How to reduce anxiety in your children – Part 5 of 5 – Specific strategies to stop avoiding your worries
This article is Part 5 of a 5-part series on How to reduce anxiety in your children. If you missed the first four parts, you can find them below:
- Part 1 of 5 – Introducing anxiety
- Part 2 of 5 – Understanding anxiety and its impact on the body
- Part 3 of 5 – What maintains anxiety?
- Part 4 of 5 – Problem-solving and Worry Time
In the last article, we talked about postponing our worries in a Worry Box until Worry Time, where we could then problem-solve our realistic thoughts or take our unrealistic thoughts to court.
In this article, we are going to discuss the following:
- The vicious circle of avoidance and anxiety
- Break the vicious circle – exposure in small steps
- Toolbox to help reduce anxiety in you and your children
The vicious circle of avoidance and anxiety
Imagine there’s a lake and it is freezing cold. You jump in feet first, and the shock of the cold water makes you rush out straight away. Would you want to do it again? Probably not. You would most likely want to avoid the lake altogether. If you do something and you really don’t like it, then it’s highly likely you won’t do it again.
If there is water in front of you, you would probably dip your toes in first to test whether the water was warm enough. You keep testing and testing until you finally get into the water. And, the water might feel warmer than the last time. so, what did you do? You took lots of small steps to get into the water.
It’s the same with anxiety. If you are faced with something that you are afraid of, you will get anxious about it, and your anxiety levels will go up. But, if you take small steps to expose yourself to that worry, you can reach your goal without avoiding the situation over time.
Let’s use an example.
You’re scared of dogs. You see a dog and your anxiety levels rocket. You will probably be anxious for a while, so you avoid the situation, and eventually, your anxiety levels will come back down. But, remember in Part 3, we learned that avoiding the worry only offers temporary relief. And if you continue to avoid dogs, you will feel just as anxious the next time a dog comes into the room. You will be stuck in a vicious circle of avoidance and anxiety.
Below is a graph provided Step2 CAMHS at the Multi-Family Anxiety Group Session (MFAGS) that shows how your anxiety levels would look when, in this example, you are faced with a dog. The dip shows what happens when you avoid the dog and eventually calm down.
Avoiding and running away a from the problem only manages your anxiety in the short term – it hasn’t changed anything. Your anxiety will keep coming back until you finally face your fears.
Break the vicious circle – exposure in small steps
You need to stop avoiding and expose yourself to your fears. But the best way to do this is to take it step-by-step, in small manageable pieces.
Let’s use our above example again.
You are faced with a dog again, and your anxiety levels go up. This time, however, either the dog is in the room, and you’re outside, or vice versa. You slowly start to realise that the dog can’t get to you and so your anxiety levels begin to dip. You stayed with the anxiety until you realised that the dog couldn’t hurt you. If you kept doing this again and again, your anxiety levels will drop quicker than the last time, and you will probably feel less anxious when you are faced with your fear. Your anxiety will gradually start to reduce, and you will learn that this fearful event is not what is causing you your fear. This notion breaks the vicious circle of avoidance and anxiety, as you can see in the graph below, provided by Step2 CAMHS at the MFAGS.
We need to face your fears to overcome them. So if you have a phobia and you avoid it, you will be stuck in this vicious circle of avoidance and anxiety. But, if you face your fear, slowly and over time, then you can break that cycle, and your anxiety levels will naturally reduce on their own.
It can seem personally challenging, but if you follow the four below conditions you can make exposure and habituation more effective 
Condition 1: Avoidance hierarchy – grade your worries
The first step is to grade your worries, from most anxious to least anxious, and then place your worries in order of the things you most want to avoid.
Below is a ladder worksheet from Psychology Tools that you can print out and give to your child to fill out.
The ladder will help you and your child to identify the things you are currently fearful and avoiding at the moment. Place your most fearful concerns at the top and work downwards to medium and then to easy difficulty.
Once you have created our avoidance hierarchy, select one of the steps that cause you some anxiety, but you feel you could manage. A good start would be to pick a worry that makes you around 50 – 60% anxious. Your child may put everything at the top as all worries feel horrible to them. Just pick the lowest worry on the ladder to begin with.
Conditions 2 and 3: Prolong and Repeat
Once you have created your avoidance hierarchy ladder, select your first step and write this in the section on the worksheet below  provided by Step2 CAMHS at MFAGS.
For example, your goal may be to get your child to sleep in their room. So you use the worksheet above to write down their goal at and then write down achievable steps they will take to achieve that goal.
Let’s use the above example of getting a child to sleep in their room to show possible steps
- 1st step – Parents sit on the bed. Mum or dad stays with them every night. The first step might raise your child’s anxiety slightly, and so you ask them to rate that anxiety out of 10. Perhaps, it causes them to have an anxiety level of around 5/10, but do this every night until their anxiety levels go down. Wait until their anxiety levels are low before you move onto the next step
- 2nd step – Parents sit on a seat by the door – Repeat this process until their anxiety levels dip before you move onto the next step
- 3rd step – Parents sit outside the room – Continue this process until your child finally sleeps on their own
Repeat the steps until your are no longer anxious or worried about this particular concern
Condition 4: Without the distraction
Try to remove things from their hierarchy that reduce anxiety artificially or distract them from how they are feeling during these exposure exercises. While it may seem they give your child temporary relief from feeling anxious, they are in fact keeping your child stuck in that vicious circle. Think about safety behaviours to manage anxiety. For example, your child always need to have a cuddly teddy during sleep. Incorporate taking teddy away in the ladder as this is safety behaviour and you could work on taking that teddy away. This works for adults too. Work through your own ladder and find steps that you can take to face your fear. The key is to make lots of little steps to get to your goal.
Finding time to do this is tough. But, think about it like this. If you are paying for a football club, would you find time to take your child to every session? You would find the time, so find time for this exercise because it is a priority for your child’s mental health. Mark this exercise in your the diary as if this is something that you are paying for. But make it realistic. Perhaps only do 10 minutes every day, so you and your child achieve the goal of facing your fears. You want something to change in them, so you need to take it seriously and support them.
Toolbox to help reduce anxiety in you and your children
As you work through all the steps to ultimately reduce your child’s anxiety, you will now have a toolbox of tools that you can take with you to practice with your child. Below are some of the tools we learned in the 5-part series, which will help you on the road to reducing anxiety in you and your children:
Below is a summary of what you can now practice at home every day.
- Recognise anxiety when you have it
- Practice breathing every day
- Practice relaxation every day
- Practice noticing thinking traps
- Practice thought challenging – taking thoughts to court
- Postpone your worries in a Worry Box and schedule Worry Time
- Practice problem solving your thoughts
- Practice mindfulness exercises to help you be in the present moment
- Practice Ladder to success
- Practice every day!
Please leave a comment below if you found this 5-part series helpful. What do you do with your child to reduce their anxiety at home?
- © Marie Chellingsworth & Paul Farrand, 2010 – 2014
- Materials and Worksheets from Anxiety by Paul Stallard published by Routledge