As a therapist working in an inpatient facility, I see many young clients with anxiety. I probably see it more often than any other diagnosis. In fact, according to the Child Mind Institute, about 31.9 percent of children suffer from anxiety disorders, with about 8.3 percent severely impaired by the symptoms. To make matters worse, parents do not always recognize what their children are going through. A whopping 80 percent of children suffer from a diagnosable anxiety disorder that is not being treated.
I know firsthand how hard it can be to explain to parents that their child’s oppositional, defiant, or moody behavior is related to anxiety. Anxiety, they think, means something else.
In Working with Parents of Anxious Children: Therapeutic Strategies for Encouraging Communication, Coping, & Change, psychologist Christopher McCurry outlines the behaviors and symptoms to look for in children with anxiety disorders, and offers a guide for clinicians who work with their families.
Anxiety can mimic the symptoms of disruptive behavior disorders, McCurry writes. Six is the age of onset: the age at which kids are entering school, making friends, learning new things, and being expected to conform to social norms. If they are struggling with anxiety during this stressful time, families are likely to see a slew of behaviors and symptoms.
McCurry helps clinicians think about how biology and environment work together to either support or work against a child with an anxiety disorder. For example, a child who is biologically predisposed to anxiety and who also has a very anxious parent can sink into more severe forms of anxiety over time. And a parent who does not realize these ramifications can end up making things harder.
To that end, McCurry helps the clinician facilitate greater understanding in parents, highlighting therapeutic tools the therapist can use to help educate families. And, McCurry writes, parents should be open to not only changing their child’s behavior, but also their own responses. He approaches the issue from a behavior modification and cognitive behavioral perspective.
In general, McCurry does a wonderful job of introducing the subject of childhood anxiety, offering therapeutic tools, and bringing up ideas that clinicians may forget to consider in their work with families. However, his book fails to discuss children with resistant and chronic anxiety who find school attendance and daily life very challenging.
Engaging these kids in therapy is often difficult, if not impossible. For example, a child with chronic and pervasive OCD symptoms will find it difficult to exact any benefit from certain approaches if their anxiety is uncontrollable. Many kids with resistant anxiety symptoms are intelligent and able to conceptualize therapeutic concepts, but struggle with putting concepts into action. McCurry would have helped clinicians if he had addressed this population of youngsters. In addition, the book lacks information on external resources or studies.
Still, despite these oversights, McCurry provides clinicians with a bio-psycho-social understanding of anxiety disorders in children, as well as useful techniques to use with families.
Working with Parents of Anxious Children: Therapeutic Strategies for Encouraging Communication, Coping, & Change
W. W. Norton & Company, June 2015
Hardcover, 368 pages