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July 29, 2019

Reports of a youth anxiety epidemic are highly exaggerated, according to research. But in the face of much media coverage, we are understandably alarmed when our children exhibit or even utter the word anxiety. In this era of “I just want my kids to be happy,” we rush to rescue and shield, fending off whatever seems to unsettle our little (and not-so-little) ones. That may be the epidemic.

Too often, we rescue anxiety-challenged kids from developmentally normal experiences by providing ever-expanding accommodations: sleeping nightly with a frightened son until he falls asleep; permitting a worried daughter to stay home from school; responding to endless calls or texts that seek assurances or guidance; agreeing to avoid certain people or venues that make the child uncomfortable; chauffeuring when a youngster feels uncomfortable on the school bus. Available data indicate that a majority of parents of youth with anxiety disorders report engaging in accommodating behavior, and a majority report accommodating at least once a day.1 We do it because we see that it helps avert so much discomfort. But what if our well-intentioned accommodations perpetuate the problem?

Research out of Yale’s Child Study Center reported this spring that for many youngsters, parental accommodations tend to be counter-productive. Yale’s program of parent coaching to modify and eliminate accommodations proved every bit as effective as medication or cognitive behavioral therapy (CBT), the current gold standard for anxiety treatment, in freeing youth from anxiety’s grip.2

Instead of accommodating their children’s anxieties, parents in the Yale program learn to rely on a mix of “old fashioned” approaches — humor, pep talks, working up a plan to tackle fears, transmitting the expectation that the child will succeed — while learning about the developmental benefits of facing fears. Undergirding it all is the belief that youth build resilience by encountering what’s safe but initially scary until they achieve a sense of mastery. 

“Even before we start to work on changing the accommodation, we work on helping the parents to respond to their child in a supportive manner,” said Eli Lebowitz, PhD, the principal researcher. “We don’t want the message to be ‘I’m sick of this’…or ‘You need to suck it up.’ [With fewer accommodations, children discover] that they can be okay, that their anxiety will pass.”3 

For many anxious kids, that’s what’s needed. Professional counseling can guide parents in how to approach it.

References & Citations

Kagan, E. R., et al. (2018). “Accommodation in youths’ mental health: Evidence and issues.” Current directions in psychological science.

2 Lebowitz, Eli R., et al. “Parent-based treatment as efficacious as cognitive-behavioral therapy for childhood anxiety: A randomized non-inferiority study of supportive parenting for anxious childhood emotions.” Journal of adolescent psychiatry, in press.

Giordano, Rita. “Childhood anxiety treatment may best be targeted at parents, study finds.” The Philadelphia Inquirer, March 13, 2019.