New Stress & Anxiety Clinic at RNBC

Kfischer/ September 2, 2010/ Special Features

We at Rush NeuroBehavioral Center are pleased to announce a new service, starting in September, for the assessment and treatment of stress and anxiety disorders in children and adolescents. We’ve all experienced some level of anxiety during childhood. It may be short-lived and not have much of an impact on our lives. But when a child experiences fear or worry recurrently, it can begin to adversely affect the child’s life.

Anxiety disorders can take many forms. Young children, particularly when starting school, may experience separation anxiety. The thought of being apart from their parents leaves them feeling very distressed. Sometimes children have an excessive fear that their parents will die or fall ill. Other forms of anxiety include panic attacks or phobias triggered by specific things such as particular animals or insects, blood or needles, clowns, or dark places. Some children experience high levels of stress associated with social situations or when expected to perform on tests, in athletic competitions, in concerts or plays. The anxiety can become so severe that children simply want to avoid the situation and their performance suffers because of their feelings.

Avoiding such situations can feel comforting for the moment but it can create a very difficult cycle to change. Sometimes children will become difficult and defiant in an effort to avoid a particularly stressful situation. Performing poorly also encourages avoidance and makes children feel worse about themselves.

Another manifestation of anxiety is obsessive compulsive disorder.  Children with this disorder will have persistent thoughts or images that are very troubling and not related to day-to-day events. They may feel contaminated, imagine something gruesome, or have a strong need for things to be in a very set order. To help reduce the anxiety and neutralize the thoughts, children will repeat certain acts over and over again, such as washing their hands or body repetitively, checking to make sure something was done, counting steps, or repeating certain words. These repetitive acts significantly interfere with the child’s life but, at the same time, help the child feel less anxious.

Post-traumatic stress is another form of anxiety that is caused by exposure to something traumatic such as abuse, severe bullying, or a natural disaster. The initial reaction to the trauma persists beyond what is typical and the child may have reoccurring memories or flashbacks. The child deliberately attempts to avoid anything that resembles that initial event.

If you observe any of these behaviors or think your child is anxious, upset, or worried more than you would like, we encourage you to make an appointment for a preliminary interview with one of our clinicians. If the clinician believes it is warranted, further assessment may be recommended. One important consideration is whether a child’s ability to function is being seriously affected. Is a child avoiding other kids at school? Resistant to playing sports when he has natural talent? Failing tests when she knows the information? Or becoming hysterical when anticipating a visit to the doctor? 

A full assessment will normally include an interview with you and your child, a review of medical records, a talk with those familiar with your child, such as a physician or teacher, who may have insight into the problem, and some specialized tests. RNBC is nationally known for the thoroughness and accuracy of its assessment process. After the assessment is complete, the clinician will meet with you to discuss the findings, map out a plan of action and, if appropriate, define goals for therapy.

Many parents, seeing a child’s behavior that on the surface seems very difficult to change—such as severe temper tantrums when a child is left at school—may believe that the treatment for anxiety will be long and drawn out. However, depending on the severity of the anxiety and whether there are other issues that a child or family are struggling with, a child’s anxiety might be successfully treated in as little as twelve weeks.

One of the best treatments for anxiety disorders is cognitive behavioral therapy (CBT). This form of therapy includes a series of well-defined steps designed to help children realize that their fears are irrational and without a basis in fact, help them gain control of their feelings and actions, and the eventual elimination of behaviors that impede their functioning. Children also learn new ways to manage their stress, such as relaxation strategies and the use of mindfulness techniques.

Three of the clinicians at RNBC are trained to provide such treatments as cognitive behavioral therapy, dialectical behavior therapy, mindfulness stress reduction techniques, progressive relaxation, and hypnotherapy. They are trained to help children and adolescents free themselves from the fears and worries that have come to interfere with school, with friendships, with family, or with extracurricular activities

At the end of treatment, says Dr. Bernadette Evans-Smith, Director of Clinical Services at RNBC, “We can tell a child, ‘You have an opportunity to feel happier, more successful, and able to do more of what you would like.’ With this kind of support, children can feel that they have better control of themselves, and be more confident and capable.”

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