Transitioning to virtual therapy was challenging for most clinicians at the beginning of the pandemic, but in the last two years, we have adapted and found various ways to provide quality clinical services, to our clients. As therapists, we have developed more and more creative strategies to engage everyone including younger children. I have personally found that for children and teens it helps to keep the screen engaging and interactive to ensure their attentivity throughout a therapy session. In addition, keeping a youth’s session to 45 minutes has proven to be effective.
A few months ago, while conducting a therapy session with a child, a scavenger hunt activity was being utilized to guide the session.
This was the fourth session and is still considered the rapport-building stage, so careful planning goes into building trust with the child while keeping them engaged. The instructions for the activity were provided, which included finding an object throughout the home that represented each statement on the activity. The child would read the list from the computer screen and then find the object and reveal it upon returning to the computer. In addition, they explain their choice and how it impacts their life.
This activity proved to be engaging and sustained a discussion disclosing varied qualities and experiences of the child. As the activity progressed, the child then revealed a stress ball to answer the statement, “something you could use to calm yourself down if you are angry or upset”, and without hesitation stated that it helps to relieve the intensity of panic attacks. Before this moment, anxiety or stress was minimized and denied. There were other activities and prompts used weekly to explore this area of functioning, but a scavenger hunt game disclosed the presence and prevalence of this condition.
Further exploration of the condition indicated that a strive for perfection led to increasing anxiety so severe that panic attacks began occurring. The source of this perfection was to ensure that the child was accepted by their peers, by always appearing excellent in all things. Discussions with the parents also revealed that they had no insight into the anxiety and were concerned with the child’s propensity to isolate. Childhood anxiety may be overlooked, because it mimics other behavior patterns like agitation, irritability, resistance/non-compliance, shyness, being reserved, or being disruptive. Anxiety in most children has an onset around school-aged years. In my experience working with youth, anxious tendencies are developed based on environmental factors, psychological factors, or biological factors. Anxiety is intense worry or fear about life. Children will struggle with identifying these feelings unless they are introduced to and given context about them.
The anxious body is in a state of alert, which means that the brain
is prompted to prepare the body to respond with a protective reaction of fight, flight, freeze, or fawn. This occurs when natural hormonal communication between the brain and the rest of the body prepares it for protection. The hormones adrenaline and cortisol are released because their job is to help in times of danger. However, a constant state of anxiety means that the body is overwhelmed with these hormones all the time, and thus remains in a state of alertness which can affect one’s overall functioning. Therefore, anxiety should never be overlooked- whether in a child or an adult. The anxious child needs adult support to understand what they are experiencing and ways that coping skills can be used to improve this. Adults also need to explore the source of their anxiety so that strategies for coping can be implemented to improve functioning.
Learning to manage anxiety does not have to be hard, but you must be intentional. Whether you are an adult struggling with anxiety or an adult assisting a child with anxiety, some behaviors must be learned for one to begin experiencing a sense of control over their anxious feelings and moments. It is always best to identify the source of these anxious thoughts and feelings and explore ways to minimize or eradicate them.
Here are some activities to consider:
- Deep breathing
- Practice Self Care
- Increase Positive Self Talk
- Validate your feelings
- Diet and Nutrition
- Set healthy boundaries with yourself and others
- Take a time out when you need one
For children, it is essential that they are taught about their feelings and how to embrace them. Children can be taught affirmations, boundary setting, deep breathing, how to journal about their feelings and experiences, how to take breaks to relax, and how to talk about their feelings.
Recommendations for Parents:
Anxiety is a normal emotion that is experienced when faced with a dangerous or uncomfortable situation. However, being anxious all the time isn’t normal and should be explored. In addition to all the strategies above, talking with a Licensed Professional Therapist can be of significant help.