and accept her anxiety (rather than repressing or feeling bad about it).

Then you want her to learn to do the thing she is anxious about, in spite of her fears! Even if this means tackling a big fear in small steps this is the best way to proceed.

For example, if a child was afraid of dogs, you might first get her to manage her anxiety when a dog is nearby before doing something more challenging such a walking by a dog near by.

Coach her in how to manage her fears
There are lots of great techniques that you can teach your child to use to help her manage and reduce her anxiety. Many of these come from cognitive behavioural therapy and there are lots of great worksheets on teaching these ideas to children and teenagers (if you search online).

In particular, you can take time to teach your child how to use her breathing to relax her body and mind. Introduce a daily time (perhaps before bedtime) when you both count your breaths and/ or listen to relaxing music (there are some brilliant children’s relaxation clips on YouTube).

Once she gets good at relaxing before bedtime, she will be able to use this technique when she is feeling anxious.

You can also teach her to use positive visualisation to deal with anxiety. Anxious children are usually visualising a whole series of negative outcomes when they are worrying.

Get her to use her powerful imagination more constructively. Each evening practise imagining a favourite place together or recalling a happy memory. Once you identify this positive visualisation skill you can employ it against worries. For example, you might say, “You have already imagined the worst possible outcome. Now let’s imagine things going really well; what would that look like?”

Finally, if problems persist do seek support from a child mental health professional.

Prof. John Sharry, Irish Times Newspaper, February 2015. John writes in The Irish Times Health+Family every Tuesday.
For information on John’s upcoming courses for parents click here.