Worriers as warriors: CBT strategies for helping young worriers.
Charlotte Wilson, Trinity College Dublin, Ireland
Most children worry some of the time and some children worry a lot of the time. Although the aim of worry is often to solve a problem often worry persists and problem solving is unsuccessful. Worry is ‘sticky’, repetitive, negative and distressing. Persist worry that interferes with everyday life is also the defining characteristic of Generalised Anxiety Disorder, a debilitating disorder experienced by approximately 1 in 25 (4%) children and young people under 18 years.
Worry is a cognitive process which in adults is generally language based. In children worry emerges from approximately the very early school years and is associated with cognitive and language development and the ability to anticipate and evaluate the future.
When we explore cognitive-behavioural factors that are important in adult GAD we find that they look very similar in adolescents. However, in younger children that might not be the case. Children as young as six years old can certainly express positive and negative beliefs about worry, but only by adolescence do they relate to worry in the processes we see in adults.
Worry in adolescents and adults are maintained by cognitive factors including beliefs about worry such as “Worrying will help me figure out a solution”, “If I worry about the future it shows that I’m being responsible” and intolerance of uncertainty. They are also likely maintained by avoidance of internal experiences. These cognitive and behavioural factors can be reinforced or challenged by parents, often inadvertently.
The best treatments for GAD in adults are cognitive-behavioural, with effective interventions including a focus on meta-cognitive beliefs, intolerance of uncertainty and avoidance of certain thoughts and feelings. In children CBT often focuses more generally on challenging negative automatic thoughts, addressing avoidance, and increasing problem solving ability. This workshop will explore additional strategies that can be used in younger populations to enhance the effectiveness of CBT for worried children.
The workshop will focus on three key areas
- Key CBT strategies for helping anxious children
- Meta-cognitive strategies for helping worried children
- Involving parents for maximum effectiveness
This workshop will help CBT therapists to identify and understand worry in children and adolescents and to appreciate how it interferes with well-being and functioning. They will be able to explain the impact and experience of childhood worry to adults who support children and young people, e.g. parents and teachers. At the end of the workshop clinicians will know how to assess worry in children and young people and understand how to adapt psychological interventions for worry so that they can be used by children and adolescents. The workshop will help therapists include parents appropriately and how to work with children when this isn’t possible.
Charlotte Wilson is a clinical psychologist and assistant professor in clinical psychology at the University of Dublin, Trinity College.
Key learning objectives:
By the end of this workshop, participants will be able to:
- Understand the epidemiology of worry in children and adolescents
- Help parents understand why children worry and ways to help manage this
- Critically evaluate measures of childhood worry
- Formulate childhood worry and identify key treatment strategies
- Adapt treatment for worry to children’s developmental stage
Wilson, C. Understanding Children’s Worry (2020). Routledge.
Esbjorn B. et al. (2015). Adapting Metacognitive Therapy to Children with Generalised Anxiety Disorder: Suggestions for a Manual. Journal of Contemporary Psychotherapy, 45, 159-166.
Payne S. et al. (2011). A pilot investigation of cognitive therapy for generalized anxiety disorder in children aged 7-17 years. Cognitive Therapy and Research, 35, 171-178