Step-ladder approach to anxiety

If your child suffers from any form of anxiety, consider trying this step-ladder approach drawn from cognitive-behavioural therapy (CBT).

This step-ladder treatment approach can be applied to many common childhood anxieties such as the fear of social situations, fear of separation or fear of sleeping alone. It can be used to help anxiety in children (and adults) of all ages and is useful to know about when encouraging your child to address their fears.

To make a start, imagine a simple step-ladder with several rungs. Decide on the final goal (this task becomes the top of the ladder), then determine what an easy starting point might be (this becomes your first step). Next, work out what tasks might serve as intermediate steps, with each situation a little bit more challenging than the last as you move towards the top of the ladder.

When planning your child’s step-ladder, it’s important that the leap between steps is not too daunting. If the jump from one step to the next seems too great, consider how you might break it up into a few smaller steps by creating variations based on what it is your child does, where they attempt it, how long for or who they’re with. This step-by-step approach allows your child to practise coping with their anxiety in manageable doses. In this way, your child also experiences successes along the way, which builds up their confidence and sense of mastery.

Here are a few hints to improve your chances of success:

  1. Let your child decide what tasks they add to their ladder. If they do need your help with this, make a few suggestions from which your child can choose. As much as possible, your child needs to feel like they’re an active, motivated participant in the process, as this makes it more likely that they’ll stick with it.
  2. Teach your child some strategies for coping with their anxiety before you start. Try slow, relaxed breathing, or giving them a simple message to think about such as, “I’m safe and this worried feeling will go away” or “I’m okay and my Mum will be back soon”. It’s a good idea to plan and practise these strategies with your child before you begin, so that they know what to do as soon as they start to feel worried.
  3. Encourage your child to try to stay in the situation until their anxiety passes. Anxious feelings don’t last forever. In fact, our bodies can only maintain high levels of anxiety for a matter of minutes (rather than hours), but if your child always leaves a situation while they’re still feeling anxious, they might never learn this.
  4. Wait until your child has mastered one step on their ladder before moving on to the next. This might take one attempt or it might take 20 before a step is no longer considered anxiety-provoking. It’s always best to work at your child’s pace.
  5. Reward success. This doesn’t need to be something expensive or chocolate-coated. Praise, letting your child know how proud you are, spending some special time together, or suggesting they call a grandparent or close adult friend to share news of their success are all great ways to reward your child.
  6. Be a good role model. Children learn so much from us. If they watch us panic each time a dog approaches, they’ll soon be doing the same. Consider what you say and how you behave when you feel anxious. Sometimes we need to be as brave as we’d like our children to be!
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