Parents of anxious children/young people: How they help, how they hinder.
/
There is no doubt that biological factors play a large part in contributing to children and young people’s anxiety. We now have research which strongly suggests a genetic component (e.g. identical twins are more likely to have similar rates of anxiety than non-identical twins) to anxiety, research which has identified physiological differences (for example heart rate reactivity, a number of brain structures/processes) between more and less anxious children and research which has found differences in infant behavior which predict which children grow up to be more or less anxious.
As I explain to families I work with, all these fields of study put together indicate that at least some tendencies towards anxiety in humans is “hard wired” into some young people much more strongly than in the average young person.
However there are other research studies which show that there are aspects of a young person’s environment which also influences their levels of anxiety. For instance, various studies have found factors such as early traumatic life experiences, friend and peer relationships, school life, sleep quality, nutritional intake, exercise and technology use – also contribute to how much anxiety children and young people experience.
In other words, when families ask about the causes of anxiety in young people, we can confidently state that it is a combination of nature and nurture.
It’s with this background and context that I’d like to focus in this article on one particular aspect of a young person’s environment which appears to influence anxiety –and that is parenting behaviours.
Although it is only one factor in what causes anxiety, it is an important one. There are now hundreds of studies which have examined the ways parents/caregivers respond, relate to, behave around and talk to children/young people which potentially help – and potentially worsen – anxiety in young people.
This is a sensitive subject. While it’s encouraging for parents/caregivers to know their behavior can potentially reduce their child’s anxiety, it’s hurtful and upsetting to think what they are doing may be inadvertently making things worse for children.
It goes without saying therefore that conversations about this topic need to be had with great empathy and acknowledgement of parenting challenges. However, providing they are done in this manner, these conversations can be helpful for parents/caregivers. It provides essential information and reassurance for them to know what they are doing right – and what they might like to change.
Below are the four parenting approaches or behaviours research suggest may be associated with anxiety in our young people. I’ll summarise these below, but if you’d like to look at a review yourself, you might start with Wei and Kendalls’ review (2014) in Clinical Child and Family Psychology.
1. Parental Control
The idea of “parental control” refers to how much parents/caregivers try to control what a child does, thinks, feels, says and the situations they experience. Parental control can be measured by both laboratory studies (parents and children being observed together) and questionnaires about parenting (completed by both parents/caregivers and children/young people).
Parents who score “high” on measures of parental control are more likely have children who are more anxious, and who become more anxious over time, than parents who score lower on this measure. Interestingly, parents/caregivers who are high on parental control are more likely to experience more anxiety themselves.
High “parental control” might look like the following:
Over-protecting children (ie stopping them from experiencing situations which many adults believe are safe)
Being over-involved/intrusive in too many aspects of children’s lives (asking too many questions, being around all the time, insisting on monitoring everything the child/young person does)
Not allowing young people to choose or make enough decisions about their lives
Providing young people with too many instructions about what to do – particularly when these are about how to think and feel about situations or their life.
Although it will depend greatly on the age of the young person, here are some sentences parents with “high parental control” might use:
You can’t do that, it’s too risky.
Tell me everything.
I will make these decisions.
You’re not old enough to do that.
I need to tell you exactly how to do that.
I need to be there to watch you.
I must be involved in that.
There’s a lot that could go wrong here, I should be involved.
In contrast, parents who score lower on parental control have children with lower levels of anxiety.
These parents allow their children to have a range of experiences (even those with a small amount of manageable risk), allow their children to make age appropriate decisions, to allow them privacy in their experience of thoughts and emotions, allow them to have their own experiences and relationships without having to know and be involved in every aspect of them.
Again, it will depend greatly on the age of the young person, but here are some sentences parents with lower parental control might use:
It’s up to you
You are old enough to decide
Would you like to choose
You can tell me about that when you are ready
How do you think you should manage that?
I can help you if you need it, but you can try first
2. Warmth and acceptance
The term “parental warmth” refers to how much love, empathy, affection, positivity and acceptance parents/caregivers show towards their children/teens. Again, parental warmth can be measured via observation and coding of actions between parents and children and it can also be measured by questionnaires.
Low levels of parental warmth has been found in most studies (but not all) to be associated with higher levels of anxiety in children.
Let’s look more specifically at what low levels of parental warmth looks like. It might mean:
Rarely telling children they are loved
Not showing enjoyment about being with or around children,
Rarely using praise, thanks or acknowledgement
Staying silent or not responding when children or young people are hurt or upset.
Using harsh criticism or punishment.
Not using physical affection of any kind
Low warmth parenting might include repeated use of sentences like:
Toughen up/stop crying
(No response) when a child has helped, tried hard or done something well
I don’t care
Too bad
I’m not interested.
Silence (when child is upset)
In contrast, high levels of parental warmth has been found (again, in most studies) to be associated with lower levels of anxiety in young people. High levels of warm behavior from parents includes telling children/teens they are loved, showing them physical affection, showing empathy when they are hurt or experiencing negative emotion and avoiding harsh criticism or physical punishment. These parents/caregivers use sentences such as:
I love you
I enjoy being with you
I appreciate you
I know you are trying
I admire you
(Hugs/pats on the shoulder)
I care about you
I’m sorry this is tough for you
3. Accidental rewarding or reinforcing of young people’s anxious (or “avoiding”) behaviour
A third factor researchers have found to be associated with anxiety in young people is how parents/caregivers respond when their children are feeling anxious or acting in an anxious way. Studies have found that rewarding or reinforcing of anxious behaviour by parents/caregivers is associated with more anxiety in young people over time.
Parents/caregivers who do this may do the following:
Show children/young people excessive and repeated sympathy or interest in their anxiety (asking about anxiety or difficult situations very frequently or in a very anxious manner)
Show anxiety or distress when their children/young people tell them about their worries or when they see children experience difficult situation (oh NO! that’s terrible!).
Allow (or encourage) young people to avoid (all or most) situations which make them anxious.
Not require children/young people to do anything which worries or is difficult for them
Accidentally rewarding or reinforcing anxious behavior might include sentences such as:
You feel anxious?/That happened? That’s terrible/awful.
If you are worried, you shouldn’t do it.
I’ll help you get out of that.
You don’t have to do anything that feels scary
We must fix this, it’s not okay that you feel anxious.
(When child/young person tells them about anxiety) Oh no, that’s terrible
(When child/young person tells them about difficult or worrisome situations) How terrible/awful
In contrast, parental reinforcement and encouragement of brave and confident behavior in children is associated with less anxiety in young people over time.
Parents/caregivers who act in these ways are caring towards their children when they are anxious, but act and speak calmly to them about it. They gently push their children/young people to do things which are scary or worrying. They might say sentences such as:
You can do it
I’ll help you do this – bit at a time
I’m sorry you feel anxious, but I know this is safe
I will be there for you but this is an important step for you to take
I believe you can do this
I’m sorry that happened.
Feeling really anxious is hard. I do believe you can handle it.
Feeling worried is tough. It happens to lots of people.
4. Repeatedly acting in anxious ways around young people
The fourth parenting behavior associated with anxiety is parental modelling. Children and young people who act see their parents/caregivers act or talk in highly anxious ways (about their own life) are more likely to experience higher levels of anxiety themselves.
On the other hand, young people who see their parents/caregivers act in confident ways and manage worry and anxiety are less likely to be anxious.
This relationship might be simply one related to genetic influence, however some research suggests that it is parental anxious behavior specifically which is associated with anxiety in children – not anxiety itself.
The relationship between parenting behaviours and anxiety in children is not simple
To summarise so far: research tells us that there are four parenting behaviours associated with higher anxiety in children/young people - high parental control, low parental warmth, reinforcement/ accidentally rewarding anxious behaviour and repeated modelling of anxious behavior.
However, there are two important ideas to keep in mind about this research.
First – many of the studies (not all) referred to above are correlational. These parenting behaviours have been associated with high anxiety in children, but we don’t know for sure these behaviours cause anxiety.
As you know, in this type of research we can’t be sure what comes first: it’s quite possible that anxious children and teens might cause the parenting behaviours above – not the other way around.
This is a feasible hypothesis in many cases. For example, children with a high level anxiety might have more frequent negative experiences with the world around them from a young age (eg they feel more upset, more often), which might then cause parents/caregivers to start controlling more of their children’s experiences as they attempt to reduce and manage the child’s frequent high distress. Thus child anxiety causes higher levels of parental control – not vice versa.
Another example is that children who are very highly anxious might cause their parents to show more concern about anxiety (because these parents know more about how difficult anxiety is) than parents without anxious children. In other words higher child anxiety causes higher levels of parental reinforcement/attention to anxious behavior – again not vice versa.
There is likely to be a circular loop – children influence parents, who influence children – and so on
As you can see, it is likely that anxious children/young people who are anxious prompt their parents/caregivers to act quite differently compared to parents of confident children/young people. If this is the case, this might then perpetuate anxiety in children- prompting more changes in parents.
I should just add at this point that not all of the research is correlational – some studies have looked at long term changes in children’s anxiety as a result of parents behavior – but the majority of the research is.
The second factor to consider is – as stated at the beginning – parental behaviours is only one factor which is linked with anxiety in children and young people. The research about other factors is also strong. We know that there are other - very important purely biological and other (non parenting) environmental causes of anxiety in young people.
What behaviours should we encourage in parents/caregivers who have anxious children
Regardless of potential for there to be a bidirectional relationship between parenting behavior and childhood anxiety, and the fact there are other factors outside parenting which cause anxiety in young people, it is still very likely that changing some of the parental behavior listed above will still help children who are anxious.
To summarise, here are five types of behaviours we most want parents/caregivers towards their children who experience anxiety. We want them to:
1.Provide an age appropriate level of independence and autonomy: allow kids and teens to make decisions, have time by themselves/with peers, problem solve independently, have their own chores and manage life tasks (without us hovering or directing unnecessarily).
2.Show a high level of warmth and acceptance towards their young people: tell them they are loved, show them they enjoy being with them, find ways to praise and recognize their skills and be physically warm and affectionate.
3.Help, encourage and support their children/young people to face their fears (bit at a time, and gently): for them to confidently assume their children are capable of managing scary situations, for parents/caregivers to ensure their children do not avoid feared situations, for them to avoid “rescuing” their children/young people from things/situations which worry them.
4. Tell (and show) young people know that being anxious or worried is not terrible: tell their children they believe they can cope with feeling worried and being in difficult situations, using a neutral or positive facial expression and confident tone of voice.
5.Get support for their own anxiety and stressors: actively work on their own anxieties and stressors so that children and young people can see parents/caregivers act in brave, confident and self-assured ways in a range of life situations.
Supporting parents/caregivers to effectively parent children/young people with anxiety
Parenting a child/teenager without any particularly emotional challenges is hard enough – parenting one with a tendency towards anxiety or an anxiety disorder is extremely tough. There is a significant amount of additional parenting work required from these parents – teaching, reassuring, coaching and encouraging. All of this work is at the least wearying – and for children with anxiety disorders and intense fears it is also saddening, worrying and disappointing.
If we are to work effectively with parents/caregivers of young people with anxiety they need to hear – often repeatedly – from us that their child’s anxiety is not their fault.
We also need to acknowledge the work, time and energy they are putting into supporting their young person with their anxiety.
We need to be empathetic towards them and acknowledge the emotional challenges which come with parenting a young person with high anxiety.
It is not until we provide this empathy and acknowledgement that we can work with them to see whether there are any changes they can potentially make to adjust their own behaviours. This work needs to be done carefully, gently, with permission, mostly using socratic questioning and using the provision of research and information - and then allowing them to use it in ways which suit their family.
If you would like to provide parents/caregivers which an article specifically written for them about this topic, click below.
If you work with primary aged children with anxiety, you might find our "Calm Kids" online anxiety course helpful. You can use it in the classroom/therapy room with children - it includes animations, activity sheets and posters - and unlimited online access to a panel of child psychologists for professional supervision/consultation. For more information, go to www.calmkidpro.com
Parental Involvement: Contribution to Childhood Anxiety and Its Treatment
Wei, Chiaying; Kendall, Philip C.Clinical Child and Family Psychology Review; New York Vol. 17, Iss. 4, (Dec 2014): 319-39.DOI:10.1007/s10567-014-0170-6
