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    TUESDAY Q & A: Start with steps at home to ease anxiety in young child

DEAR MAYO CLINIC:
My daughter is 11 and has always been a worrier, but it’s getting worse. She checks her planner multiple times each night to make sure she’s not forgetting any schoolwork, even though she is a great student. She often won’t participate in activities because she’s worried she will get hurt or won’t be able to do them well. Is there something I can do to help her, or do I need to take her to see a counselor? I don’t want to make it worse by making her feel like she has a problem.  

ANSWER:
Your daughter’s situation sounds similar to many children who struggle with anxiety. There are certainly ways to help her. You can start with some steps at home that may ease her worries. If those do not work, talk with her physician or a therapist for more help. 

As you mention, parents often do not want to draw attention to their child’s anxiety for fear it will upset the child more. While this may happen at first, the long-term benefits of effectively managing anxiety will likely outweigh any initial discomfort. 

Start by having a conversation with your daughter. Emphasize that you are proud of how well she does at school and in her activities. Tell her that you are concerned, though, that her worries make it hard for her to enjoy herself. Talk with her about ways she may be able to reign in those worries. 

First, explain to her that every time she rechecks her planner or avoids an activity, she misses a chance to learn that things often turn out okay without her worrying about them. Second, suggest that the two of you experiment together with ways to decrease her anxiety-related habits. 

For example, instead of checking her planner multiple times each evening, go over it once together. Confirm that she has completed her homework. Talk about questions or problems with schoolwork that she may have. Discuss any upcoming tests, projects or other school activities that may be of concern. Then put the planner away. If she goes to check it, gently ask her what is on her mind. If it is something you have already discussed, remind her that you are experimenting with overcoming worry. Encourage her to resist checking and see if the worries go away with time. 

If she feels strongly that she needs to check her planner again, that’s fine. The goal is to decrease the behavior. It will not stop completely right away. Strive to be reassuring and encouraging. Do not use punishment to try to force a change in her behavior. 

To help her feel more comfortable with new activities, help your daughter find one activity that she’s interested in but has been hesitant to try. Have her give it a try and stay with it to the end. To help boost her confidence, at first it may be best to pick an activity that does not involve a high level of competition. 

Talk with her about the process of learning. Remind her that no one expects her to do well immediately when she is in a new activity and that mistakes are part of learning. Even if things don’t go well, if she sticks with the activity, she will be able to better recognize her own ability to successfully manage difficult situations. 

Working with your daughter to experiment with different behaviors and new ways of managing her anxiety will be hard at first. But for many children, it gets easier with practice and encouragement. If these steps do not seem to help, then set up an appointment to talk your child’s doctor. He or she can either help with treatment directly or put you in touch with a psychologist, therapist or counselor in your area who has experience managing childhood anxiety. Stephen Whiteside, Ph.D., Psychiatry and Psychology, Mayo Clinic, Rochester, Minn.

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