As part of our series on National Children’s Mental Health Awareness Week (May 6-12) we’ve been posting interviews and information about children and mental health. Today, we’re posting a brief interview on anxiety in children with Jerome Bubrick, PhD, of the Child Mind Institute.

Dr. Bubrick is a nationally renowned cognitive and behavioral psychologist who’s a dedicated advocate for children and their families, Dr. Bubrick is a significant public voice educating parents and teachers about the fear at the roots of anxiety—and how it’s effectively treated.

Welcome, Dr. Bubrick.  How do anxiety disorders affect children differently than adults?

Sometimes the symptoms of an anxiety disorder are the same, but they might affect children and adults in different ways. For example, adults are more likely to understand and articulate their anxiety, while younger children often lack that insight.

Their anxiety might make them do certain things, like line things up in a superstitious way, but they won’t know why. Kids also tend to have more disruptive behavior because of their anxiety. Teens and adults are more likely to self-medicate with drugs and alcohol.

Have the incidents of anxiety disorders in children increased in the past 20-30 years or have the reporting/diagnosis improved?

We know much more now. As an example, the field of OCD is a relatively new one, and most of the research and studies come from the last 20 years. Before that, on a professional level we were able to recognize certain interesting behaviors, but we didn’t understand them. Now we can diagnosis these behaviors as OCD and explain why.

So, yes, because of continuing education and dissemination of information about empirically based treatments, we are able to diagnose and treat more people, and this continues to improve via new research.

The stigma of psychiatric disorders has also decreased, which helps. We are seeing kids at much younger ages, and treating at the age of the onset of symptoms. With some disorders people used to have symptoms for 7 years before seeking treatment. Now that time has decreased to two years.

What lies at the root of anxiety disorders in children? Can they be prevented? How? What can parents do?

Parents often ask for a meaning behind a child’s anxiety. The answer is that it has to do with how your child’s brain is wired and how they have learned coping skills. An anxiety disorder has nothing to do with unresolved issues and it is no one’s fault.

Parents should be educated in what anxiety disorders are and be proactive about getting good help as soon as they see a problem. A good first step is discussing your concerns with a pediatrician. If the pediatrician isn’t helpful, find a mental health professional. Don’t wait to see if your child will outgrow it. What you’re noticing might be temporary, but it is always best to make sure.

Please share with us some of the latest treatment approaches you use in the treatment of anxiety disorders in children. Any case story interests our readers.

Cognitive-Behavioral Therapy (CBT) is the gold standard of treatment for anxiety disorders. It is a skill-based approach–we give children the skills and strategies they need to make different decisions and do different things.  A good example of this is Exposure with Response Prevention, or ERP. ERP exposes kids to their fears in a carefully controlled way. This helps them confront and eventually beat their fears.

We also use cognitive triad, which is made up of “think,” “feel,” and “do.” If we can change just one of those points, we change the entire anxiety cycle.

For many people, generally speaking, 2-3 months of CBT will bring 60-80 percent of reductions of symptoms. Symptoms melt away and kids feel so much better.

What should parents look for in general?

If your child’s anxiety seems: unrealistic, out of proportion, overly self-conscious, unwanted and uncontrollable, doesn’t go away, leads to avoidance.

What are possible signs that your kid might be “forming” or might have an anxiety disorder?

They often won’t want to be social.

They’ll want to stay at home more.

They will be clingy with parents.

They’ll have more headaches and stomachaches and may spend more time in nurses office and they won’t want to go to school.

They are more irritable and have lower frustration tolerations.

They may have difficult sleeping, staying asleep, or changes in appetite.

They seem edgy.

They don’t want to go to practice.

They need lots of reassurance.

Homework takes longer than it should.

Any one of these things may not be a big deal, but the more you see, the more concerned you should be.

Thanks, Dr. Bubrick

Case Stories:

An interview with Laura, whose daughter Sophie was treated by Dr. Jerry Bubrick.

An interview with Sophie. During the interview, Sophie occasionally reads from a book she wrote and illustrated about her OCD, and the work she did to overcome it.

Resources Recommended by Dr. Bubrick:

Child Mind Institute

Association for Behavioral and Cognitive Therapies

Anxiety Disorders Association of America

International OCD Foundation

Jerome Bubrick, PhD, is a nationally renowned cognitive and behavioral psychologist who specializes in the treatment of obsessive-compulsive disorder (OCD). He’s the Senior Director, Anxiety & Mood Disorders Center; Director, Intensive Pediatric Obsessive-Compulsive Spectrum Disorders Program at the Child Mind Institute. He is widely recognized for developing one of the world’s most intensive pediatric programs for OCD, and over the past decade he has been a pioneer in the cognitive-behavioral therapy (CBT) treatment of children and teens with OCD and related anxiety disorders. A dedicated advocate for children and their families, Dr. Bubrick is a significant public voice educating parents and teachers about the fear at the roots of anxiety—and how it’s effectively treated.

Dr. Bubrick co-authored Overcoming Compulsive Hoardingthe first book ever written on the topic.