To Help Anxious Children, Look to Evolution

Did you know that anxiety disorders and OCD work differently in children than in adults? This may seem intuitively obvious but is not reflected in most treatments for child anxiety and OCD. Current treatment protocols conceptualize anxiety disorders and OCD as the result of an overactive threat detection system. This understanding falls short when we are treating children because it doesn’t take into account the hard-wired instincts of parents to respond to and alleviate the distress expressed by their children.

Good parents naturally want to soothe their anxious child–it’s an inborn instinct that is part of the mammalian caregiving system. Children are dependent on their parents for all sorts of needs, including managing and removing threats. Children are biologically driven to signal their caregivers when they feel danger, and caregivers are programmed to respond by removing the threat.

The problem is, when a child suffers from an anxiety disorder or OCD, their threat detection system isn’t the only thing that is out of whack. In addition, the whole signal-response system becomes out of whack. Children put out more and more signals of distress to their parents, and parents respond, often providing repetitive reassurance, soothing, or removal of anxious stimuli. The threat detection system AND the signal-response system become dysregulated.

A parent’s response to a child’s distress signals does not CAUSE a child to develop an anxiety disorder or OCD. Nonetheless, by learning to respond differently to their child’s distress signals, parents can help significantly decrease their child’s symptoms. This is exactly the goal of SPACE treatment or Supportive Parenting of Anxious Childhood Emotions. SPACE teaches parents to reduce unhelpful accommodations in a supportive way, leading to less anxious and more confident children.

I recently became certified in SPACE treatment. In my experience, SPACE is effective at not just reducing anxiety and OCD symptoms in children and teens, but also at helping parents tolerate their child’s anxious emotions (a real gift to a lot of parents!) Many parents, after completing SPACE treatment with me, have remarked on how it feels like a treatment for kids AND for parents. And in a way it is. Because when we can bring the signal-response system back into balance, everybody benefits.

To learn more about SPACE treatment, including the research showing its efficacy, visit www.spacetreatment.net.

About the Author: Emily Berner, MFT

Emily Berner, LMFT (MFT81533) specializes in helping parents of anxious children and is in the first international cohort to receive certification in SPACE treatment (Supportive Parenting of Anxious Childhood Emotions) through the Yale Child Study Center. After more than a decade specializing in pediatric anxiety, OCD, and related disorders, Emily came to see that children and adolescents get well and stay well within a supportive family context, which often means making changes at the parent level. She is passionate about empowering parents to create the circumstances needed to help children navigate anxiety, while staying connected with their own core values. Emily brings her core values of compassion, collaboration, flexibility, and humor to her work with parents. An Oakland native, Emily completed her undergraduate degree at the University of California, Santa Barbara, and attended graduate school at the University of Hawaii and California State University East Bay. After receiving her master’s degree in counseling psychology in 2011, Emily trained in evidence-based treatments at the Santa Rosa Center for Cognitive Behavioral Therapy and at the Cognitive Behavioral Therapy & Mindfulness Center in San Ramon. She became a partner at the San Francisco Bay Area Center for Cognitive Therapy in 2016. Emily has extensive experience treating a wide variety of problems in children, adolescents, and adults including OCD, depression, perfectionism, social anxiety, separation anxiety, generalized anxiety, panic disorder, agoraphobia, specific phobias, and struggles with intense emotions and behaviors. She draws on many evidence-based therapies including cognitive behavioral therapy, acceptance and commitment therapy, mindfulness, dialectical behavioral therapy, behavioral activation, and behavior modification. She takes pride in offering empirically-supported treatments and she understands that any successful therapy first requires a strong interpersonal connection and a good working relationship. Aside from her clinical practice, Emily enjoys presenting at national conferences on topics related to pediatric OCD and parenting anxious children. She stays current on treatment advances and remains an active member of her professional community. At home, Emily is a grateful mom to a toddler, loves camping in her family’s 1995 Toyota HiAce, and is an avid yoga practitioner.