by Kasey Edwards, Sydney Morning Herald, interview with Georgina Manning

A new approach to treating childhood anxiety being trialled by Yale Medical School has flipped the standard treatment by focusing on parents rather than children.

The Supportive Parenting for Anxious Childhood Emotions (SPACE) study starts from the premise that over 97 per cent of parents who have an anxious child accommodate their child’s anxiety by changing their own behaviours to help their child not feel anxious.
"Even with the best treatments currently available, about half of all children remain highly anxious after treatment," says Dr Eli Lebowitz from Yale Medical School.

“Anxious children naturally rely on parents when they are feeling scared, frightened or stressed and parents naturally want to help their children feel better,” says Dr Eli Lebowitz who is Director Program for Anxiety Disorders from the Yale Medical School Child Study Center.

“But sometimes the things we do as parents to help our children feel less anxious in the moment can actually make them less likely to overcome the anxiety over time."
My first response to hearing about the study was “Great — now we can add our kid’s anxiety to the long list of things modern-day mothers are doing wrong”.

Fortunately, Dr Lebowitz is emphatic that his program is not an exercise in blaming parents.
“It is very important to emphasise that parents are not the cause of childhood anxiety disorders,” says Dr Lebowitz.

“It is simply that childhood anxiety is a problem of truly staggering proportions and even with the best treatments currently available, about half of all cases remain highly anxious after treatment. So we are always looking for more and different ways of helping anxious children and their families."

Beyond Blue reports seven per cent of children aged 4 to 17 years in Australia suffered from an anxiety disorder in the past 12 months.

The incidence of childhood anxiety is alarming. Beyond Blue reports that seven per cent of children aged 4 to 17 years in Australia suffered from an anxiety disorder in the past 12 months. Further, one in five of all young people aged 11 to 17 years experience high or very high levels of psychological distress.

Melbourne-based child anxiety expert and director of Wellbeing for Kids Georgina Manning agrees that new approaches to treating anxiety in children are needed — and that includes helping parents to understand that accommodating their child’s anxiety can also enable it.

“I have coached many parents to support them to make sure their child still goes to camp, even though they feel anxious, to speak at assembly even if they don’t want to, to go back to school after a hard day with friends the day before and so on,” says Manning who also runs a program for parents to support their anxious children, called Peaceful Parents.
As any parent knows, there is nothing worse than seeing your child in distress.  It's hardly surprising that we want to minimise it.

But protecting children from the immediate distress they are feeling may lead to even greater anxiety in the future by inadvertently reinforcing the belief that the problem the child fears really is as bad as they think it is. Our intervention also dis-empowers them because we are essentially telling our children that they are not skilled or strong enough to deal with the problem on their own.

“The more we encourage avoidance, the more we are saying to our child that the thing they are anxious about should be avoided because firstly they won’t be able to cope and secondly, the problem or situation is too hard for a child to manage,” says Manning.
Rushing in too soon to protect our children from distress is also unsustainable. Life gets hard some times, we all feel uncomfortable emotions, and our kids need to develop the capacity to deal with these unpleasant feelings and confront their fears. This doesn’t mean that we turn off our empathy and tell our kids that they are effectively on their own now.

“It is vital that parents can tune into their child’s emotions, understand how they feel, name the emotion for the child, but not necessarily ‘fix’ the emotion,” says Manning.

If you do have an anxious child, the advice of Yale’s Dr Lewbowitz is to start small. Pick one way you might be accommodating your child’s anxiety and plan specific changes to your approach.
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While it may be painful for both your child and you at first, you may be giving your child the life-long gift of learning to master their anxiety

They studied a group of 312 families and discovered that mums and dads who used more so-called challenging parent behaviour (CPB) had kids whose anxiety levels were significantly less than others.

Previous research has established links between how over-controlling, or helicopter-style, parenting can heighten anxiety in kids. The study by researchers from Sydney’s Macquarie University and University of Amsterdam, however, focused on parenting behaviour that may actually protect children from becoming anxious.

One of the study’s co-authors, Rebecca Lazarus, says behaviours that can have a protective effective on kids include giving them a fright, teasing, rough-and- tumble play, as well as encouraging them to be assertive and take risks. “The idea behind CPB is it gives children exposure to safe risk, so things that might be a bit anxiety provoking but lets them know that it’s actually ok,” Ms Lazarus said. “It’s this repeated exposure to things that might feel unsafe that reduces their anxiety and they learn they can cope by themselves.”Ms Lazarus said many other studies had shown that mums and dads who use “cotton wool” style parenting and restrict their kids from doing things that are age- appropriate put their youngsters at risk of developing anxiety. “That gives children the message that the world is a scary place and I need protection from it,” she said.

Seven per cent of Aussie kids aged between four and 17 are estimated to have anxiety issues. Ms Lazarus, a Phd candidate who worked at Macquarie’s Centre for Emotional Health when the study was conducted, said there are many simple everyday ways parents can display CPB to help their kids. “It could be things like encouraging the child if they are cautious about approaching something, so like a dog in a park. They might be frightened of dogs, but you can encourage them by showing them how you approach a dog and let it sniff your hand,” she said. “It also includes competitions like running races or playing games with kids. It’s all safe and gentle but it lets kids have that experience at losing and what that feels like.”
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While Ms Lazarus and her fellow researchers suggested in their study, that was published in the Journal of Clinical Child & Adolescent Psychology, more studies were needed into CPB as a possible treatment for anxiety in children.