The Fear Factor: Four Clues that Ordinary Fear has become a Child Anxiety Disorder

Mary comes into my office looking hopeful yet concerned. She can't hold her question inside any longer. It thrusts out of her like a baby with projectile vomit, "I'm concerned my Andrew's worries have developed into an anxiety disorder." As a clinical therapist who specializes in the treatment of child anxiety, parents come to me seeking professional help for their fearful and anxious children. They don't have a clue concerning the criteria employed to diagnosis a child with an anxiety disorder. As Mary tells me more about Andrew's fears, I pose questions to determine if his struggle is a garden variety, childhood fear or, a more significant problem. Four factors are in my mind as we speak.

1. How intense are Andrews worries? Do they overwhelm him? Does it appear that he cannot control his fear even when he attempts to? Does fear captivate Andrew, becoming all consuming for periods of time? The higher the intensity of a child's anxiety, the more significant the problem.

2. What is the impact upon Andrew's life? How impacted is the whole family? Is the fear interfering with obligations, social relationships, academic progress, developmental progress, and the physical well-being of the child or other family members? The impact of the child's anxiety on the child and other family members is the second factor used to assess the problem.

3. How exaggerated is the fear? Does Andrew worry about age appropriate fears or are his worries beyond what other children consider normal? Are his concerns out of proportion given the circumstances? Did the freight appear to "come out of nowhere?" The exaggeration of a fear is third factor used in shaping my assessment of Andrew's anxiety.

4. What is the duration of time Andrew has struggled? Many fears are consistent with normal child development and abate with the passage of time. Mary's account of his struggle leads me to believe that the first three factors are affirmed and his fears are persistent and intensifying with time. The duration of Andrew's struggle is particularly significant. The problem is deepening as the roots of fear grow with time.

To prevent worry and anxiety from becoming a long-term struggle (when untreated it can last into adulthood), get help immediately. Mary sought out my help first but she could have also started with her pediatrician. Child anxiety is on the rise, and they are on the front lines recognizing the signs of it and recommending treatment. If your doctor advices further help, request a referral. Most communities have therapists who specialize in child anxiety.

Common child anxiety disorders include Generalized Anxiety Disorder (GAD), Panic Attacks, Social Phobia, Obsessive-Compulsive Disorder (OCD), and Separation Anxiety Disorder. The symptoms can vary to a great degree and therefore so do the treatments. One child's OCD may need to be treated with medication while another's may only need education and encouragement.

Many parents are uncomfortable taking their child to a therapist, or may be unable to afford it. Materials are available online regarding childhood anxiety, but in most cases they are tailored to the parent, not the child. While parent education is absolutely vital, a parent is not a therapist and must be cautious in treating their own child. Among the books available, some are based on clinical research, while others contain the personal experience of the writer with their child. Such wisdom often lacks broader application.

Informed Therapy Resources (ITR) has released an excellent audio program called Turnaround: Turning Fear into Freedom. Developed by two clinically experienced therapists, it uses cognitive-behavioral theory and technique, which research shows to produce the best results in the treatment of anxiety. The uniqueness of the program is that it uses children to speak to children, while adults play a secondary role. Over the course of ten days in an adventurous outdoors/hiking/camping setting, the children meet entertaining characters and face life-changing challenges that teach them how to manage, and ultimately overcome, their anxieties. From knock-knock jokes to talking beavers, from cliff-jumping to eating s'mores by the campfire, the band of young hikers gradually learn to master their fears. Each episode of the program lasts 20-30 minutes. Once the child finishes listening to each day, they complete exercises in the Turnaround Journal. Further information can be found at the link below.

If you're a parent, and are concerned about your child's worries, seek help immediately. Treating it now can eliminate potential escalating problems in the future. Mary's concerns for Andrew were well founded and he benefited from additional help. He enjoyed listening to Turnaround in the comfort of his own home while I saw him twice a month to reinforce Turnaround's message. Many child anxiety issues can be treated without medication, and many children who need medication, only need it for a season if they are they are taught coping strategies at the same time. Research shows that medication and treatment have the best results in greatly reducing, or eliminating, child anxiety. Help is available. Don't delay.

Christopher T. McCarthy, M.Ed., LPC (www.myanxiouschild.com)