Tena Davies is a Melbourne-based psychologist with an interest in anxiety interventions across the lifespan. Tena has worked as a psychologist in schools, hospitals and the private sector for over eleven years.
What are the some of the signs of anxiety in children? What impact can they have?
Anxiety can manifest in different ways at different stages. Some children may actively worry, while others display fears such as separating from their parents at night and have difficulty sleeping. Still others appear withdrawn and avoid activities altogether.
What is a psychologist’s role in supporting children with anxiety?
A psychologist can assist both the child and the adult in managing the anxiety and its impact on the family. Psychologists can support parents to further develop insight into their child's difficulties. For example, this could include understanding what is behind the behaviour and the factors that may maintain the anxiety. When working with children with anxiety it is important to understand how the anxiety is experienced within the family. Parents may need coping strategies to manage the understandable distress they may experience when their children become anxious.
What are some of the assessments and interventions psychologists use to support children with anxiety?
Psychologists usually start by meeting with parents first to understand the nature of the problem and understand what precipitated the referral as well as what factors perpetuate the anxiety. They may also use projective drawings to understand a child’s inner workings.
As part of a comprehensive assessment, psychologists often use behaviour checklists such as the Child Behaviour Checklist (CBCL) to determine if the behaviour is clinically significant relative to other children their age. The checklist assesses behaviour across a range of domains including both internalising (anxiety) and externalising behaviours (rule breaking behaviour). Psychologists may seek information from both parents and teachers, which may reveal differences in functioning across settings.
How does a psychologist work with families, schools and other health professionals to support children with anxiety?
Psychologists work to assist the adults in the child’s life by providing both insight into the difficulty and offering evidence-based intervention strategies. Psychologists can help families by supporting parents in understanding what has caused and what perpetuates the difficulty. Parents can also be taught to model strategies in response to difficulties. Where psychologists work with students individually, they can provide tailored evidence-based treatments to manage the unhelpful thinking (e.g., “I’m no good this”) that fuels anxiety.
A role for the psychologist in assisting schools is to provide psycho-education regarding anxiety. Schools can also benefit from implementing preventative approaches, such as KidsMatter, that foster childhood resilience.
What tips or advice would you give health and community professionals working with children with anxiety and their families?
I think it’s really important to understand the child in the context of their family. It’s important to understand if the child’s parents are experiencing anxiety themselves. If so, they may need support in managing their own anxiety first. It is important to explore what impact the child’s anxiety is having on the parents and the family. Important questions to ask include:
- what do the parents believe is the cause of the anxiety?
- how are the parents responding to their child’s anxiety, and how do other family members respond?
- what does it mean to the parents that the child has anxiety?
- what do they fear their child’s anxiety might result in?
- what have they tried to solve the problem?
- what has worked best and what has worked least?
Finally, I think it’s important to normalise a parent’s worries, fears and reactions.