104: How to help a child to overcome anxiety

Listeners have been asking me for an episode on supporting anxious children for a loooooong time, but I was really struggling to find anyone who didn't take a behaviorist-based approach (where behaviors are reinforced using the parent's attention (or stickers) or the withdrawal of the parent's attention or other 'privileges.').   Long-time listeners will see that these approaches don't really fit with how we usually view behavior on the show, which is an expression of a need - if you just focus on extinguishing 'undesirable' behavior, you haven't really done anything about the child's need and - even worse - you've sent a message to the child that they can't express their true feelings and needs to you.   Listener Jamie sent me a link a book called Beyond Behaviors written by today's guest, Dr. Mona Delahooke, and I immediately knew that Dr. Delahooke was the right person to guide us through this. Listener Jamie comes onto the show for the first time as well to co-interview Dr. Delahooke so we can really deeply understand our children's feelings and support them in meeting their true needs - and overcome their anxiety as well.   Dr. Mona Delahooke's Books

Beyond Behaviors: Using Brain Science and Compassion to Understand and Solve Children's Behavioral Challenges

Beyond Behaviors Flip Chart: A Psychoeducational Tool to Help Therapists & Teachers Understand and Support Children with Behavioral Changes (Affiliate links).

  Jump to highlights 01:28 Introduction to Dr. Mona Delahooke, author of Beyond Behaviors 02:45 Introduction to listener Jamie, joining as co-interviewer 05:13 How most psychologists define anxiety, and the shift away from strict DSM labels 08:04 Why cognitive behavioral therapy and medication only help about a third to half of children 09:39 A look at a Yale study on parent-led anxiety treatment, and what it may have missed 23:33 Does responding to a child's "non-preferred" behavior just reinforce it? 27:09 Why we give autism a "pass" but hold other kids to a stricter standard 30:22 Why social engagement, not stickers or candy, is the most powerful reinforcer 33:52 Two different ways to reassure a frightened child, and why tone of voice matters more than words 36:57 What co-regulation actually means, and why pulling it away too soon backfires 40:10 Building hardiness in children by tending to our own emotional regulation first 44:33 Supporting a child whose anxiety seems built into their temperament 49:29 Book recommendations for helping children understand their bodies and emotions   References Beesdo, K., Knappe, S., & Pine, D.S. (2009). Anxiety and anxiety disorders in children and adolescents: Developmental issues and implications for DSM-V. Psychiatric Clinics of North America 32, 483-524.

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Delahooke, M. (2019). Beyond Behaviors: Using brain science and compassion to understand and solve children’s behavioral challenges. Eau Claire, WI: PESI.

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Lebowitz, E.R., Marin, C., Martino, A., Shimshoni, Y., & Silverman, W.K. (2019). Parent-based treatment as efficacious as Cognitive Behavioral Therapy for childhood anxiety: A randomized noninferiority study of supportive parenting for anxious childhood emotions. Journal of the American Academy of Child & Adolescent Psychiatry.

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Porges, S.W. (2007). The polyvagal perspective. Biological Psychology 74(2), 116-143.

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Wood, J.J. (2006). Parental intrusiveness and children’s separation anxiety in a clinical sample. Child Psychiatry & Human Development 37, 73-87.