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Parenting the Anxious Child

Presented by Marla Deibler, Psy.D.

View the webinar’s corresponding slides here        View the Webinar

Anxiety Disorders are among the most common childhood mental health struggles. Learning to effectively cope with distressing thoughts and anxious emotions can be challenging. When feelings of anxiety are excessive and become overwhelming, children instinctively rely on their parents to help them cope and rid them of these unwanted feelings. And, many well-meaning, caring parents do just that; however, this can become unintentionally problematic, impairing the ability of the child to function independently and preventing them from developing the ability to cope on their own. Understanding the context of anxiety in the family system provides a unique opportunity for parents to effectively help their children through their own behavioral changes.

Marla W. Deibler, PsyD is a Licensed Clinical Psychologist and the Founder and Executive Director of The Center for Emotional Health of Greater Philadelphia. Dr. Deibler holds a doctorate in clinical psychology (Psy.D.) with a concentration in health/neuropsychology and a post-doctoral master of science in clinical psychopharmacology (MSCP). Dr. Deibler gained her formative clinical and research experiences at the National Institute of Mental Health (NIMH) at the National Institutes of Health (NIH), Children’s National Medical Center, and the Kennedy Krieger Institute at Johns Hopkins University Medical Center. She gained specialized behavior therapy experience in the treatment of obsessive compulsive and related disorders at the Behavior Therapy Center of Greater Washington. Dr. Deibler served as a clinician at the National Center for Phobias, Anxiety, and Depression as well as on the clinical faculty at Temple University Children’s Medical Center and Temple University Schools of Medicine, Dentistry, and Allied Health.

Comments(24)

  1. SandyD says

    Left untreated, what are the risks associated with childhood anxiety into adulthood?

    • Dr. Marla Deibler says

      Left untreated, anxiety tends to restrict a child’s ability to function and may lead to continued or worsening of impairment, including the development of anxiety disorders or related disorders that commonly co-occur.

  2. Kristen S says

    What have you found to be most challenging about changing anxiety within a family system?

    • Dr. Marla Deibler says

      There are times when anxiety is maintained, in part, because of a shared belief within a family system. For example, a child with OCD who has scrupulosity obsessions and rituals involving prayer may have practices that appear to be reasonable religious practices shared by family members, when in actuality, they case the child a great deal of distress and impairment. Or, a child with contamination OCD who insists on washing his hands prior to dinner, may also have parents who view this practice as being necessary hygiene. In both scenarios, despite the child’s OCD, the family system shares the belief that the behavior is reasonable, even though it is being carried out to decrease anxiety related to the obsession in the short-term and increases the distress and maintains the symptoms in the long-term. These parents are not accommodating the symptoms in the same way as some of the others in our lecture, but they aren’t providing corrective information and are nonetheless reinforcing the problem. When this happens, we have to spend time talking to the family to educate them about this and sometimes consulting with others as well, such as religious leaders to discuss the importance of being flexible in the interest in the child’s health.

  3. SGreen says

    How do I respond to my child when they ask about fears that I don’t feel like I have a satisfactory response to? For example, right now, my child asks me what’s going to happen with the pandemic. Is it safe? Is he going to go back to school? Is this going to end? Are we going to get sick? How do I respond?

    • Marla Deibler says

      Help a child to identify how they are feeling about the situation. Let them know that their feelings are ok and that many kids feel the same way. Acknowledge the uncertainty of what is going to happen and focus on what is within their control. Talk about what can they do to stay safe. (wash hands, wear masks in public spaces, practice social distancing, etc.) Talk about what others are doing to keep them safe. (This includes others in the family, doctors, researchers, CDC, local government, etc). Lastly, talk about what they can do to manage their feelings (get a hug from mom or dad, play with a sibling, call a friend, play a game, listen to music, etc.) Remember to give high quality support.

  4. FNottingham says

    My grandson is in 1st grade and prior to this pandemic situation he was already struggling with school refusal due to anxiety around the active shooter drills. Now it’s this virus. I can’t imagine how he’s going to manage getting back to school when it reopens. I would appreciate your comments.

    • Marla Deibler says

      There will be many children who will struggle with transitioning back to the classroom; he is not alone. Acknowledging his strong feelings is important. This is hard. And, it’s scary. We don’t know when or how kids will return to school yet. When worry creeps in, it’s important to pull kids back to the present. What do we know right now? Right now, we know that kids are not yet returning to school. That’s it. Ok. So, the hard part is the not knowing. Yeah, that can be hard. When we know more, we can talk about what we do know, how we feel about that, and what we might do to help make that easier for you. Until then, it sounds like, it’s just that we don’t know. Let’s see if we can practice getting good at not knowing and being ok with that.

  5. bcrosby says

    Is there a rule of thumb for how long a child should show anxiety before it becomes not normal?

    • Marla Deibler says

      There is no rule of thumb in terms of length of time. We are more concerned with developmental appropriateness and how impairing it is to an individual’s ability to function.

  6. cwojihowitz says

    Isn’t it difficult for a parent who has trouble self-regulating to care for a child who has the same behavior? Don’t they sort of feed off each other?

    • Marla Deibler says

      Yes, this can absolutely be a challenge. Sometimes, it can be helpful for dysregulated parent(s) to also have their own therapist(s) to learn better self-regulation as well. Family therapy can sometimes be helpful in addressing issues around systemic communication.

  7. HFarmer says

    Would it correct to say that it’s not wrong for the child to ask for chicken nuggets, but rather their behavior when they don’t get what they want?

    • Marla Deibler says

      (Assuming this is referring to the dinner party example from the presentation) I wouldn’t say that it’s wrong for a child to ask for chicken nuggets; the child is just being a kid, trying to figure out how to bring down the distress they feel they see there’s only grilled chicken available, so they do what they have learned works.

  8. FHolmes says

    Regarding the child who’s checking in with parents during the day about their welfare: could that not be a red flag that there is some other issue in the home? Is there a fine line between looking deeper into a particular home situation?

    • Marla Deibler says

      Yes, of course. I would not make an assumption about what is going on. If, for example, this texting behavior was going on at school, the school would certainly want to contact home to assess the situation. We were using examples of anxiety-driven behavior. We should not make the assumption that a behavior is anxiety driven and should always assess for safety.

  9. ArnoldP says

    What do you suggest for kids that are flooded with stress all day with many triggers (LD, TS, social issues, gifted)? Is a smaller setting accommodating the anxiety, or could it be part of the treatment?

    • Marla Deibler says

      Well-crafted accommodations in school for LD, TS, and ADHD, for example, are likely to help a child minimize distraction, maximize their ability to stay on task, and minimize their academic distress as it relates to their diagnoses. Sometimes, kids require smaller class sizes, for example, in order to cultivate a learning environment that is more conducive to learning for that individual because of their disabilities. That isn’t “accommodating” in the sense that we are using the word. That is the intended function of the 504 and IEP. And, that’s a good thing. However, as I mentioned, in the presentation, “the devil is in the details”. The function of each recommendation is important to consider, as the goal, of course, is to maximize the child’s ability to function independently and to their own potential. So, the goals may change to scaffold the child toward higher functioning.

  10. AmyZ says

    My child has had a lot of questions around death. When she will die? How she will die? When will I die? What will happen to her if I die? Are there resources or stories I can use to better explain to her?

    • Marla Deibler says

      This is a common fear for kids and there are some good resources out there, depending on the age of your child. Normalize her feelings. They are understandable. Everyone has these thoughts and feelings. There are so many different beliefs about what happens after someone dies. You can talk about some of those stories and beliefs, religious or otherwise. Convey the facts about how our bodies stop working when we die and that we will all die some day and that all living things die. There are also some storybooks (depends on her age) you can find on Amazon that are good reads.

  11. MMThurston says

    I would appreciate your comments on co-sleeping. My grandson is 3 and until very recently was co-sleeping with his parents. Now he starts out in his own bed, but inevitably wakes up and mom gets in with him. Otherwise he’s behaves appropriately for his age, he’s toilet trained, speaking in sentences etc. Do you think this is an anxiety issue or just a bad habit that needs some tough love?

    • Marla Deibler says

      Parents often have strong beliefs and feelings about co-sleeping. While some parents enjoy sharing a “family bed,” it is an important developmental task for a child to learn to fall asleep and fall back asleep on one’s own. Sometimes failure to do so is related to anxiety, or sometimes it is simply related to reinforcement of the behavior of being joined by a parent or joining the parent(s) – it’s warm and snuggly – or sometimes both. Also, it’s important for families to have boundaries for kids and parents and sharing sleep space (although a really nice experience, at times, for everyone) can blur those boundaries. For a healthy family system, and a good night sleep for all, it’s best to teach kids to sleep in their own beds.

  12. Tracy says

    How do I go back to listen to this webinar? I fell asleep before the end and missed the answer to my question.

    • Marla Deibler says

      It did go late, didn’t it?! You can watch it again or skip around. Just click “View the Webinar” at the top of the page.

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