Helping Anxious Children – Part 2

Last week I wrote a post ‘Helping Anxious Children – Part 1‘. The post introduced a wonderful book ‘Helping Your Anxious Child’, which is a step by step guide for parents to help their children overcome anxiety. In the post I outlined the types of anxiety and how to use detective thinking to help children think realistically. Today I want to address the concept of stepladders as the second strategy for managing anxiety in children. In my next post I will write about social skills to assist anxious children.

Detective thinking teaches children to find different and more realistic ways to think about something that causes worry, anxiety or fear. However, thinking realistically is only the first step. The second step is changing behaviours. Stepladders are an effective strategy to help children face fears and anxieties. The process is carried out in a step by step manner so that the child isn’t overwhelmed, but rather becomes gradually confident to face and cope with difficult scenarios.

Anxious children will often avoid apparent dangers that aren’t reflective of reality. However, this continual avoidance strengthens the anxious beliefs. During a stepladder a child will learn to tolerate feeling anxious or worried. Practice is essential. It is very important to repeat each step until it no longer causes anxiety for the child. As an adult it is important to be sympathetic and understanding but also believe that the child can tolerate their anxiety and discomfort. Below is the process for developing a stepladder with a child:

Step 1: Explaining stepladders: It is important that the child is willing to participate in the process. You need to explain that in order to conquer a larger fear or worry you will be working together to experience smaller fears one at a time. It may be helpful to provide an example such as swimming in shallow water and then becoming confident to swim in deep water.

Step 2: Making a fears and worries list: Have the child brainstorm all the things that cause worry or fear. Whilst you can make suggestions, it is important that the child is responsible for generating the list. Next help the child sort these fears into categories – really hard, moderately hard or not too hard. Rating the fears out of ten can help with the categorisation. During this discussion some anxious children ‘fake good’. This means they deny having any fears or difficulties. In this instance, it can be helpful to suggest one or two recent situations where the child was anxious in order to begin brainstorming together.

Step 3: Working out a step by step plan: Organise the fears into a practical plan. The aim is to have one or more stepladders from easiest to hardest. Many of these may already be represented in the list of fears and worries. An example can be seen below. Each stepladder must logically connect to the same overall fear. For example you might have one for giving a speech in class and another related to fear of the dark. It is important that each step is not too far apart and that each is practised until the child feels comfortable. It is critical that the first few steps feel achievable, so that the child is comfortable commencing the stepladder.

Step 4: Motivations and rewards: Giving rewards after each step will increase the child’s motivation and creates a balance between negative and positive experiences. A reward is different to a bribe. A reward is a signal of delight and approval of the child’s behaviour. This is exactly how conquering a step in the stepladder should be addressed. Rewards do not have to be tangible, they can include fun activities. The reward doesn’t need to be large, it just needs to be relevant to the child. The reward must be given for doing any step, whether the child was anxious or not.

Step 5: Doing stepladders: The child should pick which to tackle first. It is important to only work on one stepladder at a time. Then set a time and a date to attempt the first step. Some steps may be done by the child independently. For example if the fear is around making new friends, the first step might be sitting next to someone different on the floor in the classroom. Therefore you might decide with the child that the step needs to happen ‘some time this week’. Reward and record when a step is achieved and then repeat the step so the child has plenty of practice. You can adjust the steps in response to progress being made. It might be necessary to bridge a gap if the child has reluctance to move to the next step.

Stepladder Example

Goal: To go on Year 3 camp and sleep overnight without worrying that Mum isn’t there.

1. Stay at home with Dad whilst Mum goes out for twenty minutes.
2. Stay at home with Dad whilst Mum goes out for the afternoon.
3. Stay at home with a babysitter while Mum goes out for two hours in the afternoon.
4. Stay at home with a babysitter whilst Mum goes out for half of Saturday.
5. Stay at home in the evening with Grandma whilst Mum goes out with Dad for one hour.
6. Stay at home in the evening with Grandma whilst Mum goes out with Dad for the whole night.
7. Stay at home in the evening with a babysitter whilst Mum goes out with Dad for the whole night.
8. Stay the night at Grandma’s house with Mum and older sister also sleeping over.
9. Stay the night at Grandma’s house with older sister, call Mum before going to bed.
10. Stay the night at Grandma’s house with older sister, no phone calls to Mum.
11. Stay the night at Auntie Sue’s house with older sister, no phone calls to Mum.
12. Stay the night at home with a babysitter, call Mum before going to bed.
13. Stay the night at home with a babysitter,  no phone calls to Mum.
14. Stay the night at a friend’s house, call Mum before going to bed.
15. Stay the night at a friend’s house, no phone calls to Mum.
16. Stay at Grandma’s house for two nights, no phone calls to Mum.
17. Stay at Auntie Sue’s house for two nights, no phone calls to Mum.
18. Stay at the campsite for Year 3 camp for three nights.

Question for you: What stepladder could you help your anxious students to work towards?