Anxiety & Trauma
Anxiety is the most common mental health diagnosis among children. Most children experience some fears and there are even fears that are developmentally appropriate and expected, but when a child’s anxiety gets in the way of their typical development, including their relationships (it’s exhausting when your little one is constantly clingy to you and you have no personal space!), intervention can help ensure that they can return to their kid jobs of learning, growing, playing, and safely exploring the world around them.
Your child may be experiencing anxiety if you’ve noticed any of the following signs:
Trouble sleeping (falling asleep and staying asleep)
Decreased appetite or wont eat away from home
Complaining of headaches, stomachaches, or other body pains
Difficulty separating from their primary caregiver to go to school or to spend time with other adults (separation anxiety)
Resistance to trying new things
Crying or tantrums if their routine is disrupted or something unexpected happens
Expressing worries that something bad is going to happen to them or someone they love
Seeming excessively clingy or shy
Seeming hyperactive or inattentive (ADHD and anxiety are commonly confused in early childhood)
Use this screening tool to see if your child could benefit from help with their big feelings.
Why is my child so anxious?
Since anxiety is so common in children it can be hard to pinpoint any one cause. Sometimes it’s obvious when a child has experienced something scary like adults fighting or they lose someone close to them but other times the origin of the anxiety is less clear.
The really good news is that, regardless of the origin, we can teach and model cognitive-behavioral therapy (CBT) techniques to help children cope with their anxiety no matter the cause and no matter the worry. In a developmentally appropriate way (in child-ese) and with lots of support from their grownups, little children can begin to identify their feelings (“I’m having a big worried feeling. My tummy feels rumbly when I have to meet new kids.”), use relaxation and coping skills to calm their bodies (“I can do hard noodle/soft noodle when I feel rumbly.”), and change their unhelpful thoughts to more helpful ones (“When my brain tells me that kids dont like me it’s a cold prickly thought. I can use the magic remote I made with Ms. Halley to change the channel and make it a warm fuzzy thought like I had fun making a new friend at the park last time.”).
When the cause of your child's anxiety is known and related to a scary or traumatic experience, or series of experiences, I use two evidence-based treatments to reduce anxiety and stress and to effectively cure posttraumatic stress disorder (PTSD) related to trauma exposure: Child Parent Psychotherapy (CPP), for children from birth through age 5, and Trauma-Focused Cognitive Behavioral Therapy (TF-CBT), for children ages 3-18. Trauma to the young child, especially in preverbal children, is very different than trauma for older children and adults, and these models address these differences, using play and language specifically tailored to your child’s story and symptoms to promote their healing with your help.
Child Parent Psychotherapy (CPP)
CPP is an evidence-based treatment that has been studied with children ages birth through 5 in many diverse family systems. Rooted firmly in attachment theory, CPP acknowledges that all people, and especially young children, heal in the context of relationships. In CPP, you, as the caregiver, are held as central to your child’s healing and one of the primary goals of treatment is to strengthen and support your relationship with your child.
During CPP we'll work together in 3 phases:
1. Getting to know you, your child, and your family: During this initial phase I spend time meeting alone with parents/caregivers to understand your family's needs and challenges, strengths and values, and history and experiences.
2. Addressing your family's needs: This second phase comprises the majority of our work together during which we'll meet once a week; you and your child will always attend these sessions together, with me, your helper. If your kiddo is old enough we'll first help him/her understand who I am, why you are coming to my office, and what we will do together. There will always be toys because young children show feelings and thoughts through play. I will help you and your child better understand one another, talk and play about difficult experiences, respond to difficult feelings and behaviors, and create a family story that leads to healing.
3. Wrapping up and planning for the future: In this final phase we will celebrate progress and how hard everyone worked, we'll consider how endings and goodbyes may bring up different feelings, and we will talk about what will be needed and helpful in the future.
CPP may help when:
Children have been through scary or painful events
loss of a loved person,
serious medical procedures,
physical or sexual abuse,
witnessing violence at home or in the community
Children have a change in placement or caregivers including adoption and DCF involvement
Family members have physical health, mental health, or substance abuse difficulties
Caregivers would like help with parenting and improving parent-child relationships
CPP research reliably shows positive outcomes for both children and parents
Children show improvements in:
Mood (less crying, less irritable)
Problem behaviors (fewer tantrums, less aggression, less defiance)
Learning (more attention, more engagement with peers, developmental leaps)
Trauma symptoms (fewer nightmares, less jumpy, less clingy)
Biological stress (less cortisol, the stress hormone, in their systems)
Parents show improvements in:
Trauma-Focused Cognitive Behavioral Therapy (TF-CBT)
TF-CBT is an evidenced based treatment for children from 3yrs to 18yrs of age. Over the course of 25 years of research and development, TF-CBT has been shown to be the gold-standard in treating symptoms of posttraumatic stress disorder (PTSD) in children.
The focus of this treatment is to:
• Assist the child or adolescent to develop coping strategies for traumatic stress reactions.
• Reduce symptoms of depression, anxiety, or acting out behavior which are common in children exposed to trauma.
• Provide your child with an opportunity to discuss details about the trauma in a support and nurturing environment, with your involvement.
Over the course of treatment your child will learn that the scary thing that happened was not their fault and that they are not the only ones who have survived a similar traumatic event. Their brain will begin to replace traumatic memories with the more helpful thoughts about the trauma which allows for their return to typical child development.
TF-CBT is designed to help with traumas
an unexpected death of a loved one
natural disasters, and
TF-CBT research reliably shows positive outcomes for both children and parents from preschool through adolescence
Children show decreases in:
PTSD symptoms, shame, and abuse-related fears
anxiety and depression
Children show increases in:
their ability to recognize/respond to potentially abusive situations
Parents show decreases in:
Parents show increases in: