I ask kids ALL THE TIME to be brave – to take a chance, to not know for sure how something will go, or end, and do it anyhow. I ask them to do something new, to feel worried – or scared – on purpose. I routinely ask these sorts of things from kids, because we know exposure therapy is effective, imperative even, in the treatment of childhood anxiety. Little did I know that coaching and encouraging kids in this way would make me more daring, more brave. I ask them to do this hard work, and they show me, time after time, what bravery looks like. They motivate me to face fears, do new things, do them differently, and be okay with not knowing. These kids have taught me a lot about being brave.

Why be brave? We learn a lot by doing things differently (i.e. being brave when worried vs. avoiding). We can challenge unhelpful or unrealistic beliefs, we get to push back against self-imposed limits and test our predictions.

I’ve raved about the Worry Wise Kids website on here (a few times, at least) and I often make the recommendation to families of anxious children (whom find it a helpful resource). So, without question, I wanted to attend a workshop put on by some of the same professionals involved in the creation of the site (and affiliated with The Children’s and Adult Center for OCD and Anxiety). Again, I traveled to suburban Philadelphia to learn from some of the best. They looked at the topic of uncertainty and how it applies across the spectrum of anxiety disorders. We all face uncertainty – it’s inherent in both the big and small makings of our lives. Nothing is guaranteed and there’s no way to secure certainty. This you know, but it’s striking to really think how often we are asked (or forced) to tolerate uncertainty. You have a big day at work, but need to call out because your child wakes up sick. You want to talk with the other parents from the school – may go well, may not. About to have a baby, start a new job, take a trip, cook a new food — how will it go? how will it end? Even with the most educated guess, there’s no way to know for sure, you must tolerate uncertainty in order to freely (and without great anxiety) move through life. Here’s the thing that struck me, the thing that made my trip to Philly so worth it:  the goal isn’t to just tolerate uncertainty, but to embrace it.  To embrace – as in to accept willingly and excitedly –  uncertainty — well that’s an ambitious and awesome goal! With that as the goal, Anxiety doesn’t have a leg to stand on. 

This past winter I attended a 3-day intensive training course on CBT for the treatment of pediatric OCD, through the Behavior Therapy Training Institute and International OCD Foundation. This was a big opportunity – as in worth my travel to the University of South Florida –  to learn from the leaders in the field. My blog comes many months later, now that I completed my follow up consultations with program faculty and considered a BTTI graduate.

The International OCD Foundation puts forth a remarkable effort to properly train professionals in the treatment of OCD. Additionally, they aim to create community and disseminate information to those affected by OCD. Their website provides a wealth of information. See HERE

Returning to school after months of summer fun, sleeping in and no homework is a hard transition! For some kids, it’s a matter of readjusting to the routine and demands of school. Give them a week or two and they’re back in the groove.  They don’t seem all that fazed by entering a new grade with a different teacher and an unfamiliar mix of peers. They appear to take the transition in stride.

Not your child?

For some kids, especially those experiencing anxiety, the unknown and uncertainty of a new school year is utterly overwhelming. The “what if…” questions are unrelenting, widespread and VERY far-reaching. It’s not worry over a specific problem that has an answer or solution, rather it’s worry in the form of chain reactions and worst case scenarios. The response is to worry – worry – worry, because it’s figured  that worrying about the “what ifs” ahead of time helps to prepare for the future, escape disaster and feel in control.  Truth is – it’s a trap. This kind of worry is unproductive and only serves to heighten anxiety. In CBT, children are taught useful tactics for responding to thoughts of worry, and they come to realize they have a choice – ride the “what-if” train or decide to get off.

www.worrywisekids.org is a terrific resource for parents of anxious children. It describes symptoms of various anxiety disorders and how to find effective treatment. Dr. Tamar Chansky, creator of the WorryWiseKids, is also the author of the highly recommended books, Freeing Your Child From Anxiety and Freeing Your Child From Obsessive Compulsive Disorder. 

This book hits on an important topic, a topic that often comes up in my work with kids: focus. To give you an idea of what I mean by focus, and Drs. Siegel and Bryson refer to as the Wheel of Awareness, put your hands to your face and make blinders – the kind a horse may wear in a parade – they obstruct and narrow your view, right?  Recall a time that you approached a situation or problem from this restricted perspective, maybe only seeing the negative, failing to recognize the bigger picture or the moments beyond the immediate. Think now of widening the blinders and expanding your view by bringing in additional facts, seeing the flip-side to the situation or person, or not filtering out information that doesn’t fit your initial belief.  A broader perspective helps us to more accurately assess a situation, regulate our emotions and bodies, and solve problems. Kids get this stuff (this is CBT)!

Drs. Siegel and Bryson provide a number of useful ways to engage and parent children with these concepts and skills in mind. While I was motivated to highlight the authors’ application of focus, I acknowledge that my comments fall far short of representing the scope of knowledge and strategy included in this book. In total, I highly recommend the The Whole-Brain Child: 12 Revolutionary Strategies to Nurture your Child’s Developing Mind, by Daniel Siegel, MD and Tina Payne Bryson, PhD.

I unexpectedly tuned into a radio program the other day that I found fascinating and worthy of sharing. Dr. Daniel Siegel was on the Diane Rehm Show (NPR) talking about the latest research on the adolescent brain and promoting his newly released book, Brainstorm: The Power and Purpose of the Teenage Brain — a title I would have likely skipped over on the bookshelf if it weren’t for catching this discussion On Air. I found Dr. Siegel’s practical application of neuroscience compelling and well worth a further look. It’s on my list of must reads.

http://thedianerehmshow.org/audio-player?nid=18723

I recently achieved accreditation through the Academy of Cognitive Therapy (ACT), a certifying organization specifically for Cognitive-Behavioral Therapy. The rigorous credentialing process, as highlighted on the Academy’s website, “evaluates applicants’ knowledge and ability before granting certification. The exacting standards of the Academy are designed to identify clinicians with the necessary training, experience, and knowledge to be effective cognitive therapists.” As part of my training in CBT, I completed an intensive supervision program through the Beck Institute, during which I worked weekly with expert CBT therapist, Elisa Nelbolsine, LCSW.

For more information on ACT, visit http://www.academyofct.org

I like this article for its overview of childhood anxiety, its reference to Cognitive Behavioral Therapy as an empirically founded, effective treatment for anxiety, and its wonderful strategies for parents on how to best help their children.

NYTimes.com – When Anxiety Interrupts a Child’s Life

Brené Brown, an author and researcher, gives us an interesting look into the subject of vulnerability. Her research began with a focus on shame – something we all know about – it can be brought to life with the question, “is there something about me that if other people know or see, I won’t be worthy of connection?” Brown’s exploration into shame generated unexpected insight into the topic of vulnerability. Specifically, how some people, referred to as the “wholehearted”, live with their vulnerability. As Brown explains, vulnerability can be the source of shame and guilt, but it is also the birthplace of joy, creativity, belonging and love. Her findings offer a compelling case for embracing vulnerability (rather than numbing or fighting against it).

Check out her talk – I think there’s a good chance you’ll find it interesting, maybe even personally meaningful.

For a child experiencing anxiety, appropriate supports & accommodations in the educational setting can make an enormous difference in his or her academic achievement. Additionally, such intervention can be the key to getting the overwhelmed and avoidant child to attend school regularly.  WorryWiseKids, a great online resource on anxiety, provides a valuable listing of possible classroom accommodations. Parents, I encourage you to take a look. You may find an idea worth discussing with the school – an idea that, when put into practice, may go a long way in your child’s ability to overcome anxiety and find mastery and enjoyment in his or her school day.