Tac$cs for teen anxiety: What parents and teachers can do to help Lindsay Scharfstein, Ph.D. Licensed Psychologist, Center for Anxiety and Behavioral Change Whitman High School March 17, 2015 Overview •  What is anxiety?
•  Common signs of anxiety
•  Typical vs. clinical
anxiety
•  Practical strategies for
managing anxiety
•  Do’s and Dont’s
•  When to get help
Anxiety is typical for all of us!
•  Adaptive, keeps us safe, can help us succeed
•  Associated with new or unexpected events (e.g., 1st day
of school; thunder)
•  Associated with uncertainty (e.g., awaiting college
decisions; results from medical tests)
•  Can be handled by self and/or minimal reassurance and
encouragement from others
Anxiety can help our performance!
Bell Shaped Curve
“Sweet Spot”
Anxiety can help keep us safe!
What is anxiety?
Fight, flight or freeze!
Increased
Heart Rate
Rapid
Breathing
Sweating
What is anxiety?
•  What’s
different?
When anxiety becomes debilitating
Perspective
But this may not be completely surprising…
“Montgomery County Syndrome”
Lifetime prevalence
of anxiety disorders
Kessler et al, Archives of General Psychiatry, 2005
Anxiety is often overlooked •  Anxiety disorders are the least likely to be
identified and referred for treatment
•  Belief that “S/he will grow out of it”
Substance Abuse
Social Anxiety
Anxiety as a gateway Suicidality
Substance abuse
Depression
Generalized Anxiety
Help is on the way!
•  Awareness of anxiety- what to look for
•  Strategies to prevent/manage anxiety
•  Seeking professional help
Awareness: Developmental Stress
™ Elementary School – Separa$on ™ Middle School – Changes in demands for academics – Social acceptance – Bullying ™ High School – College pressure – Social pressure – Time management Awareness: What to look for?
•  Performance/behavior deterioration
–  School (academic functioning)
–  Peer relationships
–  Family functioning
–  Physical symptoms
Awareness: What to look for?
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Reluctance to work in a team
Reluctance to make choices or give suggestions
Rigidity or compulsiveness
Avoids new activities unless outcome is certain
Only performs tasks that s/he can do perfectly
Awareness: Taking an even closer look
Functions of behavior
Positive Reinforcement
 Obtain attention
Negative Reinforcement
 Avoid something
aversive
 Obtain a tangible reward
 Escape from something
aversive
Strategies!
Do’s for managing anxiety
•  Be supportive – validate feelings +
encouragement
•  Share your own coping skills NOT mastery
•  Challenge anxious thoughts
•  Provide positive feedback AFTER successful
coping (rewards vs. bribes)
•  Catch teens being brave
–  Reward with praise
Empowerment
•  Refer them to their own coping skills
•  Encourage your child with “loving firmness” to
enter low level feared situations or activities
–  “I can see that you feel anxious, but I also know that
you can do this”
Do’s for managing anxiety
•  Help identify trigger; label emotions
•  Problem solve – start by brainstorming ideas
for facing and managing the situation
•  Address peer teasing and humiliation
immediately
Remain neutral during ‘turbulence’
Building Coping Skills
 Coping self-statements
 Our internal dialogue
 Problem solving-skills training
 Assertiveness skills
Coping with Academic Stress
 Work on organizational strategies, academic
problem-solving skills
 Best to emphasize process and effort rather
than outcome.
Extracurricular Activities
“The Montgomery County Syndrome”
 Does the child have two full-time jobs?
 Complete inventory of number of
activities and number of hours including
travel
 The Perfectionistic Parent
Self-care
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Focus on strengths
Exercise
Sleep
Engage non-academic enjoyable activities
Practice self-compassion
Reframe negative thoughts
Engage supporters
Strategies: Don’ts
•  Invalidate
–  e.g., “I know this is hard for you
but I know you can do it” vs.
“This is not a big deal, why are
you being such a baby?”
•  Compare child to peers
•  Make it more rewarding for
child to be away from feared
situation than in situation
•  Put child on the spot when
you notice s/he is changing
for the better
Key strategies
•  Learn what style is most
effective for your teen
•  Break patterns that are not
working
•  Model self-care
•  Validate experiences
•  Provide empowerment
•  Think outside the box
(humor; flexibility)
When to look for help
 Emotional hygiene
 Sudden changes in behavior
 Avoidance of normal activities
 Excessive irritability
 Frequent somatic complaints
 Social isolation
 Teen asks for help
 Safety concerns
 Trust your instincts!
Thank you!! Lindsay Scharfstein, Ph.D. Center for Anxiety & Behavioral Change (CABC) Email: [email protected] Phone: 301-­‐610-­‐7850 x 5 Clinic Website: www.changeanxiety.com