Anxiety Disorders and Congnative Behavior Therapy (CBT)

About Savanna
Savanna has an anxiety disorder which can be best explained as her feelings at times run the show. Some of the side effects is she can do some pretty strange stuff at times in class, in addition with playing in her mind a remotely possible risk into a matter of fact. This turns into their mind blanking during tests, becoming ill, strange behavior. You can see a full set of some “common red flags” below.

What we have tried
We have tried medication, but as time went by we realized that the medication was doing more harm than good along with the health risks associated with the medications. More importantly the medication was not tooling her for any real success in life but more of a not in my back yard approach. After some extensive research we realized that not only was cognitive behavior therapy the right thing for Savanna, but schools and every parent and even non parents quality and success of life would be improved by learning and practicing these very simple facts.

Quick Stories
Once we started CBT we started to see immediate results, it was almost comical at times. For example she would do something that the rest of us would never get worked up about, I would ask her factual questions about what she was thinking during her outburst of crying and stating that the end of something was going to happen. After a few questions she would begin to cry and laugh at the same time realizing that her feelings were tricking her thoughts, and her actions were crazy. I remember the first story I read about CBT was about a dog. Imagine a dog was barking at the front door each time the postal working would deliver mail. Imagine of you as a child could tell the dog, nothing to worry about, just the mail carrier, then the dog says “Oh, thanks, I will go back to itching my self and maybe lay down” But instead the dog hears a noise and thinks intruder, intruder… get away. The dogs feelings gave in/her thoughts, which relayed to actions inappropriate of the risk, at least we know that. If you could talk to a the dog, you would eventual be able to let the dog know ahead of time, you will hear noises, its the mail carrier, so you can lay there and not get up. The difference between the dog being able to sleep sound (in Savanna’s case, focus on school) and freaking out and barking (Savanna’s case, not paying attention, doing strange things in class, falling off of her chair, blanking on a test or being so worried about missing a bus that she doesn’t’ bring her homework back, then gets home and feels she will be held back, that her parents don’t lover, we would get rid of her) are simple facts and not the feelings.

What helps
We try and tell her that feelings are important but not what we make decisions on.

Fact or Fiction games
Teaching her about Maslows Hierarchy (sound strange at first but if you understand Maslow stuff it will make sense)

Most importantly that she understands and believes that feelings, thoughts, actions is a circle with us all, so separate your feelings from facts and know the difference


So what can Schools Do
http://www.worrywisekids.org/schools/sample_accomodations.html
Seat them away from rambunctious children
Having instructions in a permanent location so she can go back to them if need be
Give a heads up on classroom participation
Make front of the class participation an option
Safe person (Very important)
Offer cool down passes
A parents heads up on any major changes in routine
Time estimates on larger assignments. This places a grounded an know expectation. (this will help all kids)
Children feel safest when they sense that their needs are being met, or at minimum, that their needs are respected and understood. Though anxious children may attempt to keep their discomfort hidden out of sight, the toll their worry takes in terms of physical and emotional costs as well as interfering with social and academic functioning is one that adults can not overlook.
Often some sensible and no-cost accommodations in the classroom are enough to keep an anxious child in the game at school. When a child’s anxiety is interfering with any aspect of their educational experience or learning they are entitled to help. The following are general recommendations for children who are having school-related difficulties. These ideas can be shared with your child’s teacher or guidance counselor, these may need to be formally documented with an Individualized Educational Plan (IEP), or a 504 plan. (See Sample Accommodations for Anxious Kids). These recommendations can be printed and shared with school personnel.

Risks of not understanding CBT and anxiety disorders
Imaging building a beautiful garden and someone comes along and thinks it needs a fertilizer so sprays the garden. They did not know that your garden would die from that kind of fertilizer, thus undo all the work you have done. I wanted to make sure that anyone dealing with Savanna would have the right information so they would not undo progress made.

Benefits to all Children and Education professionals
There is not a child or education profession that would not benefit from understanding Anxiety disorders and CBT. We all have a certain degree of anxiety, with out it we would take unnecessary risks and eventually no longer exist as humans. Since the simple fact is all of us follow to some degree or another the anxiety blue print, practicing CBT in life in general will benefit all.

The Blue Print
Feelings affect your thoughts >> Thoughts affect your actions >> Actions set up future feelings (see visual chart in linked page). Every one is different both physically and mentally, and just as some men have less hair than others, you also have people with different defense mechanisms based around warning signs and how their minds feel appropriate to react to these warnings or preconceived risk.

More in depth Anxiety Information
See normal versus what is considered to have anxiety disorders.

Problem Anxieties
Unremitting anxiety lasting for weeks or months at a time can cause physical distress in the form of headaches, stomachaches, nausea, vomiting and sleeplessness, Difficulty sleeping, reluctance to go to school or elsewhere outside of the child’s comfort zone, crying jags, tantrums and clinginess are common. Anxiety can also interfere with a child’s concentration and decision-making. An anxious child’s thinking is typically unrealistic, catastrophic and pessimistic. They may seek excessive reassurance and yet the benefit of that reassurance is fleeting. Irritability and anger can also be red flags for anxiety when a child becomes frustrated by the stress of worry, or worn down from sleep deprivation. For some children, feeling “different” from other kids can be an additional source of concern.

Common Red flags
Demonstrating excessive distress out of proportion to the situation: crying, physical symptoms, sadness, anger, frustration, hopelessness, embarrassment

  • Easily distressed, or agitated when in a stressful situation
  • Repetitive reassurance questions, “what if” concerns, inconsolable, won’t respond to logical arguments
  • Headaches, stomachaches, regularly too sick to go to school
  • Anticipatory anxiety, worrying hours, days, weeks ahead
  • Disruptions of sleep with difficulty falling asleep, frequent nightmares, difficulty sleeping alone
  • Perfectionism, self-critical, very high standards that make nothing good enough
  • Overly-responsible, people pleasing, excessive concern that others are upset with him or her, unnecessary apologizing
  • Demonstrating excessive avoidance, refuses to participate in expected activities, refusal to attend school
  • Disruption of child or family functioning, difficulty with going to school, friend’s houses, religious activities, family gatherings, errands, vacations
  • Excessive time spent consoling child about distress with ordinary situations, excessive time coaxing child to do normal activities- homework, hygiene, meals

Other Resources
The Introduction
http://www.cognitivetherapyforkids.com/cognitive.html

Worry Wise Kids
http://www.worrywisekids.org

Getting In Depth on what it is and how you use the tool
http://www.anxietybc.com/what-cbt

Thank for taking the time, my hopes are this will improve life for all.

  2 comments for “Anxiety Disorders and Congnative Behavior Therapy (CBT)

  1. jadmin
    October 16, 2010 at 9:07 am

    Great book by Tamar E. Chansky, Ph.D. call “Freeing your child from Anxiety”

    Page 44 states
    “Child psychologists are most often trained in cognitive behavior therapy, the treatment of choice for child anxiety disorders.”

    Also I have read this in numerous web sites. The interesting things has been general practice medicine doctors normally recommend drugs because they do not know any different. Psychologists normally recommend CBT. So the people who are really good use the right tools. I am not saying that drugs are never prescribed by Psychologists, but I am saying CBT is not the tool of choice, only to be used when you have to.

  2. Mary
    December 16, 2010 at 7:04 pm

    I understand what you are saying. It is so hard to work with the kids though, I find their anxiety sometimes over comes me. What do you do when that happens

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