All Posts Tagged: cognitive behavioral therapy

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Social Anxiety In Toddlers

Toddlerhood is defined as the age range from 12 to 36 months. During this period, a child’s emotional and cognitive development grows by leaps and bounds, as do their social skills. This also coincides with the time when children are likely to go into a daycare environment or head off to preschool. As they engage more often with other children and adults, it may also be the stage when a toddler’s social fears begin to emerge.

Just as with adults, some children are comfortable with social interactions while others may not be. Each group of kids will have the social butterfly as well as the “shy” child who quietly observes and doesn’t interact as much. It is one thing to be shy, however, and another to be intensely fearful and anxious in a social setting. Because we know it can show up early in life, a toddler who shows such strong reactions in a social environment is often regarded as having social anxiety.

What causes social anxiety in toddlers?

We aren’t really sure what causes social anxiety in toddlers. Genetics likely plays a role, since it contributes to a child’s temperament and personality. We also know that some genetic traits can influence certain mental health conditions.

A toddler’s environment could also predispose them to social anxiety. For a young child who already has a higher genetic risk, living with trauma or a severe parenting style may be enough to initiate social anxiety.

Social anxiety may also be learned from a parent, according to a 2006 study by de Rosnay, et al. Their research focused on indirect expressions of a mother’s social anxiety on their infant. The results showed that, “compared to their responses following their mothers interacting normally with a stranger, following a socially anxious mother-stranger interaction, infants were significantly more fearful and avoidant with the stranger. Infant-stranger avoidance was further modified by infant temperament; high fear infants were more avoidant in the socially anxious condition than low-fear infants.”

Is Social Anxiety a form of autism?

Studies have shown that social anxiety is not a form of autism, although the two have overlapping indicators, such as separation anxiety and avoiding eye contact. In fact, not only are they two distinct disorders, but the symptoms and diagnostic criteria for each are vastly different.

As the name implies, social anxiety is driven by anxiety. A child who has social anxiety will function within the parameters of their level of unease. For instance, they may simply keep to themselves, avoid other children, or might talk too quietly. Some kids may not talk at all.

On the other hand, a child with autism spectrum disorder doesn’t behave based on their anxiety level. Instead, this child has trouble understanding social cues and the nuances of communication. They might speak too loudly, may push their way into a group of children, or might misinterpret facial expressions or gestures.

Does my kid have social anxiety?

Children who have social anxiety may be branded as difficult kids because their anxiety can show up in forms other than just in social interactions.

Toddlers with social anxiety often show certain signs, such as:

  • Being a picky eater
  • Easily startled by noises
  • Not adapting well to new situations
  • May have a higher sensitivity to tactile sensations
  • Acting shy around new people and fearing strangers
  • Disliking being separated from their parents (separation anxiety) and distraction doesn’t calm them
  • Having strong emotional reactions and difficulty self-soothing
  • Might have sleep issues
  • Seems afraid to interact with peers, both individually or in a group setting
  • Often has other phobias or fears

Therapists who specialize in treating children’s mental health concerns can do an assessment, however a definitive diagnosis in a toddler with social anxiety may not be feasible due to their young age. The results should highlight challenging areas, though. It may also reveal the basis of the child’s social anxiety, which allows for early intervention.

How to help a child with social anxiety

At home, parents can demonstrate healthy social interactions when their child is with them, so the toddler learns not to be so fearful.

They can also rehearse a new situation with their child before it comes up. For example, a toddler who will be going to daycare for the first time might role-play some of the things they’ll do while they are there. Practicing certain aspects of the day or even dropping by the daycare a couple of times before officially attending can ease fears because the daycare will already be familiar. It would also be helpful to let the teachers or caregivers know about your child’s fears, so they can help build confidence.

Other supportive methods include:

  • Encouraging your toddler, but not forcing them into social interactions.
  • Using praise when the child successfully navigates a scary situation.
  • Not criticizing them for their fears.
  • Being calm and showing the toddler that you are confident.
  • Not being overprotective, which only reinforces the idea that the toddler has something to be afraid of.
  • Reading books or watching videos that show confident children.

Get Help for Social Anxiety in Toddlers

Our warm and welcoming Children’s Center offers a wide range of clinical, therapeutic, educational and supportive services specifically for children ages two through twenty two. Additionally, our facility is the South Florida regional clinic for the National Social Anxiety Center (NSAC).

For more information about how our child psychologist can help your child with their social anxiety or other mental health needs, contact the Children’s Center for Psychiatry Psychology and Related Services in Delray Beach, Florida or call us today at (561) 223-6568.

References

  1. de Rosnay, M., Cooper, P. J., Tsigaras, N., & Murray, L., (2006). Transmission of social anxiety from mother to infant: An experimental study using a social referencing paradigm. Behaviour Research and Therapy, 8(44), 1165-1175. Doi: https://doi.org/10.1016/j.brat.2005.09.003
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Boy with heart shaped paper

Autism Spectrum Disorder: ASD And Anxiety In Children

Autism Spectrum Disorder (ASD) comes with a variety of challenges. For many children, it can mean issues with compulsiveness and repetitive behaviors, learning and social deficits, and a resistance to change. ASD also can manifest with various emotional difficulties – although not specifically linked, we know that ASD and anxiety frequently appear together in children.

Kids with ASD and anxiety can have physical symptoms (example: racing heart or a stomach ache) or their anxiety may also show up in the form of rituals that can help calm them (for instance: shredding paper). Because many autistic children are either non-verbal or have trouble communicating, an outward display of anxiety may be their only way of telling you that they are distressed.

Autism And Anxiety Comorbidity

“40% of young people with ASD have clinically elevated levels of anxiety or at least one anxiety disorder, including obsessive compulsive disorder”, according to an article by Dr. Elisabetta Burchi and Dr. Eric Hollander of the Autism and Obsessive Compulsive Spectrum Program at Montefiore Medical Center and the Albert Einstein College of Medicine.

They stress the importance of anxiety treatment for children with autism spectrum disorder. “While untreated comorbid anxiety has been associated with the development of depression, aggression, and self-injury in ASD, an early recognition and treatment may convey better prognosis for these patients“.

Some studies have shown that high-functioning children suffer from more anxiety disorders than do lower functioning children on the spectrum. Additionally, other research reports that adolescents and teens with ASD may be more challenged by anxiety than their younger peers.

How To Recognize Anxiety In Asperger’s and ASD

It can be difficult to spot the signs of anxiety in a child who has ASD for a couple of reasons: kids who are verbal may not be able to recognize and express their emotions, while children who are nonverbal can’t tell you that they are afraid or worried.

Also, children with ASD often display common behaviors that can look similar to those found in anxiety disorders. For example, the compulsions that are carried out in obsessive compulsive disorder can look much like the repetitive behaviors that a child with ASD will use, however the autistic child may not actually be anxious.

Although there are no specifics to watch for, anxiety often presents in the form of physical or behavioral issues. The signs may not be apparent in a younger child, but may show up in later years as they mature and their world expands to include school and other settings.

  • Social anxiety may show up in the form of avoidance of social situations. This keeps the child from experiencing interaction with peers and the opportunity to practice social skills.
  • Separation anxiety may be present if the child acts out when being parted from their parent, such as when a babysitter comes to the home or when the child goes off to school for the first time.
  • Phobias are anxiety responses to specific fears (i.e. fear of insects or acting out after being startled by a loud noise).
  • Distress about changes in routine can show up in the form of physical rituals or repetitive behaviors that the child uses to soothe themselves until they can calm down.
  • Controlling behavior or threats to hurt themselves or someone else are often a sign of high levels of emotional distress.
  • In adolescents and teens, alcohol and drug abuse are destructive coping methods that may be used to mask anxiety.

Treatment For Autism And Anxiety

Research has shown that behavioral interventions are helpful for many ASD children who have anxiety. One of the most effect therapies for treating autism and anxiety is cognitive behavioral therapy (CBT). This therapy is best for a child who has some verbal abilities.

CBT teaches kids how to uncover the fear beneath their anxiety so they can challenge their negative or inaccurate thoughts. For instance, if a child has anxiety about going to school, they may actually be afraid of getting lost and not being able to find their parents again.

Once the fear has been identified, the therapist can use small doses of exposure therapy to provide the child with evidence that they are safe. In the case of school anxiety and the resulting fears surrounding being separated from a parent, exposure therapy might involve having the child spend a minute or two in a room without their parent. When mom or dad come back in, the child feels safe. As the length of time apart from their parent increases with an end result of the parents returning, the child’s anxiety level can begin to decrease when they are away from the parent in other situations.

Depending on the child, an anxiety medication, such as a selective serotonin reuptake inhibitor (SSRI) like Prozac, may also be used in combination with behavioral therapy.

Need More Information About ASD And Anxiety In Children?

Our warm and welcoming Children’s Center offers a wide range of clinical, therapeutic, educational and supportive services specifically for children ages two through twenty two.

For more information about how our child psychologist can help your child with their ASD and anxiety, contact the Children’s Center for Psychiatry Psychology and Related Services in Delray Beach, Florida or call us today at (561) 223-6568.

 

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Intensive Outpatient Therapy Helps Children With Depression And Anxiety

We all have our anxious moments or times when we are depressed. It’s normal to feel these emotions when we are in stressful situations. In children, anxiety and depression can manifest differently than it does in adults. We often see more dramatic signs of frustration, irritability, and even anger. Kids might be restless, withdraw socially, or lose their appetite.

Usually these conditions go away once conditions improve. For many children, however, anxiety or depression can drag on and on. It may get worse over time and might even start to interfere with their school life, social relationships, or daily activities. When it reaches this point, it is likely that the child has an anxiety or mood disorder that requires treatment from a child psychologist. Be assured that these conditions are highly treatable.

Traditionally, children who are undergoing treatment for anxiety or depression will see their therapist once or twice a week for 30-60 minute sessions. These sessions often continue for three to four months, but could go on much longer depending on the severity of the child’s disorder. However, a relatively new concept in psychotherapy, called intensive outpatient therapy, is showing promise for helping kids get better faster.

What Is Intensive Outpatient Therapy?

Intensive outpatient therapy is focused therapy that is given over longer treatment sessions. For example, intensive treatment might be concentrated into daily, three-hour sessions given five days in a row over a two to four week period.

Just as with a regular psychotherapy session, intensive treatment uses methods like cognitive behavior therapy CBT, mindfulness, and exposure response and prevention (ERP). The idea behind the intensive sessions is to teach strategies to decrease the child’s symptoms and provide support, but to do it within a framework that allows them to live at home and continue school and family activities.

An intensive outpatient therapy program includes:

  • Comprehensive treatment planning
  • Learning to recognize unhealthy behaviors
  • Building successful problem solving abilities
  • Learning coping strategies and skills
  • Methods and practice to aid in asking for and getting support
  • Follow up sessions to reinforce these new skills

Although intensive therapy is fairly new, research is showing that it is just as beneficial as long term therapy or in-patient centered therapy. A 2012 study of adults by Ritschel, Cheavens, and Nelson at the Emory University School of Medicine reported that, “Depression and anxiety scores decreased significantly and hope scores increased significantly over the course of treatment.“

Children who have anxiety and depression make similar advances when they undergo intensive outpatient therapy. These gains are long-lasting, just as they are for traditional treatment.

Intensive therapy involves parents as well as children. During treatment, family meetings are held so that parents can better understand the therapy process and learn how to best support their child.

Additionally, children may interact with other kids so they can see that others are going through similar challenges. This is also an opportunity for them to relate to children their own age in a way they may not be able to with their peers or siblings who don’t face the same concerns.

If you are looking for an intensive program for your child, be sure that whichever one you choose utilizes therapists who have been highly trained in treating anxiety and depression in children and teens.

Also, you want the program to be individualized to your child. They should feel a connection with the therapist. The therapist should work with your child to develop a plan specifically for their needs in order to maximize the outcome of their treatment.

Who Would Benefit From Intensive Outpatient Therapy?

Sometimes a child struggles with depression or anxiety symptoms while still being able to function in their daily life. At other times, they may need more focused therapy and support. Intensive outpatient treatment would work for both children. Intensive therapy can also provide rapid and effective management in someone with severe symptoms who has taken time away from school for their recovery.

To be most effective, children who participate in intensive therapy should:

  • Attend every session. This can be difficult if they are having bad days, but they will get the most benefit by coming to every appointment.
  • Allow themselves time to process what they are learning.
  • Treat themselves gently while they learn that it’s okay to make mistakes
  • Trust in the therapy and therapist.

Learning coping skills and effective management of symptoms may continue on and off during a child’s life. Sometimes kids need a “booster” even after intensive therapy, but trusting that the psychotherapists and treatment will help can aid in quickly reducing and managing moderate to severe anxiety and depression.

Learn More About Our Upcoming Intensive Outpatient Therapy Sessions For Children – Starting Soon!

For more information about our upcoming intensive outpatient therapy sessions for children and teens, talk to the professionals at the Children’s Center for Psychiatry, Psychology and Related Services in Delray Beach, Florida. Contact us or call us today at (561) 223-6568.

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School Violence and PTSD

School Violence and PTSD

This week marks the first anniversary of the school shootings at the Marjory Stoneman Douglas High School in Parkland, FL. On February 14, 2018, 17 students and teachers were senselessly killed and 14 more were wounded.

Reflecting on the tragedy and remembering those who lost their lives will no doubt bring up strong emotions in some children. Even those who weren’t personally connected to the event may feel sad and re-experience a sense of loss. For some kids, the anniversary may even trigger or worsen symptoms of post-traumatic stress disorder (PTSD).

Distressing events such as school shootings can affect children just like they can affect adults. In fact, it’s normal for kids to go through a range of emotions when they hear about a tragedy – they might have trouble sleeping or may express fear, sadness, anger, and grief.

PTSD After Trauma

While many people have moved past the distress brought on by the Parkland shootings, some students may have developed post traumatic stress disorder (PTSD) afterward. This is because children who saw the news coverage or heard about the event may have felt scared, threatened, and unsafe in their own school. Now, the anniversary may bring these troubling thoughts to the surface again.

PTSD is often the result after exposure to a terrifying event or ordeal, especially one in which intense physical harm has occurred or was threatened. It isn’t uncommon for people who were not personally present during a tragedy to find themselves going through some of the symptoms of PTSD, as well.

Just think of your reaction to the events on September 11, 2001. We all watched countless news images of the planes impacting the Twin Towers and of their eventual collapse. Many Americans had strong emotional responses during the tragedy – it seemed as if that’s all we talked about for weeks afterward.

In simple terms, we felt threatened. In this way, you can see how varying degrees of PTSD were the result for many people. Kids can feel the same symptoms after something that hits close to home for them, such as a school tragedy.

PTSD Symptoms

The symptoms of PTSD fall into three categories:

  • Hyperarousal symptoms
  • Avoidance symptoms
  • Re-experience symptoms

With hyperarousal, the person may have problems sleeping or anger easily. They may also be easily startled or seem to be constantly tense and on alert.

Those kids who experience avoidance symptoms might have strong feelings of guilt or worry. Some may be depressed or emotionally numb or may lose interest in the things they used to enjoy. Others might avoid anything that reminds them of the ordeal.

Kids whose PTSD falls into the group that re-experiences the trauma may be burdened with nightmares or frightening, overwhelming thoughts.

Younger children may reenact the event or draw it out on paper. They may also regress or show fearful behavior.

How Is PTSD Treated Professionally?

With time and a period of adjustment, most people will recover from a traumatic event. If a child has gone through a trauma, however, and still has PTSD symptoms for more than a month, seek help from an expert.

A therapist can work with your child to address their symptoms and depression. They will move at the child’s own pace while helping your teen or child adjust.

The therapist may use cognitive behavioral therapy (CBT), which is very effective for dealing with the negative feelings and thoughts that come with PTSD. CBT helps the child replace the destructive emotions with positive ones.

Eye movement desensitization and reprocessing (EMDR) is another therapy that has a proven track record in the treatment of post traumatic stress disorder. It uses focused eye movements to treat PTSD and works in combination with cognitive behavioral therapy.

For young children, engaging in play therapy can be a great way to help them deal with a trauma.

Medication is sometimes prescribed to help a child cope after a tragic event. This is usually reserved for serious symptoms of depression and anxiety.

Helping Your Child At Home

A child who has been through a trauma needs an adjustment period to help them process the event. During this time, they will need plenty of love, support, patience and understanding from you.

  • Let them talk about what happened, but don’t force them to do so – they need to be ready to talk. If they won’t talk, encourage them to draw or write about their feelings.
  • Let the child know their emotions and thoughts are normal. Get immediate professional help if they are thinking about self-harming or are talking about suicide.
  • Keep their routine as close to normal as possible. Try not to let them take too much time off from school or away from activities like sports or music classes, etc.
  • Support groups can be very helpful for expressing emotions after a trauma. Ask the school counselor or your child’s pediatrician for nearby groups.
  • Don’t condemn behaviors like sleeping with a stuffed animal or keeping the lights on when they go to bed. Sometimes these things can give the child an added measure of comfort during a distressing period in their lives.

 After School Violence – We Can Help

Our Children’s Center staff has specially trained clinicians to help those who need help dealing with the anniversary of the school shooting or other traumatic situations. For more information, contact The Children’s Center for Psychiatry Psychology and Related Services in Delray Beach, Florida or call us today at (561) 223-6568.

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Dermatillomania (Skin Picking Disorder)

While it’s simply “being human” to occasionally pick at your skin, at calluses, or at the cuticles on your fingers, when a person obsessively self-grooms, it could be a sign of dermatillomania or excoriation disorder. In layman’s terms, this is a skin picking disorder. The condition is a form of obsessive-compulsive disorder and is one of a group of body-focused repetitive behaviors (BFRB). Dermatillomania damages skin and is characterized by compulsively picking, touching, pulling, rubbing, digging into, scratching, or even biting at one’s own skin as a way to get rid of perceived skin irregularities.

Signs of Dermatillomania

Research shows that anywhere between 2% and 5% of people compulsively pick at their skin. Females make up about 75% of those who are diagnosed with excoriation disorder. Skin picking can begin at any age, but commonly shows up in adolescence or at the onset of puberty. The condition made come and go over time, and the location the person picks at may change, but the disorder is generally chronic.

The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) signs and symptoms of dermatillomania include:

  • Skin picking that results in visible lesions, skin damage, scars and possibly disfigurement
  • The person has made repeated, unsuccessful attempts to stop picking at their skin
  • The symptoms cause clinically significant distress or impairment
  • The symptoms are not caused by a medical or dermatologic condition or by a substance (example: opiate withdrawal)
  • The signs and symptoms are not better explained by another psychiatric disorder

Picking at the skin can cause anxiety, depression and embarrassment in those who have dermatillomania. They may attempt to cover their skin lesions with makeup or clothing and may avoid situations in which their condition may be discovered. This can lead to isolation and emotional distress, which can increase the risk of having a mood or anxiety disorder in addition to their dermatillomania. Another complication can be the need for medical care because it isn’t uncommon for the person to get a skin infection, open wound, or scars from picking too much.

Treatment for Skin Picking Disorder

It is thought that fewer than one in five people will seek treatment for excoriation disorder, however Cognitive Behavioral Therapy (CBT) is very helpful for those who do. CBT helps patients identify the negative or inaccurate thoughts, feelings and behaviors that have become problematic and teaches them how to challenge and change their reaction to them.

While the main therapy for dermatillomania is behavioral therapy, medication is sometimes used to reduce the feelings that lead to compulsive skin picking. Although psychiatric medications have limited success, there are some people who benefit from temporary use of them, particularly if they have a concurrent condition, such as anxiety or depression. Additionally, some skin medications can help the underlying condition (such as acne) that causes the individual to pick at their skin.

As a family member, it can be difficult to be supportive of a person with dermatillomania or other BFRBs. The behavior can strain relationships with friends and family. Remember to communicate with patience and empathy and remain calm when talking to the person. If you feel overwhelmed, join a support group or explore the resources in self-help groups or in books on the subject.

Get Help for Dermatillomania

For more information about how a child psychologist at the Children’s Center can help your child overcome skin picking, contact the Children’s Center for Psychiatry, Psychology and Related Services in Delray Beach, Florida or call us today at (561) 223-6568.

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PANDAS Disease Following a Strep Throat Infection

PANDAS Disease Following a Strep Throat Infection

PANDAS disease (short for Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections) isn’t a true disease. Instead, it is a rare disorder that can occur in children following a strep throat infection. With PANDAS strep, the child’s body sets up an immune response to the invading streptococcus bacteria, but ends up attacking the child’s own tissues in addition to the strep bacteria. The result is inflammation within the brain, and the dramatic onset of OCD (obsessive-compulsive disorder), tics, intense anxiety and other debilitating symptoms.

The hallmark of PANDAS is that these new symptoms and disorders appear or worsen very suddenly. In fact, parents say they come “out of the blue” or that their child changes “overnight.” Keep in mind that children who have been previously diagnosed with OCD or tics will always have their good days and their bad days, so an upswing in symptoms does not necessarily mean the child has PANDAS disease just because they’ve had a throat infection. With PANDAS disease, however, the child’s tics or OCD would flare up dramatically and continue to stay elevated anywhere from several weeks to several months.

PANDAS Symptoms

The National Institute of Mental Health (NIMH) reports that the diagnosis of PANDAS syndrome is strictly a clinical diagnosis. There are no lab tests that can diagnose the PANDAS disorder. Additionally, the diagnosis of PANDAS is controversial, so some clinicians either don’t understand it or may overlook the syndrome.

Currently, the only way to determine whether a child has PANDAS disease is to look at the clinical features of the illness, so health care providers use diagnostic criteria to make a PANDAS diagnosis.

NIMH’s diagnostic criteria for PANDAS:

  • Presence of obsessive-compulsive disorder and/or a tic disorder
  • Pediatric onset of symptoms (age 3 years to puberty)
  • Episodic course of symptom severity (see information below)
  • Association with group A Beta-hemolytic streptococcal infection (a positive throat culture for strep or history of scarlet fever)
  • Association with neurological abnormalities (physical hyperactivity, or unusual, jerky movements that are not in the child’s control)
  • Very abrupt onset or worsening of symptoms

If the symptoms have been present for more than a week, blood tests may be done to document a preceding streptococcal infection.

Additionally, the NIMH reports that children with PANDAS often experience one or more of the following symptoms in conjunction with their OCD and/or tics:

  • ADHD symptoms (hyperactivity, inattention, fidgety)
  • Separation anxiety (child is “clingy” and has difficulty separating from his/her caregivers; for example, the child may not want to be in a different room in the house from his or her parents)
  • Mood changes, such as irritability, sadness, emotional lability (tendency to laugh or cry unexpectedly at what might seem the wrong moment)
  • Trouble sleeping, night-time bed-wetting, day-time frequent urination or both
  • Changes in motor skills (e.g. changes in handwriting)
  • Joint pains

PANDAS Disease Risk Factors

The risk factors for PANDAS syndrome are:

  • A family history of rheumatic fever
  • The child’s mother has a personal history of an autoimmune disease
  • The child has a history of recurrent group A streptococcal infections
  • PANDAS is more common in males
  • It is more common in prepubescent children

PANDAS Syndrome Treatment

Treatment for PANDAS disorder is medication to treat the strep throat infection (*Tip: Sterilize or replace toothbrushes during and following the antibiotics treatment, to make sure that the child isn’t re-infected with strep.). Treatment also includes medications to control the neuropsychological symptoms and Cognitive Behavioral Therapy (CBT) to help with the child’s OCD or ADHD symptoms.

Research does not indicate long-term penicillin use to try to prevent recurrence of PANDAS disorder. Current information suggests the syndrome is caused by the antibodies produced by the child’s body in response to the streptococcus bacteria, not by the actual bacteria itself. Research also does not support the removal of the child’s tonsils strictly to prevent recurrence of PANDAS disease.

Have Questions about PANDAS Disease?

If you are concerned your child may have PANDAS syndrome after a strep throat infection, we can help. Our Children’s Center focuses specifically on offering a variety of clinical, therapeutic, educational and supportive services to children ages two through twenty two in a warm and welcoming environment.

To learn more, contact the Children’s Center for Psychiatry Psychology and Related Services in Delray Beach, Florida or call us today at (561) 223-6568.

 

 

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How Does Virtual Reality Therapy Help School Anxiety?

How Does Virtual Reality Therapy Help School Anxiety?

The start of a new school year is just around the corner. While many children are happy about heading back to the classroom and seeing their friends again, for some kids, a new school year embodies fear and school anxiety. But, what if your child could go into their classroom in a non-threatening way, interact with a new teacher and classmates, and learn effective methods for coping with the anxiety-inducing situations they dread in school? With virtual reality therapy, they can do just that.

This innovative treatment is emerging as a high-tech solution that lets kids challenge their fears in a safe, realistic environment, but in a way that gives them control. VR therapy can be used across age groups and can be adjusted to the child’s developmental age as they mature.

Additionally, this therapy can be tailored to vary the complexity of school phobia scenarios. For example, one child might be apprehensive about taking exams, while another dreads interaction with their peers. Both can be helped with virtual reality therapy, which is a combination of cognitive behavioral therapy (CBT) and in-vivo exposure therapy, but with a state of the art twist.

For example, if your child has a high level of test anxiety, as studies indicate anywhere from 15% to 25% of students do, virtual reality therapy will allow them to mimic test taking in a non- or less stressful environment (just like in-vivo exposure does) in order to overcome their negative thought patterns (“I always fail tests.”) through cognitive behavioral therapy. In a test-taking scenario, the virtual reality simulated distractions and stresses of taking exams would be minimal to start with, and then slowly be increased as the child learns to process and adjust to them. At the end of the therapy, the child will be able to face an exam with reduced or minimal fear.

What Happens During Virtual Reality Therapy?

Because most kids relate so well to video games, virtual reality exposure therapy seamlessly integrates treatment with real-world interface. It helps children retrain their brain so they have a defense against problems like meeting a new peer or being bullied, which makes them feel more comfortable about situations at school. VR therapy has also been successful in teaching or improving social cognitive skills and emotion recognition in high-functioning autistic children.

When kids go through VR therapy, they first learn coping skills to help them stay calm under a stressful circumstance. Once they are comfortable with these strategies, they continue on to virtual reality therapy, where they view computer-generated environments and use an avatar to experience interactions with adults and other kids.

As you can see in this Today Show video, the teens have the freedom to pause or review and repeat their avatar’s interaction with others inside the setting until they feel confident about the situation. A therapist listens in on the virtual reality session and offers feedback and coaching to help the child navigate the difficulties that have created their school refusal.

Studies have shown that virtual reality therapy actually “rewires” the brain so that the areas relating to sociability and attention are heightened. This leads to increased awareness and understanding of social cues, enhanced perception of the give and take in conversations, and more control when faced with real-life school issues. In studies done after kids have gone through virtual reality exposure therapy, scans have shown that the regions in the brain associated with social skills and those sections that exchange information during social interactions are heightened.

This interactive and visually stimulating approach to treating school anxiety delivers a dynamic platform that can simulate an unlimited number of phobia situations. By targeting a child’s specific fears, it provides meaningful close-to-life scenarios with immediate feedback, which greatly enhances the child’s ability to cope under stress.

Did You Know?

Our Children’s Center focuses specifically on offering a variety of clinical, therapeutic, educational and supportive services to children ages two through twenty two in a warm and welcoming environment.

For more information about how our child psychologist team can use virtual reality therapy for your child’s school refusal, contact the Children’s Center for Psychiatry Psychology and Related Services in Delray Beach, Florida or call us today at (561) 223-6568.

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Child Anxiety – Divorce Therapy for Children

Child Anxiety – Divorce Therapy for Children

Going through a divorce is stressful enough for the couple involved, but when children are added to the mix, it can bring a youngster’s fears to the forefront and trigger a cycle of child anxiety. The youth suddenly finds his or her world fracturing apart as the family divides into separate households. And, often the child has to adjust to living in a new home or going to a new school in addition to coping with their parent’s split.

Among other things, a divorce can increase a child’s aggression, bring up issues of separation anxiety, and negatively impact either (or both) the social and school performances of the youngster. It also increases the stress levels in children who already suffer from anxiety issues or mood disorders and can initiate anxiety-related concerns in children who do not normally have them.

Helping Children Cope with Divorce

When parents divorce, their children often react by showing:

  • Regressive behaviors (bedwetting, tantrums, thumb sucking, refusing to go to bed)
  • Rebellious behaviors (anger, disobedience, or (in an older child) disregard for the parents)
  • Increased episodes of crying or whining
  • Feel “sick” when they are healthy or becoming clingy
  • Separation anxiety
  • Blaming themselves for the divorce

The following are some ways that you, as a parent, can help diffuse some of the tension and child anxiety when going through a divorce:

  • Respect your child’s feelings and encourage them to talk to you about their fears. You may not have all the answers, but sometimes just listening and being supportive to your child can be enough.
  • Remember that your child has lost something, too. They have lost their time with one parent when they are with the other parent and, in many cases, have lost their familiar surroundings, peers, and maybe even a beloved pet or best friend.
  • Reassure your child that, no matter what, you love them now and will always love them. Be sure they understand that the divorce was not their fault and that there is nothing they could have done to prevent it.
  • Try to keep the same routines for bedtime, homework, play time, etc. New routines might need to be added (for example: going to the other parent’s house every Friday night), but keeping as close as possible to the same schedule helps children feel secure. It lets them know what to expect.
  • Rituals also create a sense of safety for your child. A family ritual such as “game night” creates an anchor for your child and gives them a sense of familiarity and a way to relate within their new world.

How Divorce Therapy for Children Can Help

Many times children will adjust to the breakup of a marriage after a “settling in” period, but in the case of youngsters who already have some anxiety, therapy might be the answer to helping children cope with divorce.

Divorce therapy for children is usually conducted through Cognitive Behavioral Therapy (CBT). This type of treatment is based on the theory that our thoughts cause our behavior and our resulting feelings – other people do not cause them. By understanding this and learning to modify our reactions, we can influence our emotions in a positive way so we can feel better about things we can not change. Becoming aware of inaccurate or negative thinking allows your child to change to a more positive way of thinking in order to decrease their anxiety.

Need More Information?

Is your child struggling with your divorce? We offer divorce therapy for children in a safe, supportive South Florida environment. For more information, contact The Center for Treatment of Anxiety and Mood Disorders in Delray Beach, Florida or call us today at 561-223-6568.

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