Parents struggle to identify anxiety disorders within children for several reasons:

  • Terminology. The word anxiety is used to describe a natural, healthy reaction every individual has when facing new, unfamiliar, or potentially dangerous situations. Unfortunately, the same term is utilized to describe a debilitating illness impairing functioning to a level that treatment is essential. Imagine using the word diabetes to describe both the sugar high you have after eating a decadent piece of cheesecake AND a debilitating illness where insulin is needed to avoid death. This would be incredibly confusing! Because we do this with anxiety, parents assume the uneasiness their child describes is normal, healthy anxiety and fail to appreciate their level of distress.
  • Development. Many parents do not know a child’s brain is not fully developed until around 21-years-old. This leaves parents assuming their child possesses reasoning and self-soothing skills that they cannot and do not have. Additionally, parents may dismiss fears over matters like sleeping in the dark as “ridiculous” without understanding the child’s experience.

As therapists, one of our first tasks is to help parents understand anxiety disorders and how debilitating they can be for some children. Providing basic information about mental illness and their child’s developmental stage helps parents better understand their child’s experience and how their brain processes these occurrences.    

Once parents understand their child has an anxiety disorder, they often ask, “What caused this?” As a society, we like simple, linear solutions to issues, including health conditions. Unfortunately, anxiety disorders seldom have a single cause, making it essential to help parents develop a bio-psycho-social-spiritual model through which they view these conditions. Skipping this step fails to help parents create a healthy, supportive environment that enables anxious children to implement the skills that will later be taught in therapy. Providing psychoeducation about the factors contributing to anxiety disorders equips and empowers parents to create healthy “soil” where anxious children can stabilize and begin to grow and thrive.

  • Biology. Not all bodies are created the same! Some children are wired more emotionally sensitive, become more easily distressed or anxious, and have more trouble calming and soothing themselves emotionally. Understanding this helps parents stop assuming children can “just stop it” when they become emotionally distressed.

Medication: Many parents fear allowing children to be placed on medication. While healthy caution is reasonable, just as insulin is sometimes necessary to manage diabetes, medications are sometimes needed to rebalance an anxious child’s biology so they can do the therapy work of learning new skills. Encourage parents to take their children to a pediatrician or child psychiatrist who can help them determine if medication is needed.

Breathing: Parents can learn and regularly practice diaphragmatic breathing with their children to help manage anxiety. Teaching parents and children this method gives everyone a tool to utilize when a child’s anxiety level increases. Simply breathe in over a count of five (as the stomach goes out), hold it for a count of two, breathe out over a count of seven (as the stomach goes in), rest for a count of two, and then repeat.

  • Psychology. How children think about themselves and the world around them affects their anxiety levels. Children who see themselves as competent and the people around them as supportive and dependably present are less anxious than those who do not have this view.   

Competence: Parents are often fearful of children making mistakes or experiencing failure. As a result, they hover and inadvertently communicate that they do not see their child as competent or capable of handling life’s challenges. Empower parents to teach their children that mistakes are normal, needed, and survivable learning opportunities. Competence is not knowing everything but how to ask for and get the required assistance.

Presence: Children do not need perfect parents—they need emotionally available and consistently empathic parents. Help parents learn to be emotionally present with their children and recognize and respond empathically to their distress.

  • Social. Parents are responsible for creating a healthy environment for their children. This environment should contain the “soil” of dependability and acceptance.

Dependability: From birth, we need routine. Routines communicate safety to a child’s body. Parents should establish morning and evening routines that are low-stress and relational.

Acceptance: Children need regular times to connect with their parents and have their undivided attention. This can happen in various ways, but connection and belonging are essential and help children know they are safe, accepted, and loved—even on their worst days.  

  • Spiritual. Parents and churches often do an excellent job teaching children about God—He is powerful, all-knowing, and perfect. Children cannot reason in the abstract, so they take the most influential person in their lives and make God into a bigger and more powerful version of that person—flaws and all. Developing a healthy relationship with God requires that children not only know about God but also have encounters with God. Prayer can provide experiential encounters with God and His safety. These experiences create a safe haven for children to utilize when they experience anxiety. In His presence, they can feel safe and cared for in ways that calm anxiety. These experiential encounters with God must occur routinely and require parents to feel comfortable entering prayer experiences with their children. Therapists can equip parents with tools to facilitate age-appropriate prayer experiences.

When therapists empower parents to create an environment that addresses the bio-psycho-social-spiritual dimensions of their children’s lives, parents can establish healthy “soil” for their children’s potential growth. Therapy then plants seeds into that soil—seeds that will sprout and produce new ways for children to manage thoughts and feelings about themselves, the world, and their emotional reactions. 

Jean Holthaus, LISW, LMSW, has more than 25 years of experience providing therapy. She currently works as a clinician and manages two clinics for Pine Rest Christian Mental Health Services. Her professional experience includes working with individuals, couples, and families dealing with abuse, anxiety, depression, marital issues, divorce, spiritual issues, life changes, parenting, and more. She is an author and a member of the National Association of Social Workers and the American Association of Christian Counselors. Her latest book is, Managing Worry and Anxiety: Practical Tools to Help You Deal with Life’s Challenges (Revell).