When do anxious kids need therapy?

We all have fears, and for preschool children it can be difficult to determine what is a real threat, explains clinical psychologist Joanna Kleovoulou.

‘Some children are predisposed to anxious feelings and irrational fearful thoughts, who may become more anxious after being exposed to news about natural disasters or violent crimes. Even after the event has passed, the anxiety may persist. The child may not have the words to describe anxious feelings.

‘A child, who is dependent on adults for love, care, security, fears most the losing his or her parents and being left alone. Given that a child finds it difficult to distinguish a real threat, he or she is more likely to be overwhelmed by fears with no basis in reality.’

Does my child need therapy?

Most parents are capable of helping their child overcome basic fears. In cases of severe anxiety, when the fears persist over an extended period of time or when it interferes with the child’s ability to cope and function, you might need the help of a professional.

Some symptoms to be aware of and to know when to refer your child for Play Therapy or an assessment

• Feelings of anxiety, fears, and worries about safety of self and others (more clingy to teacher or parent)
• Worries about recurrence of violence
• Increased levels of distress (whiny, irritable, more moody)
• Changes in behaviour:
• Increased activity level
• Decreased concentration / attention
• Withdrawal
• Angry outbursts
• Aggression
• Absenteeism
• Increased somatic complaints (e.g. headaches, stomach aches, aches, pains)
• Changes in school performance
• Recreating event (e.g. talking repeatedly about it, ‘playing' the event)
• Increased sensitivity to sounds (e.g. sirens, planes, thunder, backfires, loud noises)
• Statements and questions about death and dying

In addition, at home parents may see:

• Changes in sleep
• Changes in appetite
• Withdrawal
• Lack of interest in usual activities
• Increased negative behaviours (e.g. defiance) or emotions (e.g. sadness, fears, anger, worries)
• Regression in behaviours (e.g. baby talk, bedwetting, tantrums)
• Hate or anger statements

How parents of pre-school children can help

If your child’s life has been disrupted by trauma, avoid exposing him or her to reminders of the event, advises clinical psychologist Ilze van der Merwe-Alberts.

‘Protecting the children from re-exposure includes limiting exposure to adult conversations about the events- even when you think they are not listening, they often are.'

Maintaining the family routines, particularly around sleeping, eating, and extracurricular activities is important. Be sure the bedtime routine includes safely tucking them in at night. Young children may want a night light again.

‘Expect temporary regression in your child's behaviours. Do not panic, as your child is likely to return to previous functioning with time and support,’ explains van der Merwe.

• Make sure your child is receiving a balanced diet and enough rest.
• Avoid unnecessary separations from important caregivers.
• Provide soothing activities, such as reading books, listening to music, taking a walk, riding bikes, etc.
• Increase patience with your child and with yourself. Give your family time to cope. Find ways to emphasize to your children that you love them.

Joanna Kleovoulou and Ilze van der Merwe-Alberts are psychologists at Bella Vida centre.

How does your child react to imagined fears and traumatic events?