Why did my anxious child's good work in therapy wear off?
In this episode of the Child Anxiety FAQ Podcast, Dawn Friedman addresses a listener's question about why a child's progress in therapy can seem to wear off over time. Dawn explains that anxiety in children is often reinforced by family patterns, termed 'Parenting Pitfalls', which unknowingly support avoidance behaviors. She discusses the importance of continuous practice and parental involvement in managing anxiety and reinforces that setbacks are a normal part of the learning process. Listeners are encouraged to revisit therapy if needed and to apply the skills learned consistently across different contexts and developmental stages. For submitting questions, visit ChildAnxietySupport.com/podcast.
00:00 Introduction to the Child Anxiety Fact Podcast
00:28 Listener Question: Why Did Therapy Stop Working?
01:21 The Role of Parents in Managing Child Anxiety
01:40 Understanding Anxiety Patterns and Accommodations
04:29 Therapy Success and the Need for Continuous Effort
07:25 Practical Tips for Parents to Support Anxious Children
10:46 Conclusion and How to Submit Your Questions
Mentioned in this episode:
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Transcript
Hey, everyone.
Speaker A:Welcome to the Child Anxiety FAC Podcast.
Speaker A:My name is Dawn Friedman and I've been working with kids and families for more than 30 years as a preschool teacher, parent educator, family case manager, clinical counselor, and now as the owner and operator of Child Anxiety Support, where I help parents of anxious kids.
Speaker A:FAC stands for Frequently Asked Questions.
Speaker A:I answer listener questions about child and teen anxiety.
Speaker A:This episode's question is, why did my child's good work and therapy wear off?
Speaker A:I recently gave a talk at a school about child anxiety and someone in the audience said that their child had previously worked with a therapist and made a whole lot of strides and really had overcome their anxiety.
Speaker A:And now it seemed like they were backsliding back into their anxious, avoidant behaviors and they wondered if I had any insight about it.
Speaker A:Now, obviously I was not this child's therapist.
Speaker A:I don't know how therapy went, but this is what I shared with the parent and this is what we talked about in their experience of therapy.
Speaker A:So, first of all, therapy is a great option for anxious kids.
Speaker A:It's terrific.
Speaker A:If you can find the right therapist for your child, go for it, absolutely, 100%, and they can make a lot of progress there.
Speaker A:However, unless you do your bit as the parent, your child is likely to backslide.
Speaker A:Why the heck is that?
Speaker A:That's because we know that child anxiety is perpetuated by family patterns of anxiety.
Speaker A:Let's go even further back about this.
Speaker A:When we first started looking at these anxiety patterns called accommodations.
Speaker A:And as many of you know, I don't use the term accommodations when I'm talking about them, because accommodations in the context of IEPs are good things.
Speaker A:Our children who struggle with learning, who have learning disabilities, maybe our autistic kids might need some accommodations to be successful at school.
Speaker A:Accommodations in the context of anxiety are not a good thing.
Speaker A:It means we're accommodating the anxiety that is creating patterns that enforce avoidance.
Speaker A:And I call those parenting pitfalls.
Speaker A:Those pitfalls can happen also in school and they can happen in other intimate relationships.
Speaker A:When we were first looking at this in the research we were examining the way couples accommodate anxiety.
Speaker A:Accommodations are present in pretty much every relationship that someone has with an anxious person.
Speaker A:That is in that relationship.
Speaker A:We start helping the anxious person avoid the things that makes them anxious, avoiding their discomfort with anxiety.
Speaker A:Unless we stop doing this, that loved one does not learn how to go towards the anxiety provoking stimuli.
Speaker A:They do not learn how to acclimate to the feeling of discomfort and uncertainty.
Speaker A:And so the anxiety is perpetuated.
Speaker A:What my Guess is, with this family, and this is what I shared with them, is that their child was able to make good progress in therapy around whatever specific anxiety challenge they were working on.
Speaker A:And we didn't get into that in this presentation.
Speaker A:I don't know what they specifically were working on in therapy, what their child was working on, but let's say that they were working on a, oh, I don't know, speaking up in class.
Speaker A:Maybe that's what they were working on.
Speaker A:And so they were working on that in the context of the therapy.
Speaker A:The child is learning their tools.
Speaker A:They're learning more about cognitive behavioral tools.
Speaker A:They're probably coming up with some exposures, that is ways for the child to practice doing the thing that scares them.
Speaker A:And maybe that would start by just raising their hand.
Speaker A:Maybe they were just going to raise their hand.
Speaker A:They weren't going to answer when called on.
Speaker A:Maybe they arranged with the teacher.
Speaker A:I'm just going to raise my hand and you can call on me, and then I'm going to shake my head.
Speaker A:And that's enough.
Speaker A:You know, that's enough to start with.
Speaker A:And then as I get comfortable with that, then I'm going to raise my hand and say out loud, never mind.
Speaker A:Those are the kinds of exposures we would be building on to slowly acclimate the child to anxiety.
Speaker A:And it was successful.
Speaker A:According to the mom, this therapy was successful.
Speaker A:But when it comes to anxiety, our anxious brains will find things to be anxious about.
Speaker A:If we're anxious about speaking up in class, we might start getting anxious about showing up to a birthday party.
Speaker A:Or we might get anxious about going to bed alone at night, or we might get anxious about going to a school dance.
Speaker A:Anxious brains are going to be anxious.
Speaker A:This child learned how to deal with the anxiety in the context of this particular event, but they were unable to take that learning and out into the rest of the world.
Speaker A:There are lots of reasons why children struggle to transfer learning from one context to another context.
Speaker A:And part of it is, that's hard for all of us.
Speaker A:That takes the ability to see the similarity between the two situations.
Speaker A:But also, kids are growing all the time.
Speaker A:They are relearning things in new ways because their brains are growing and they're laying new neural pathways.
Speaker A:So the child may have learned these skills in the context of, okay, this is how I handle learning how to speak up in class.
Speaker A:But then to transfer that, that big, complicated learning to a completely different situation, like going to a birthday party where I may not know people, that's a whole new kind of learning.
Speaker A:Even Though it's the same sort of face your anxiety, overcome your anxiety.
Speaker A:Kids need to learn these things over and over again in those new contexts, but also at different developmental stages because their brain is relearning things.
Speaker A:Kids also sometimes forget things on their way to learning things.
Speaker A:So you'll see this happen really obviously when they're infants and toddlers and they're learning to talk and they're learning to walk, and they will sometimes drop skills as they're picking up new skills.
Speaker A:So a child that is learning how to make certain sounds will make those sounds for a while.
Speaker A:You see this in infants.
Speaker A:They'll say, ba, ba, ba, ba ba.
Speaker A:And then they don't say that again for a while because they're too busy saying, na, na, na, na na.
Speaker A:And then they bring those both together later on in their talking.
Speaker A:This is true throughout their learning.
Speaker A:You'll see them drop skills as they gain skills.
Speaker A:You'll see.
Speaker A:You'll see them keeping their room clean, but their backpack is a mess or whatever.
Speaker A:Same with anxiety.
Speaker A:What this means is twofold.
Speaker A:The first is that wasn't a failure of therapy, that was a success of therapy.
Speaker A:And now, you know, you could go back to that therapist.
Speaker A:If that therapist knows your child well, then it'll be easier for them to pick that back up.
Speaker A:So going back to therapy after having been in therapy and graduated is not a failure.
Speaker A:It is leaning on a resource that, you know works.
Speaker A:So that's one.
Speaker A:The other thing is you, the parent, can learn the skills to teach your child.
Speaker A:So if you learn what it looks like for your child to speak up in class, if you're working with a clinician to understand what that looks like, you can take that learning and bring that into other situations for your child.
Speaker A:You can also learn, what was I doing that helped my child?
Speaker A:And what was I doing that didn't help my child?
Speaker A:Where am I getting stuck in those parenting pitfalls?
Speaker A:Where am I helping my child to avoid?
Speaker A:How can I learn to disrupt those patterns for myself so I can recognize them?
Speaker A:As soon as I look around and say, my kid's getting stuck in anxiety again, I know what to look for.
Speaker A:I'm going to look for it.
Speaker A:I'm going to interrupt it.
Speaker A:I'm going to support my child.
Speaker A:When we're working on coping with the reality of having an anxious brain, there are certain things that we need to do to help us overcome our anxiety.
Speaker A:And that starts with understanding anxiety, understanding how it works.
Speaker A:You need to understand it, your child needs to understand it.
Speaker A:And again, your Child will be relearning that at different times of their life.
Speaker A:So whether or not they go back to therapy, whether or not they start with therapy at all, you need to know this because you're going to be helping your child learn that therapists share information and teach skills.
Speaker A:But parents are obviously the ones who are going to continue to supply their child with information and practice those skills with their child.
Speaker A:So one reason that child ended up kind of falling off the anxiety coping wagon is that the parents didn't realize, oh, we got to keep doing this.
Speaker A:We got to keep working on it.
Speaker A:We got to keep trying.
Speaker A:We got to keep our eyes out for those pitfalls.
Speaker A:Anxiety treatment is not one and done.
Speaker A:It's not one and done for kids.
Speaker A:It is ongoing.
Speaker A:It's not one and done for us.
Speaker A:We need to, if we are anxious, continue to practice those skills, to notice when we're kind of falling off our own wagon and jumping back on.
Speaker A:That's part of learning to live with anxiety, is learning how to continue to confront it, to continue to overcome it, to continue to face it, and to continue to take care of ourselves when we're struggling.
Speaker A:In those anxious times.
Speaker A:We can expect anxiety to increase whenever something new is happening.
Speaker A:If your child is going to sleepaway camp for the first time, if they're about to start at a new school or go up a grade when they're headed off to college, or getting their own apartment the night before they get married, when they become parents, on and on and on, we continue to practice those skills of taking care of ourselves and facing our anxiety.
Speaker A:In short, when your child's good work in therapy wears off, that means, well, we need to get back on that wagon.
Speaker A:We need to start working on our skills again.
Speaker A:We need to start identifying avoidance.
Speaker A:Maybe we need to go back to that therapist and revisit the things that we have learned.
Speaker A:If you have a question for me on the podcast, please go to my site, childanxietysupport.com choose podcast in the menu.
Speaker A:You can submit your question there.
Speaker A:And while you're there, you can sign up for my Sunday newsletter where you will get lots of useful information about supporting your anxious child.
