Work Samples

Kids and Anxiety: Successful anxiety therapy needs parents to be on board


Parents may think putting their child in therapy means secretive, behind-closed-door talking sessions that end with their writing a check then wondering what went on in those confidential conversations. But with cognitive behavioral therapy, the most recognized, evidence-based treatment recommended for children with anxiety, parents are an integral part of the process and vital to its success.

Psychologist Carrie Spindel Bashoff, who sees children in Hackensack, Montclair and Manhattan, calls parents the "eyes and ears" outside of a therapy session. The anxiety that strikes at school, home or a friend’s house can’t be seen in a therapist’s office. Parents must report back as well as know and be practiced in the skills children are given to overcome their fears. There is still confidentiality, but parents spend a portion of every session in the therapist’s office with their child, talking about what was discussed that day, what they should look out for and what to work on between sessions.

It is important that parents are supportive, active participants in the process. Of course, that is not always the case.

"I’ve had therapies where I’ve felt one parent might sabotage it, and you really have to address that parent," said psychologist Rob Zambrano, a cognitive behavioral therapist at Stress and Anxiety Services of New Jersey in East Brunswick. "I think a lot of parents are afraid of therapy because the stereotype of therapy is that we’re going to blame you. … That doesn’t happen hopefully too much anywhere these days in any form of psychotherapy, but I think that’s what parents are sort of wary of. They think the therapist is going to blame them for everything, where it’s more like, ‘I’m just here to train you guys. None of our kids came with a training manual. My job is to help you feel more effective and teach you how to do that.’ "

Therapists may have to mediate between parents who take different approaches to the child’s anxiety disorder.

"When we have the school-of-hard-knocks parent and the coddling parent, we have to deal with them and come to a middle [ground]," said psychologist Anne Marie Albano, director of the Columbia University Clinic for Anxiety and Related Disorders.

First, Albano and both parents agree on the common goal — making the child functional. Then Albano will tell them, "Look, your approach you’ve been using for a while now … where has it gotten you? Can we make an agreement to do and follow our plan at least for the next four weeks, and let’s see how it goes?"

"If we don’t get change, we reassess, we rethink," she said. "But if we do, then the parents are able to see, ‘Ok, this kid isn’t just acting out to get attention, and this stuff actually does help.’ It gets buy in."

Parents need to know there is hope with the right treatment, according to psychiatrist Lisa Kotler, medical director of the New York University Child Study Center in Hackensack.

"There’s help for them," she said. "There are effective and evidence-based therapies, as well as effective and evidence-based medication. It’s important to get a qualified professional and to be positive that there’s hope. Things get better. That’s really important. It’s not their fault, and the most important thing is to get help for your child."