Overcoming anxiety: How behavioural experiments can help teens face their fears
ANXIETY among children and teens is on the rise, and that concerns clinical psychologist and Temple University professor Philip Kendall.

Kendall directs Temple’s Child & Adolescent Anxiety Disorders Clinic, which treats kids ages seven to 17. The clinic charges low treatment fees in exchange for enrolling children in research to better understand what works best.

Kendall said neither he nor his two children (now adults) were overly anxious growing up, but everyone experiences some anxiety as a normal, self-protective reaction to an unfamiliar situation.

He gravitated toward helping children and teens manage their anxiety, in part because anxiety disorders are often treatable, which he finds professionally rewarding.

Kendall spoke to The Inquirer about how parents can better recognise unhealthy anxiety in their children and help them “dial it down.”

What is the best way to help children manage anxiety?

You don’t get kids to overcome or manage anxiety by talking about it. The way to get over anxiety is to practise through behavioural experiments, also called exposure tests.

If you’re afraid of a dog and you don’t change your behaviour, that’s not a big deal. But if you’re afraid of a dog and you won’t go to a friend’s house or you won’t walk home from school because there’s a dog in the neighborhood, then it’s interfering.

The best way to overcome interfering maladaptive anxiety is through exposure. You start by patting a small dog and you work your way up to patting the big dog. And when it’s over the kids kind of strut, ‘Wow, I can do it now.’

How do you tell the difference between everyday worry and an anxiety disorder?

It’s hard for some people to recognise. And the reason it’s hard is that parents in particular will sometimes adjust their own behaviour to reduce their kid’s emotional distress. So the kid has social anxiety and they’re afraid to order their own meal in a restaurant, so when the waiter comes over and says to the kid or teen, ‘What will you have?’ and the kid doesn’t say anything, the mum or dad says, ‘Oh, he’ll have blah, blah.’In the moment, the parents reduce the distress. In the long run, they make it worse for the kid. The key is to recognise the tricks that anxious kids will engage in to avoid doing something. Avoidance doesn’t allow them to learn mastery.

You’ve written 35 books. Can you recommend one on anxiety for parents or teens?

The Resilience Recipe: A Parent’s Guide to Raising Fearless Kids in the Age of Anxiety. Part of the take-home message of the book is how parents can back up a little bit. Parents will be overly involved with their kids. Now, if you’re a conduct disorder, delinquent kid getting in trouble with the law, more parental monitoring is good. For anxious kids, sometimes less parental monitoring is preferred. We learn from taking little risks.

How has social media affected anxiety among children?

Social media is not good or bad. There are studies that show social media can be good – keeping up with your peers, chatting with friends. On the other hand, access to inappropriate material can be bad. Constantly scrolling and looking at pictures and making social comparisons and not really interacting with anybody except the media itself, there’s some pathology associated with that.

The American Psychological Association and the American Association of Child and Adolescent Psychiatrists both have recommended that there should be some education about social media use. One feature of that is teaching adolescents how to deconstruct photos they see on social media.

What do you recommend for kids who use computer gaming as social avoidance?

A teenager needs autonomy and agency. So I’d have the teenager be active in picking which way they want to try to cut back. I wouldn’t say somebody should impose cold turkey or impose overarching rules. Talk about options and let them pick the one they want to try.

Can you talk about the link between anxiety and substance abuse?

Socially anxious teens will use substances to self-medicate. I’d be cautious about vaping, beer, whatever it is. You don’t want to get excessive. It shouldn’t be a crutch. If you talk to friends, if you can make friends, if you can approach situations and not avoid without the substances, that means you can do it. Teens should increase interactions and challenges without relying on a substance. – The Philadelphia Inquirer/ Tribune News Service
It’s hard for some people to recognise anxiety as a disorder because parents will sometimes adjust their own behaviour to reduce their kid’s emotional distress.