When Your Child Is Scared and Worried: Dr. James J. Crist Answers Parents’ Questions About Parenting an Anxious Child

By: James J. Crist, Ph.D., CSAC

Seeing your child struggle with anxiety and the problems it causes can be difficult for parents. Taking extra time to deal again and again with a child's worries can be exhausting. You may feel frustrated when, despite your reassurance, your child continues to be fearful. Yet your child needs your continued support.

Q: How can I tell if my child is having problems with worries and fears? What are the signs to look for?
A: Different children respond to their fears in different ways. Some kids are very open about them, others show their anxieties and fears in their behavior. Here are some common ways children may respond:

Q: What are some ways we can help our child?
A: There are many ways parents can help. One of the best things you can do is to set an example for handling situations without anxiety. Anxious children are often overly sensitive to their parents' feelings. Dealing with your own worries and fears will help your child greatly. Exercise can be very helpful for anxious children. Find ways to make exercise a part of their day. Let your child know it's okay to express feelings. Many children don't like talking about how they feel. You need to reassure your child that although it may be hard to talk about strong emotions, the more he does, the sooner he will start to feel better.

Q: Does a reward system help?
A: For some children, rewards can be an extra incentive to do the hard work necessary to overcome fears. For other children, a reward system can seem like another opportunity to fail. Ask your child first if she would like to try a reward system—don't push it. Reward systems work best for younger children, up to about age 12. Make a day-by-day chart of the behaviors you want to encourage (staying in school all day, asking for help, etc.). Decide how many points, from 1 to 5, your child can earn with each behavior. Make a list of rewards your child would like to earn and the number of points needed to earn each one. Review the chart with your child every day and at the end of the week, your child can “spend” the points she has earned.

Q: Who can we turn to if we need professional help?
A: First, take your child to the pediatrician for a checkup. Sometimes there are medical reasons for physical symptoms and this possibility should be ruled out. Mental health professionals can diagnose the problem and decide whether your child's worries are normal or whether the problem is more serious. Be sure to ask what kind of training and experience the therapist has in working with children with anxiety disorders. If you aren't sure where to start looking for a therapist, ask the school guidance counselor or a health-care professional for recommendations. You can also check the Yellow Pages under Mental Health Services, Counselors, or Psychologists.

Q: When is medication necessary?
A: When counseling is not working, or when the symptoms are so severe they're interfering with daily life, the therapist may recommend medication. Usually, a child psychiatrist will be consulted who can prescribe and monitor the medication.

Before your child is placed on medication, it's wise to insist on a full medical checkup complete with blood work. This way, the doctor can monitor any effects the medicine may have. While medicines can be very effective and safe when properly monitored, there can be risks. Ask the doctor or pharmacist about any concerns you have regarding safety, side effects, or other questions.

Remember, while it's hard to see your child struggle with worries and fears, you can provide valuable help. By monitoring your own behavior, helping your child learn and practice exercises like the ones in What to Do When You're Scared & Worried, and pursuing counseling and medication when needed, you can help ensure that your child is able to overcome troubling fears and lead a more productive life.

James J. Crist, Ph.D., CSAC, is a licensed clinical psychologist and certified substance abuse counselor with the Child and Family Counseling Center in Woodbridge, Virginia. He is the author of What to Do When You're Scared & Worried: A Guide for Kids (Free Spirit Publishing).

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