Understanding Anxiety in Children Through a Virtual Lens
Tips for diagnosing & treating children with anxiety through a virtual care lens
In 2023, according to an analysis of the Census Bureau’s Household Pulse Survey, 30% of all adult Americans reported having symptoms of anxiety and depression. However, since the COVID-19 pandemic, there has been a dramatic rise in chronic anxiety cases. These mental health struggles are not limited to adults— the CDC reports an alarming 5.8 million children also suffer from anxiety disorders.
Causes of anxiety in children could include genetic predispositions, limited ability to deal with stress or exposure to traumatic events. Untreated anxiety disorders can interfere with a child’s school work, home life and social development. This is why it's crucial, as a mental health provider, to be in tune with how anxiety manifests itself in children and best practices for virtual treatment.
Signs of Anxiety in Children
Symptoms of anxiety in children are not always obvious and can be difficult to detect. This is likely because many anxiety symptoms in kids can be similar to other developmental struggles. Particularly if a child has a quieter temperament or is stubborn, signs of anxiety can go unnoticed. Below are common indicators of anxiety in young children:
Nervous ticks/habits
Bedwetting
Social withdrawal
Restlessness
Aggression
Struggling in school
Clinginess
Stomach aches
Tantrums
Children who experience anxiety may also have trouble focusing and want to miss school or other obligations. A good rule of thumb is to discuss symptoms with the child’s parent/caregiver. Having a discussion with the child's parent or caregiver can help you understand the length and seriousness of the child's symptoms and determine if there is an underlying anxiety disorder.
Common Types of Anxiety in Children
Children can experience many different types of anxieties. A common type for children between the age of 18 months and 3 years old is separation anxiety. This disorder manifests itself as persistent worry or distress when a child is away from a parent or loved one and approximately 4% of children suffer from some severity of separation anxiety. Other anxiety disorders frequently found in children include:
Social anxiety
Selective mutism
Obsessive-compulsive disorder
Phobias
Generalized anxiety disorder
Treatment options These anxiety disorders can be treated in a variety of different ways including medication and therapy with a child therapist. A type of therapy that's become much more prevalent since the COVID-19 pandemic is virtual cognitive behavioral therapy (CBT). Virtual CBT (or teletherapy) is a great option for children who live in areas where there is limited access to mental health resources, specifically therapists who specialize in child therapy.
Conducting virtual counseling sessions not only makes therapy more accessible to children but also allows them to receive care from the comfort of their home (which can significantly increase the child’s cognitive progress). Virtual child therapy sessions are similar to adult therapy sessions. However, there is an extra emphasis on ensuring the child understands what anxiety is and feels supported.
In addition to cognitive behavioral therapy (either traditional or virtual), other types of therapies that could help a child deal with anxiety includes:
Play therapy
Family therapy
Parent-child interaction therapy
Many of these therapies can also be conducted virtually. However, if you are planning on conducting online counseling of any sort, it is essential to set yourself up for a successful telemedicine visit.
Tips for conducting online therapy
Although conducting mental health counseling sessions virtually is similar to in-person sessions, there are a few important things you should keep in mind. Below are some tips to help you practice good “webside” manner and create a seamless experience for both you and the child.
Test your audio and visual beforehand. Technical difficulties are bound to happen, however being proactive and testing beforehand can help limit these.
Collaborate with the child's caregiver to set up a counseling space. The environment should be comfortable and distraction-free. This will help the child stay engaged.
Plan breaks during the session. Children have shorter attention spans, especially virtually. Built-in breaks will reduce the chance of the child becoming overwhelmed and fatigued.
During online counseling you may also want to integrate fun videos and virtual games into the sessions, particularly if the child struggles with expressing their feelings right away. Clips from the Disney Pixar film “Inside Out” is a great and fun resource to help children understand emotions.
Explaining anxiety & mental health to kids
Treating children with anxiety is largely about helping them understand the cause of their feelings and why they are in therapy. One method is to compare mental health issues to medical problems. Kids know that when someone is sick they need to see the doctor to get better, so explain that when your mind is sick - you see a different type of doctor to feel better.
Additionally, using online books and videos that explain anxiety and mental health through the lens of a child is another effective strategy to consider. Below are a few children’s books that cover the topic of anxiety:
No matter how you approach diagnosing and treating a child with anxiety, it is crucial to include family members in the discussion. Family support and acceptance are essential for young kids who struggle with anxiety. Family support can significantly reduce feelings of isolation and assist in managing symptoms.
Powering mental & behavioral health therapists
Increasing access to mental health services via virtual care is essential to destigmatizing mental health issues and treating children who struggle with anxiety. So if you're ready to expand your practice to telemedicine, we’d love to introduce you to OpenLoop.
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