This article was published on: 09/16/24 7:19 PM
How Parents Can Recognize and Support Children with Anxiety and OCD
Yellow school buses back on the road? Advertisements for composition books, binders, and notebooks everywhere? “Pumpkin Spiced” everything seems to be making its seasonal return? All subtle cues that communicate one main message to us: Back-to-School season is upon us! Though the start of a brand-new school year spells out joy and wonder for some kids, it could result in anxiety, stress, and despair for others.
The Back-to-School season comes with a richness of all that is “new” for kids: lockers, classmates and friends, teachers, lessons, technologies, routines, rules, and even sensory experiences (new smells, tastes, physical sensations, noises). With so much that is “new,” it also makes sense that kids and families are challenged by the “unknowns” or uncertainty. “What if my bus is late?” or “What if I can’t ask my teacher for help?” Anxiety and worry makes sense for kids in a lot of ways, so what’s developmentally appropriate vs. a concern? If childhood anxiety disorders are considered the most prevalent pediatric mental health condition, with estimated ranges from 10-32% of youth (Merikangas, K.R., et al., 2010), what signs should parents watch out for in the classroom?
Childhood Anxiety and Back-to-School
Children with back-to-school anxiety might present as fearful, shy, and overly worried about the academic year, but other times parents might observe different emotional and behavioral responses to anxiety. They might exhibit extreme crying spells and temper outbursts in relationship to school-related topics. Kids with perfectionistic tendencies may request constant approval and reassurance from parents and other authority figures. They may also spend excessive time on assignments, often re-reading and re-writing. Even if behaviorally it was difficult to identify warning signs of childhood anxiety, parents should keep a lookout for Mother Nature’s messaging. In other words, kids with anxiety and OCD also experience somatic complaints including stomachaches, headaches, breathing difficulties, and a racing heartbeat. In adolescence, it’s common for teens to experience panic attacks, or bouts of extreme anxiety.
OCD and Back-to-School
But what about kids with OCD and the start of the new school year? Obsessions are intrusive and unwanted thoughts and images that occur on re-play in a child’s mind. Compulsions are characterized by those “must-do” behaviors that kids believe they must perform to stop unpleasant emotions/internal experiences. Kids might also believe that these compulsions will prevent bad things from happening in the future too. Obsessions and compulsions can become time-consuming, and directly impact daily functioning.
What Can Families do to Help?
The International OCD Foundation presented a helpful resource for families and the community, Anxiety in the Classroom (Anxiety in the Classroom, 2024). Common behaviors of students with anxiety and/or obsessive compulsive disorder (OCD) are characterized as: becoming easily agitated, repetitive question-asking, attendance problems, classroom participation refusal, classroom “tiredness,”, spending excessive time on assignments, and/or failing to complete homework on-time or at all. Indeed, many educational teams and families might also struggle with the following dilemma: “Are the students’ needs best accounted for by anxiety behavior, attention deficit/hyperactivity disorder (ADHD), or both?”
So, what can parents do to help their children cope? First and foremost, it is important to connect your child and family with a mental health provider specializing in anxiety/OCD treatment for support. Some studies indicate that it takes approximately 17 years for patients with OCD to receive adequate treatment (Ziegler & Bednasch, 2021). Second, adopt a validating, understanding, and empathic view of your child’s anxiety and related problems. In the state of Maryland, public high school students complete an annual survey detailing high risk school behaviors, mental health concerns, and behavioral problems. Of note, only 42% of adolescent students indicated that they had a caring adult in their family with whom they could comfortably express feelings (2022). Third, it can sometimes be helpful to support children and families in externalizing Obsessive Compulsive Disorder (OCD) and anxiety. In other words, children can externalize OCD by giving it a nickname such as a “OCD Monster/Bully” or “Worry Bug”. For additional information regarding ways parents can best support their children, Jonathan Abramowitz’s The Family Guide to Getting Over OCD: Reclaim Your Life and Help Your Loved Ones is a recommended reading. Lastly, formal evidence-based treatments that are parent-focused might be an excellent treatment to address back-to-school stress and anxiety. For example, Supportive Parenting for Anxious Childhood Emotions (SPACE) is an innovative, parent-based treatment program developed by Eli Lebowitz, PhD of the Yale Child Study Center. In this treatment model, parents learn and develop effective behavioral responses to support children’s management of anxious responding to stressors, including academic. Clinical trials of SPACE reveal that this parent-focused treatment model is equally as efficacious as cognitive behavioral therapy (involving child treatment participation) (Lebowitz et. al, 2019). Though a somewhat new and rare treatment opportunity, SPACE is available as an outpatient treatment service for children and families this Fall 2024 at the Maryland Anxiety Center.
With the guidance and supervision of mental health professionals, parents have the ability to generate an environment where children can learn to confront anxiety safely and optimistically. Unfortunately, too many families encounter painful family experiences where OCD practically rules households. Family-based interventions to address pediatric OCD are critical, as parents are the main conduit to their children’s learning. When parents model healthy ways of coping with stress and anxiety, it can improve children’s mental health. Above all, it is important to remember that it takes time for children (and families for that matter!) to learn new, adaptive ways of responding to back-to-school stress and anxiety. Therefore, parents can benefit from not “getting attached to outcome,” or expecting immediate, overnight behavioral change and results. The Maryland Anxiety Center offers treatment for children, parents and families, including SPACE.
For more information about how families can support children with anxiety and/or OCD this back-to-school season, consider the following professional organizations:
- The International OCD Foundation. Learn important information about OCD and strategies that help. The Resource Directory also contains a list of qualified mental health professionals to address anxiety and OCD specific concerns.
- The Anxiety and Depression Association of America.
- Children’s Mental Health Matters! A Maryland Public Awareness campaign. Welcome – Children’s Mental Health Matters (childrensmentalhealthmatters.org)
References
Abramowitz, J. (2021). The family guide to getting over OCD: Reclaim your life and help your loved one. The Guildford Press.
Anxiety in the Classroom presented by The International OCD Foundation (2024). Anxiety in the classroom training center. I Want to Train Others | Anxiety In The Classroom.
Lebowitz, E., Marin, C., Martino, A., Shimshoni, Y., & Silverman, W. (2020). Parent-based treatment as efficacious as cognitive-behavioral therapy for childhood anxiety: A randomized noninferiority study of supportive parenting for anxious childhood emotions. Journal of the American Academy of Child and Adolescent Psychiatry 59 (3), 362-372.
Merikangas, K. R., He, J., Burstein, M., Swanson, S. A., Avenevoli, S., Cui, L., Benjet, C., Georgiades, K., & Swendsen, J. (2010). Lifetime prevalence of mental disorders in U.S. adolescents: Results from the National Comorbidity Survey Replication-Adolescent Journal of the American Academy of Child & Adolescent Psychiatry, 49(10), 980–989. https://doi.org/10.1016/j.jaac.2010.05.017.
Youth Risk Behavior Survey (2023). Youth risk behavior survey/Youth tobacco survey. (YRBS/YTS). Pages – Youth Risk Behavior Survey/Youth Tobacco Survey (YRBS/YTS) 2022-2023 (maryland.gov).
Ziegler, S., Bednasch, K., Baldofski, S., & Rummel-Kluge, C. (2021). Long durations from symptom onset to diagnosis and from diagnosis in obsessive-compulsive disorder: A retrospective self-report study. PLoS ONE 16(12): e0261169. https://doi.org/10.1371/journal. pone.0261169
The Maryland Anxiety Center was founded by Andrea G. Batton, LCPC with a vision of creating a practice where clinicians and staff work cohesively and collaboratively with patients to provide optimal psychological care. The Maryland Anxiety Center specializes in the treatment of anxiety and related disorders from a cognitive behavioral perspective, the gold-standard and most effective treatment for such conditions.