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Teaching Kids To Step-Up When Accommodations Go Down by Dr. Catherine Worthington

By May 2, 2023No Comments
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You’ve successfully reduced a big family accommodation, way to go!

But now your child is upset and left feeling helpless. Luckily, there are a few immediate things you can encourage your child to do to help them start feeling better on their own.

As a pediatric anxiety and OCD specialist, Family Accommodations (FAs) are almost always a target of treatment for my clients. These are those behaviors that anxious children ask/encourage/pull-for their parents to do (or not do) to make them feel better. The problem with FAs is that in the long term, they can actually prolong anxious feelings by reinforcing a child’s belief that, in order to be ok, their parents must help. In other words, FAs provide temporary comfort from very loving parents who hate to see their child in distress, but ultimately increase a child’s reliance on parent support. In treatment, parents often discover that although they are not the problem that caused their child’s anxiety, they are a “BIG part of the solution” (see Tip #1 of Raising Resilience: 25 Tips for Parenting Your Child with Anxiety or OCD).

Allowing your child to sleep with you because they are worried, not saying specific words because it makes your child cry, washing items more often than you would typically, or answering repetitive reassurance-seeking questions are all examples of normal and loving parent behaviors that may keep your child from experiencing distress today or tomorrow. However, during the course of a child’s treatment, parents learn that these are not actually the best responses for helping children to overcome their difficulties for good.

Although FAs have been discussed in the field of psychology for many years, the SPACE intervention (Supportive Parenting for Anxious Childhood Emotions) has been developed to specifically target these and help parents reduce accommodating behaviors while maintaining (or even increasing) supportive, alternate responding. Within this treatment there is usually very little time spent teaching children what to do now that their safety-net has disappeared. Parents can play a big role in resolving this by introducing their children to three independent strategies to help them step-up when accommodations go down.

When your child begins to feel overly upset or fearful about their situation, something for them to remember is that their anxiety loves to ask “what if” questions:

*What if something bad happens?? *What if I get sick??
*What if others see me do something embarrassing?? *What if I’m no good??

Remind children that Thoughts are not always Truths, and Feelings are not Facts:
Do I really think it’s likely for me to get hurt or for something bad to happen?

Use your smart-brain to recognize whether the situation is Scary-Safe or Scary-Dangerous (see Tip #7 of Raising Resiliencefor more information about Scary safe-Scary Dangerous.
Is getting sick safe or dangerous → SAFE, because I’ve been sick lots of times before
Is being embarrassed safe or dangerous → SAFE, because it’s something everyone experiences

Another thinking-strategy for when children’s anxiety makes them feel out of control is to use a supportive self-statement. These statements are helpful for replacing the worries and “what if” questions in their head.
This is done in three steps:
• Validate the emotion (“I am feeling _____(SCARED/UPSET/ANGRY) and that’s ok…”)
• Add confidence (“but I know that I can handle it.”)
• Include a BRAVE statement (“It’s uncomfortable at first, but I can trust that I’ll adjust.”)

Help your child to find alternative activities to engage in when FAs are no longer available. This strategy works for two reasons. First, when anxiety happens, your child’s body is being flooded with adrenalin, and doing an active-activity can help to burn off the extra energy. Second, doing things that are more enjoyable or important in the moment can distract and remind your child’s smart-brain* that the difficulty is temporary and that there are other things worth focusing on in their world.

•20 jumping jacks  •Count backwards from 10 with belly breathing
•Run around the house  •Dance to a favorite song  •Draw a masterpiece
•Play a sport •Imagine decorating a bedroom or designing a new clothing item
•Create a storyline with locations, characters, and a plot that has a beginning, middle, and end
•Think of a favorite place including all 5 senses (sight, hearing, smell, touch, taste)

Remember, children are built with minds and bodies that are much stronger than anxiety typically makes them feel. When parents reduce FAs and children engage in independent management skills, both are taking the first step in helping children learn about that strength, and even more importantly prove it to themselves!

Dr. Catherine Worthington, Licensed Psychologist, Anxiety Specialists of Atlanta

Catherine Worthington, PsyD specializes in the assessment and treatment of OCD and anxiety disorders, pediatric anxiety and OCD and parenting the anxious child

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