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Understanding Childhood Anxiety Disorders: Recognising the Signs and Addressing the Behaviours

Childhood is often seen as a carefree time of exploration and joy. However, for some children, it is a period marked by worry, fear, and anxiety. Anxiety disorders are among the most common mental health conditions affecting children, and understanding them is crucial for parents, educators, and caregivers. This blog explores childhood anxiety disorders, their symptoms, and some behaviours that might signal a child is struggling with anxiety.

What are Childhood Anxiety Disorders?

Childhood anxiety disorders are characterised by excessive worry, fear, or nervousness that significantly impacts a child’s daily functioning. While it’s normal for children to experience some level of fear or worry from time to time, especially when faced with new experiences or changes, anxiety disorders go beyond typical childhood fears. They are persistent, occur in various situations, and are often disproportionate to the circumstances.

Some common types of anxiety disorders in children include:

• Generalised Anxiety Disorder (GAD): Children with GAD experience excessive worry about a range of everyday situations, such as school performance, family issues, or future events.
• Separation Anxiety Disorder: This involves excessive fear or anxiety about being separated from home or attachment figures, such as parents. Children with separation anxiety might refuse to go to school, have difficulty sleeping alone, or frequently complain of physical symptoms like stomachaches when separation is anticipated.
• Social Anxiety Disorder: Children with social anxiety experience intense fear of social or performance situations where they may be judged or scrutinised by others. They may avoid public speaking, participating in group activities, or even attending school.
• Specific Phobias: These are intense, irrational fears of specific objects or situations, such as heights, dogs, or in some cases, clowns. The fear is disproportionate to the actual danger posed by the situation or object and can lead to avoidance behaviours.

Recognising the Signs of Childhood Anxiety

Recognising the signs of anxiety in children can be challenging, as symptoms often present differently from those in adults. Here are some common behaviours that may indicate a child is struggling with anxiety:

1. Fear of Specific Objects or Situations (e.g., Fear of Clowns)

Children with specific phobias may exhibit an intense, disproportionate fear of specific objects or situations, such as clowns. This fear can lead to avoidance behaviours, such as refusing to attend events where clowns might be present or becoming extremely distressed if they see a clown. While some fears are typical during childhood, a fear that interferes significantly with daily activities may indicate an anxiety disorder.

2. Excessive Worry About Everyday Situations (e.g., Worrying About Being Late to School)

It is normal for children to worry occasionally about being late or making mistakes. However, children with anxiety disorders may worry excessively about these situations to the point where it affects their daily functioning. They might insist on leaving the house unusually early, repeatedly ask for reassurance, or become physically ill with worry. Such behaviour suggests that the anxiety is out of proportion to the situation’s reality.

3. Difficulty Sleeping Alone or Sleeping in Their Own Beds

Separation anxiety often manifests as difficulty sleeping alone or in their own beds. Children may repeatedly seek reassurance from parents, ask to sleep in their parents’ bed, or experience nightmares. They may also have trouble falling asleep or staying asleep due to fears of being alone or something happening to them or their parents during the night.

4. Avoidance of Social Situations

Children with social anxiety might avoid social situations or activities that involve interacting with peers. They may be overly shy, refuse to participate in class activities, or avoid group games. This avoidance can stem from a fear of being judged, embarrassed, or negatively evaluated by others.

5. Physical Symptoms Without Medical Cause

Anxiety can manifest physically, particularly in children who may not yet have the language to express their feelings. Common physical symptoms of anxiety include headaches, stomachaches, nausea, and dizziness. These symptoms often occur in anticipation of a stressful event, such as a school presentation or separation from a parent.

6. Excessive Need for Reassurance

Anxious children often seek constant reassurance from parents or caregivers about their fears or worries. For example, they may repeatedly ask if they will be safe, if their parents love them, or if they are doing something correctly. While seeking reassurance occasionally is normal, an excessive need for reassurance can be a sign of an anxiety disorder.

7. Perfectionism and Fear of Making Mistakes

Some children with anxiety disorders exhibit perfectionistic tendencies, becoming overly distressed by mistakes or perceived failures. They may be overly critical of themselves, have trouble completing tasks, or procrastinate out of fear of not doing things perfectly.

Addressing Childhood Anxiety: Practical Strategies

If you suspect a child is experiencing anxiety, it is important to approach the situation with empathy and support. Here are some strategies to help children manage anxiety:

1. Validate Their Feelings: Acknowledge and validate the child’s feelings rather than dismissing or minimising them. Phrases like, “I see that you are feeling scared,” or “It’s okay to feel worried,” can help children feel understood and supported.
2. Teach Relaxation Techniques: Simple relaxation techniques, such as deep breathing, progressive muscle relaxation, or visualisation, can help children manage anxiety. Practising these techniques regularly can equip children with tools to use when they feel anxious.
3. Encourage Gradual Exposure: For specific phobias, such as a fear of clowns, gradual exposure to the feared object or situation can help reduce anxiety over time. This might involve looking at pictures of clowns, watching videos, or attending events where clowns are present, with the support of a trusted adult.
4. Establish Routines: A predictable routine can provide a sense of security and stability for anxious children. Regular routines around mealtimes, bedtime, and schoolwork can help reduce anxiety about uncertainty.
5. Limit Reassurance-Seeking: While it is important to provide comfort, try to limit excessive reassurance, as it can reinforce anxious behaviours. Encourage the child to problem-solve or think through their worries independently.
6. Promote Healthy Lifestyle Habits: Encourage a healthy lifestyle, including regular physical activity, balanced nutrition, and adequate sleep. Physical health can have a significant impact on mental well-being.
7. Seek Professional Help: If anxiety significantly impacts a child’s daily life, seeking professional help is important. A child psychologist or counsellor can provide tailored strategies and support to help the child manage their anxiety.

The Role of Group Therapy in Treating Childhood Anxiety

For some children, group therapy can be a particularly effective way to address anxiety. Group therapy provides a safe environment for children to share their experiences with others who understand their struggles. It also offers opportunities to learn coping skills, practice social interactions, and receive support from peers.

For instance, a child who is afraid of clowns, worried about being late to school, or reluctant to sleep in their own bed can benefit from group settings where they see others facing similar challenges. Such environments can reduce the feeling of isolation and provide valuable lessons in resilience and coping.

Group therapy programs tailored to children’s needs, such as those focusing on building social skills, reducing phobias, or managing separation anxiety, can make a significant difference. By engaging in group therapy, children learn they are not alone in their struggles, which can be a powerful step towards managing anxiety.

How can CBT Professionals help?

Our new group therapy, Take Action has launched at our Mount Gravatt location. Take Action is a structured, comprehensive program grounded in Cognitive Behavioural Therapy (CBT), specifically designed to help children take control of their anxiety. Take Action is delivered through six sequential treatment modules over 10 weeks, each module building upon the previous one, to help children develop an ACTION plan—a practical, coping-oriented approach that empowers children to manage their anxiety effectively.

Each letter in ACTION represents a key skill that children learn:

• A: Be AWARE of feelings and recognise signs of anxiety.
• C: Keep CALM with strategies like deep breathing and relaxation techniques.
• T: THINK strong, positive thoughts to replace unhelpful, anxious ones.
• I: Get INTO ACTION by gradually confronting fears and rewarding progress.
• O: Use my OPTIONS, like problem-solving and asking for help.
• N: NEVER stop taking ACTION, planning for the future to manage anxiety long-term.

Group therapy may be a great fit for you, or your child, even if you’re not 100% sure at first. If it’s something you’re considering, it might be a good idea to investigate one of our groups.

Whatever you decide, know that making the step toward a treatment decision is something to recognize and be proud of.

Reach out today, we are here to help!

Helensvale – (07) 5551 0251

Nerang – (07) 5668 3490

Mount Gravatt – (07) 3102 1366

If you, or someone you know, require help, please reach out to organisations like Beyond Blue. Additionally reach out to these organisations that may be able to help.

• ReachOut (youth mental health service) — online help
• SANE Australia — call 1800 187 263
• Mental Illness Fellowship of Australia (MIFA) — call 1800 985 944
• LifeLine 13 11 14 — for anyone in crisis

(Health Direct, 2020).

If this is an emergency, please contact 000 or visit your local emergency department.

Disclaimer: Content on this website is provided for education and information purposes only and is not intended to replace advise from your doctor or registered health professional. Readers are urged to consult their registered practitioner for diagnosis and treatment for their medical concerns.