1. Don’t Minimise Their Anxiety

Anxiety is an evolutionary response to a perceived threat, therefore if your child is suffering from anxiety it is because they believe that they are at risk from harm, so even if you do not share this perception, you must take theirs seriously.

Minimising how they feel, telling them not to ‘be silly’ or trying to jolly them along with not only serve to exacerbate their anxiety but will undermine their self esteem and as low self esteem underpins most mental health problems, responding to your child in this way will create more problems for them.

2. Find Out What They are Thinking

Anxiety is the result of two types of thought, if you identify both of these and work with your child to replace them with more helpful and accurate alternatives, their anxiety will quite quickly begin to dissipate. The first of these thoughts is an underestimation of a future catastrophic event (remember, this is in their eyes, not necessarily yours).

Sit down with them and try to work out what this is, with younger children ask them to draw what they think might happen, for older children sit them down quietly and spend time talking it through, keeping in mind that initially they might not know what it is they are predicting will happen and might need help to work it out. Once you have identified the ‘catastrophe’ help your child to work out how likely it is that things will pan out in this way by looking at all the other ways that it might go and has gone in the past.

The second type of thought that contributes to anxiety is a lack of confidence in our ability to cope with the perceived catastrophe. Explore this with your child and help them to feel that they are not alone in dealing with this, make them to feel as if they are a part of a team (i.e. the whole family, teachers, friends etc) and that you will work things out together. Then help them to work out what they would do if the ‘catastrophe’ occurred.

This will increase their confidence which will in turn reduce their anxiety, if they feel they can cope with the ‘catastrophe’ everything else becomes a walk in the park. Depending on the age of the child a combination of role play (with puppets for younger children) and discussion is helpful here, not forgetting to follow up and review how things are going.

Above we tackled the thoughts that lead to anxiety. Now we will address the physical symptoms of anxiety and ways of coping with anxiety that might make things worse.

1. Reduce Their Physical Symptoms of Anxiety

Anxiety results in a range of uncomfortable and distressing physical symptoms including breathlessness, dizziness, racing heart, nausea and sweating. These symptoms can be so unpleasant that some children get anxious about becoming anxious.

Teaching them some skills to reduce these symptoms can bring them relief and also build their confidence in their ability to cope, which will have a (positive) knock on effect on their anxiety.

Breathing can have a powerful effect on how we feel and using a technique called Diaphragmatic Breathing can quickly reduce the physical symptoms of anxiety. Below is a child-friendly version of this technique:

· Breath in slowly through your nose for the count of 2

· Breath out slowing through your mouth for the count of 2

· Breath in slowly through your nose for the count of 3

· Breath out slowing through your mouth for the count of 3

· Breath in slowly through your nose for the count of 4

· Breath out slowing through your mouth for the count of 4

Another technique to reduce the physical symptoms of anxiety is Progressive Muscular Relaxation. This technique involves working slowing through the body from the feet up to the head, tensing and then relaxing different muscle groups (e.g. feet, leg, bottom, stomach shoulders, neck, arms, hands, face).

The idea is that learning the difference between tension and relaxation in the body allows you to switch one off (tension) and the other on (relaxation) whenever you need to. Practice this exercise with the child at least twice a day, once in the morning and then again before bed so that they become skilled at it and can use it whenever they feel anxious.

2. Build Their Confidence in What They Are Capable of

We are programmed (by evolution) to run or hide from danger, so we often cope with anxiety by avoiding it. If your child is coping in this ways it is important to find a balance between making them face head on what they perceive to be a danger situation and not allowing them the opportunity to find out that what they fear does not occur and to develop the confidence in their ability to cope with challenges.

So once you have identified your child’s avoidance, sit down with them and work out a plan to support them to face it in a graded way by breaking it down into manageable steps. Practice each step on your hierarchy until your child feels confident enough to move on to the next one. Also, keep in mind that you are asking your child to face something they perceive as very dangerous so reward them for every step, they are being very brave.

If your child is avoiding school (commonly known as ‘school refusal’) it is advisable to seek help from a Clinical Psychologist or Counselling Psychologist who will be able to devise an individualised therapy programme to help your child gradually return to a normal school routine.