Book Review: Breaking Free of Child Anxiety and OCD
Years ago I was working in a middle school where I had to evaluate two students who were experiencing a lot of anxiety. Both the school and parents were struggling to figure out how to support them, and often they were not expected to participate in the parts of their day that they felt most anxious, if they attended school at all.
I questioned whether accommodating them in that way was helpful for them. Yes, it probably reduced their anxiety, but it also seemed as though that by allowing them to avoid the things that caused them anxiety it gave them confirmation of the message they told themselves: “I can’t handle it.” But I didn’t really know which was best, avoiding the anxiety trigger, or having them participate in the thing that made them anxious. That’s why I started my journey to learn more on this topic, and I continue to learn, which is why I’m sharing one of the more recent resources I’ve read on this topic.
Breaking Free of Child Anxiety and OCD
Whether you’re a therapist, parent, or educator I want to direct you toward the book Breaking Free of Child Anxiety and OCD by Eli R. Lebowitz (2021). If you’re looking for a clear plan to help a child’s anxiety this book is a great resource. It focuses on what you can control as an adult, primarily by learning not to accommodate their anxieties.
It is geared toward parents, but offers valuable insights for anyone who works with anxious children or supports parents who do. Dr. Lebowitz includes helpful examples, worksheets to help parents identify accommodations they are making, and worksheets to make a clear plan to discontinue accommodations. He discusses pitfalls and challenges parents may have when they may not agree on how to support their anxious child.
Some of my favorite takeaways are below.
Anxiety-Related Behaviors Are Nervous System Responses
I especially love that the book helps parents realize that anxiety-related behaviors are a result of the fight-or-flight response and that these are not behaviors that require punishment, but understanding.
Avoid the “Ping Pong Effect” When Discussing Anxiety Accommodations
The “ping pong” effect is when the child will try to talk you out of the plan to reduce accommodations, and you continue to discuss it with them rather than just staying firm in your decision. This weakens the plan and why there is support for making a clear, concrete plan to present to the anxious child.
Show an Anxious Child Support With Confidence and Acceptance
Express confidence that they can handle what they find challenging and show understanding that you know it is difficult without blame or shame.
Consistency Is Important When Accommodating Anxiety
There is evidence to show that when parents are consistently supportive and reduce accommodations for anxiety that it’s just as effective as cognitive behavior therapy directed toward the child.
Feeling Ready and Being Ready Aren’t the Same Thing
Most people don’t feel ready when there is a major life change (he uses the example of parents expecting their first child), you just need to be ready. In this situation, being ready means having a plan.
Considerations Before You Read This Book
While most of this book’s strategies can apply to all neurotypes, it does not discuss the unique needs of some neurodivergent children.
Part of this strategy involves having conversations with children, and not all children are going to understand this approach, particularly if they have high support needs that include significant language delays, and/or cognitive delays. Reducing accommodations is likely still helpful, but more professional support may be needed to help make a plan and/or to communicate it to the anxious child.
Overall, most adults who work with anxious children can learn something from this book and I highly recommend it.
