Anxiety — this common, sometimes debilitating disorder can wreak havoc on the lives of adults, children and families. When children lack self-confidence, anxiety is frequently among the culprits.

New Hampshire-based psychologist and author Dr. Dawn Huebner recently spoke to parents, teachers and mental health professionals at Beth Tfiloh Dahan Community School about “Growing Confident Children.” She knows firsthand about the challenges of parenting an anxious child. Years ago, Dr. Huebner’s son’s severe anxiety led her to embrace cognitive behavioral therapy and changed the way she practiced psychology with young patients.

Dr. Huebner is the award-winning author of eight self-help books for children. Her latest book is “Outsmarting Worry: An Older Kid’s Guide to Managing Anxiety” (Jessica Kingsley Publishers).

Jmore spoke recently with Dr. Huebner about evidenced-based techniques for treating childhood anxiety disorders and building confidence in children.

How did you come to learn about treating anxiety in children?

When my son was young, he was very anxious. And when there’s anxiety in a family, it holds the whole family hostage. At first, we tried to accommodate my son’s anxieties, but it just got worse. We sought treatment for him, but it wasn’t helpful. So I started doing some digging around and landed on cognitive behavioral therapy. I was not trained in CBT, and it was eye-opening. I began using it more broadly in my practice.

How does cognitive behavioral therapy help children to manage anxiety?

Cognitive behavioral technique is based on the idea that we all have an internal triangle made up of our thoughts, our feelings, and our actions.  All three are connected.  Our thoughts influence our feelings, which drive our actions, which link back to our thoughts and feelings.  It’s often feelings that are problematic — we feel sad; we feel anxious; we feel angry. Unfortunately, we cannot simply change our feelings.  But we can change our thoughts, and our actions — both of which lead to changes in feelings.

CBT focuses on modifying thoughts and actions to effect changes in feelings. For example: Say a child is afraid of going upstairs alone, worried there might be a monster, or a bad guy. CBT would teach this child to acknowledge his anxiety and externalize it, imagining it’s a small creature, a bully or pest. The child would learn to tell himself, “My worry is saying it’s dangerous to go upstairs [then the child would be taught to think] but I know that’s just my worry talking. I’m not going to listen to it. I’m going to go upstairs anyway!”  Children learn, in this way, not to let worry be in control.

Is praising our children helpful to them?

There are two kinds of praise — person praise and process praise. Person praise focuses more on who the child is as a person. “You’re such a good artist” or “You’re such a good runner.”

Fascinating research has found that paradoxically this kind of praise reduces motivation. It sets up in kids the feeling that they have to be the best. Kids recognize inflated praise isn’t genuine. … Kids [who receive this type of praise] crave it, but they also discount it. On the other hand, process praise focuses on the kid’s effort, creativity and persistence. This kind of praise increases motivation and frustration tolerance and lets kids know that they can handle adversity and not give up.

It is hard for us to tolerate when our kids have negative feelings, and it’s tempting to be a cheerleader. … But that tends to backfire. What kids need most is for parents to acknowledge and empathize by saying something like, “Yes, that was hard.” Only after the kid feels seen and heard can he shift into accepting it.

There’s a newish idea called growth mindset as opposed to fixed mindset. In fixed mindset, a kid thinks he’s either good at something or bad at something. With a growth mindset, kids learn that they can get better at something when they work at it.

Anything else to add?

Sometimes when there is anxiety and a lack of confidence, there is an underlying problem such as a sensory integration disorder or some other unseen [learning] disability. In that case, when kids can’t keep up with their peers, we need to recognize that and make accommodations.

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