Welcome Grace Labao, M.A. C. Psych. Assoc. School and Counselling - - PowerPoint PPT Presentation

ANXIETY IN CHILDREN AND ADOLESCENTS

Toronto Catholic District School Board –Psychology Department

Welcome

Grace Labao, M.A. C. Psych. Assoc. School and Counselling Psychology

REVIEW

What is anxiety? What does anxiety look like – the

signs and symptoms

What factors contribute to

anxiety?

What treatments are

available?

How can I help?

CASE STUDY

ANXIETY ANXIETY

Anxiety is a normal reaction to many

stressful, novel or threatening situations or to uncertainties in life – e.g., first date, major exam

Normal anxiety is a good thing, because it

prepares the body to handle a situation that may be more stressful or require more concentration

ANXIETY THAT IMPAIRS

ANXIETY DISORDER: excessive or

inappropriate feelings of anxiety so severe they interfere significantly with daily functioning (e.g., with school, home, relationships).

Anxiety Disorder is the most prevalent

mental health disorder – affecting up to 10 to 12% of the population, second to depression (5-8%)

CO-MORBIDITY

75 to 80% of children and adolescents with

an anxiety disorder suffer from another psychiatric disorder

Combinations of anxiety and depression

most common (Wagner, 2002)

Children of parents with anxiety disorder are

7 times more likely to have an anxiety disorder (Manassis et al, 1995)

Contributing Factors: Stressors, Genetics,

Experiential

SIGNS OF ANXIETY

Constant worry Muscle tension Panic attacks Extra sensitive Extreme need for reassurance Various physical symptoms Easily embarrassed Clingy behaviour

SIGNS OF ANXIETY

Extreme sensitivity to rejection or

failure

Hypervigilance Perfectionism Physical symptoms – blushing,

shaky voice, nervousness, sweating prior to or during social situation

BEHAVIOURS CHARACTERISTIC OF ANXIETY

Poor academic achievement Difficulties socializing, getting

along with peers; Social isolation/withdrawal

Irritability or outbursts of anger Reluctant to do group work or speak out in

class; not handing in work

Quiet behavioral cues – nail biting, finger

picking, hair twirling

BEHAVIORS CHARACTERISTIC OF ANXIETY

Avoidant behaviours – situations, places,

people

Restlessness or feeling on edge Difficulty maintaining relationships Easily fatigued; Shy, quiet Difficulty concentrating Difficulty falling or staying asleep Alcohol and/or drug use Drop out of activities

EXCESSIVE WORRIES/FEARS

GENERALIZED ANXIETY

SEPARATION ANXIETY

OBSESSIVE-COMPULSIVE

SOCIAL ANXIETY SPECIFIC PHOBIA PANIC DISORDER AGORAPHOBIA

POST-TRAUMATIC STRESS

STATEMENTS FROM ANXIOUS ADOLESCENTS

“I can’t seem to stop worrying”

“What if I can’t do it?” “I can’t go to school because students

will make fun of me”

“I can’t go to the school dance because

everyone will notice that I’m nervous”

“I might get sick and die” “I can’t seem to relax, I’m always tense

and uptight about something

Continuation…..

“I can’t present to the class because I will

freeze up and won’t talk; everyone will laugh”

“I’m afraid I’ll do something embarrassing in

front of my friends & my face will get bright red”

“I will fail the test” “Things are not going to work out” “They don’t like me” “They will think I am stupid”

TREATMENTS:

Cognitive Behavioural Therapy Behavioural Therapy Medication Relaxation Techniques

HOW TO HELP

Know the signs and triggers Provide support, understanding, rather than

avoidance

Model effective coping strategies Changing worried/fearful thoughts Consult with a mental health professional -

learn all you can about the disorder

Communicate your concerns to

teachers/administrators; work closely with your child’s teacher, & school team.

Continuation…..

Consult with school psychologist/Social

Worker via administrators

Encourage physical exercise to reduce

anxiety

Encourage writing, drawing, painting to

alleviate fears

Encourage “coping” behavior and discourage

• avoidance. Create a “coping’ book – e.g.

ways to relax, tasks that distract from anxiety

Weekly planning to manage school work

Continuation…..

A supportive adult (CYW, Guidance, Chaplin,

teacher, administrator) can be provided at the school level.

Encourage group social activities Remind children/youths of their past

successes

Role-play Don’t compare your child to siblings or other

kids.

Acknowledge and provide praise and positive

reinforcement for all efforts/success

SNAKES ENJOY FRIENDLY DRINK BOAT FANGS DANGER TREAT DEATH RAIN ACCIDENT TEACH GAME PHOTO INTEREST FEAR

Resources

Centre for Addiction and Mental Health

(CAMH)

Hospital for Sick Children (HSC) Anxiety Disorders Association of Ontario

(www.anxietydisordersontario.ca)

Anxiety Disorders Association of Canada

(www.anxietycanada.ca)

Canadian Network for Mood and Anxiety

Disorders (www.canmat.org)

www.anxieties.com

Resources

Helping Your Anxious Child: A step-by=step

guide for parents. Ronald Rappe, New Harbinger Publications, 2000

If Your Adolescent Has an Anxiety Disorder: An

essential resource for parents. Edna B. Foa and Linda Andrews, Oxford University Press, U.S., 2006

Freeing Your Child from Anxiety: Powerful,

practical solutions to overcome your child’s fears, worries, and phobias. Tamar E. Chansky, Broadway 2004

Resources

Help for Worried Kids: How your child can conquer

anxiety and fear. Cynthia G. Last, Guilford Press, 2005

Your Anxious Child: How parents and teachers can

relieve anxiety in children. John S. Dacey and Lisa B. Fiore, Jossey-Bass, 2001

Keys to Parenting Your Anxious Child: Katharina

Manassis,(2nd Edition), Barron’s Educational Series, Inc., Hauppauge, NY.

What to Do When You Worry Too Much: A kid’s guide

to overcoming anxiety. Dawn Huebnere, Magination Press, 2005