If your child or teen is diagnosed with anxiety disorder, they may be prescribed medications and/or be advised to have psychotherapy or make lifestyle changes. The type of treatment(s) your child receives depends on the severity of their anxiety.
How psychotherapy can help treat anxiety
Psychotherapy, also known as "talk therapy", involves a trained therapist working one-to-one with a patient or with a group of people on common objectives. Depending on the type of psychotherapy, the therapist can offer support, teach coping skills or help a patient explore their relationships.
How to access psychotherapy
You can access psychotherapy in a range of ways, for example through
- a mental health agency
- a recommendation from a doctor, private psychologist or other healthcare provider
- a recommendation from a trusted friend or family member
- an employee or family assistance program.
Fees for psychotherapy vary. Some costs – but not all – might be covered through public health plans or through private insurance.
The therapy that has been shown to be most effective for childhood anxiety disorders is cognitive behavioural therapy.
Cognitive behavioural therapy
Cognitive behavioural therapy, or CBT for short, is a structured form of therapy involving one session a week for, on average, 10 to 16 weeks. CBT can be effective for a range of mental health issues.
How CBT works
CBT is based on cognitive theory, the idea that our thoughts influence our feelings and our behaviours. If we are thinking worried thoughts, these thoughts will lead us to feel anxious, and then act in an anxious or avoidant manner.
The goal of CBT is to help anxious children:
- recognize their anxiety as a symptom
- identify their anxious thoughts
- develop cognitive strategies (different ways of thinking) to challenge anxious thoughts and replace them with adaptive (more constructive or realistic) thoughts
- learn behavioural strategies, such as relaxation techniques to manage the physical symptoms of anxiety
Over time, CBT may also include exposure therapy. This involves experiments that gradually expose a patient to the source of their anxiety to help them learn to face their fears and see that they can conquer them.
CBT can be done individually with a therapist or in a group of children with one or two therapists. Parental involvement is an important part of treatment, especially with younger children.
With individual CBT, children are often seen by a therapist for most of the session and then parent(s) or caregiver(s) are brought in for a portion of the session. With group CBT, parent and child groups may run separately but at the same time.
Teens and parents can also work through self-help CBT resources on their own.
Other forms of psychotherapy to treat anxiety
CBT has a lot of evidence to support its use in children and teens, but sometimes other psychotherapies may be recommended. These include:
- supportive or psychodynamic psychotherapy
- family therapy, if there is a lot of family tension or conflict
- behavioural approaches, for example if a child or teen has anxiety with attention deficit hyperactivity disorder (ADHD) or oppositional defiant disorder
- mindfulness and acceptance based therapies. These are new forms of therapy that can help a person manage their anxiety disorder by learning to live in the moment and experience life without judgment.
Importance of patient/therapist relationship
Psychotherapy is more helpful when there is a good relationship between the therapist and the child. If there is a poor fit, you may need to talk to the therapist or else choose to switch to another therapist.
Lifestyle changes that can help treat anxiety
Children and teens with certain anxiety disorders may experience a drop in symptoms by following some general healthy lifestyle routines.
These include:
- getting at least eight to 10 hours' sleep a night
- eating a balanced diet, following Canada's Food Guide
- getting regular exercise in line with the physical activity guidelines for children and youth.
If your child's anxiety symptoms prevent them from sleeping or eating well, your child's health-care provider can offer advice.
Further information
For more information on anxiety disorders, please see the following pages:
Anxiety: Treatment with medications
Resources
The following books offer useful advice and information about anxiety.
Foa, E.B., & Wasmer Andrews, L. (2006). If Your Adolescent Has an Anxiety Disorder: An Essential Resource for Parents. New York, NY: Oxford University Press.
Huebner, D. (2005). What to Do When You Worry Too Much: A Kid’s Guide to Overcoming Anxiety. Magination Press.
Manassis, K. (2015). Keys to Parenting Your Anxious Child. Third edition. New York, NY: Barron’s Educational Series, Inc.
Rapee, R., et al (2008). Helping Your Anxious Child: A Step-by-Step Guide for Parents. Second edition. Oakland, CA: New Harbinger Publications, Inc.
Sheedy Kurcinka, M. (2015). Raising Your Spirited Child: A Guide for Parents Whose Child is More Intense, Sensitive, Perceptive, Persistent, and Energetic. Third edition. New York, NY: HarperCollins Publishers.
