Key Takeaways:

• Childhood anxiety can present in a variety of ways that make it challenging to (1) notice and understand, (2) decide whether the child needs treatment, and (3) improve through therapy and/or medication.

• It is important for the treating clinician(s), parents or guardians, and other members of the child’s life to be in regular communication with each other and to focus on the child’s evolving needs.

• When your child is undergoing mental health treatment, it can be stressful on the parents. Sometimes parents find it hard to know how to help and can benefit from conversations with the clinician in order to better understand their child’s challenges. Below are some ideas for how to manage these situations.

In 2019, about 13% of children, ages 5-17, were in mental health counseling (CDC, 2019). During the pandemic years, instances of mental health emergencies for children of the same age range rose significantly, increasing 24% for children ages 5 to 11 and 31% for those ages 12 to 17 compared with 2019 emergency department visits (APA, 2020). Essentially, the world of child mental health is dynamic and undergoing an evolution as this blog post is being written.

So what does that mean? It reinforces what we already know about child mental health: it can present in complex ways. This complexity can be managed by understanding the following expectations:

1. Child-centric teamwork: The child should always be at the center of treatment decisions and changes. Around the child is a web of support, which includes but is not limited to: the mental health professional(s), parents and/or guardians, teaching professionals, and other health care providers. This web informs the treatment and allows the provision of care to be reflective of the child’s dynamic needs. In practice this means we should always look to understand the child’s behavior. Kids express themselves in so many ways beyond verbal, so we have to look for clues to understand what they mean and help them make sense and meaning out of their experiences. This, in turn, can empower the child to make observations about their own life and explore their own role in improving their experiences, relationships and overall well being.

2. Leading with patience: Building a relationship between a new clinician and a child client can take some time. In order to create interventions that are accessible and effective, a trusting foundation between the child and clinician must be nourished and sustained. There is no one-size-fits-all timeline for mental health treatment, so approaching with an open mind and grounding in patience. Kids take time to learn how to communicate with their therapist. Parents can be helped by speaking regularly with the therapist and asking questions about how to make sense of their child’s difficulties. A team effort- therapist, parent(s) and child – can lead to the best and most effective outcomes.

3. Environment matters: Childhood anxiety can be rooted in and/or triggered by unpredictable or overwhelming environments. Speak with your child’s therapist or other health care team members for ideas on how to build and nurture a calming environment for your child. This could look like trying different routines within the household or developing a 504 plan with your child’s school. Each child has unique needs – the more we can understand what helps them thrive, the better. But children also need to learn how to be their own advocates. Therapy should help them recognize what environments, choices and behaviors help them be the most successful, as well as help them learn how to ask for help and be assertive for what they need. This is a lifelong challenge that many people continue to work on throughout their adulthood.

4. It takes a village: Asking for and accepting help when your child is struggling with mental health does not mean that you have failed as a parent. Our world can be unpredictable and we would all benefit from having wider and deeper networks of support for ourselves and our loved ones.

Similar to any healing process – a broken leg, a scratch on the chin – child mental health therapy takes time to work. Dissimilar to other healing processes, child mental health therapy doesn’t always have a tangible “finish line.” It might take time to find the right fit in a therapist, and it might take time for the right therapist to build rapport and develop meaningful interventions. Working on mental health is an investment of time, money, energy, and self.

What is important to remember is that your child can learn new skills that can help them feel more empowered, confident and able to take initiative in taking care of themselves. This is a developmental process that needs the help of adults, friends and other significant people (sometimes including therapists) in their lives.

If you believe that your child is experiencing anxiety and it does not feel manageable, please consider reaching out to our office so that we can join your child’s health care team.