Cognitive Therapy for Children

Learn how to talk

Open communication is essential. You and the other parent need to be able to talk about your child and make cooperative decisions. If you’re able to talk naturally in a pleasant and reasonable way, you’re on the right path. But if you find yourself gritting your teeth, shouting or getting upset, try to treat your conversations with the other parent in a more detached, business-like way.

You have to conduct the business of parenting together, so treat it like a business transaction. You wouldn’t let your temper get the better of you in most business situations, so try to be polite to your ex in the same way you would to a stranger you are working with.

I worked with one family that kept ending up back in court. The bottom line was that they could not communicate in any reasonable way. Every time they exchanged children, they had a blowup. They finally went to a therapist who had them practice discussing only the situation at hand, and putting their emotions and problems with each other on the back burner to be dealt with at another time. This worked, and when they had to do the business of parenting, they were able to focus only on that task and keep the rest of their problems separate.

Get help

Co-parenting may not come naturally to you, particularly if you’re a high-conflict couple, or you’re still recovering from the nastiness of a divorce. But there are plenty of ways to get help with your parenting relationship.

Take a co-parenting class together (even if you go at separate times). These classes, which many state court systems now mandate for all divorcing couples, can be very helpful. If a class is not required in your area, check with your attorney, the court clerk or the state department of mental health services to find a class near you.

Consider seeing a therapist. A couples therapist can help you improve your co-parenting skills. Your child can also benefit from having a therapist to talk with, and that therapist may, ultimately, be able to help you and your ex work together to help your child.

If, however, you have serious, lingering disagreements about the co-parenting plan itself, a mediator can help you work through them and come to an agreement that will work for everyone. Forgive Yourself

While it may seem as though co-parenting is solely about your interaction with the other parent, a big part is your own internal thought process. Although you have to learn to forgive or at least let go of things the other parent has done, you must also forgive yourself for anything you secretly believe you’ve done – whether to the other parent or to your child. Everyone who goes through the emotional turmoil of a divorce makes mistakes and you need to tell yourself it is OK.

You also need to learn to forgive yourself for the slip-ups you will make as you co-parent. No one can keep up a perfect façade at all times. You’re going to lose your temper, be inflexible or let your hurt get the best of you sometimes in dealing with the other parent. Tell yourself it’s OK and that you will simply try harder the next time.

Separation anxiety is actually very common in children under the age of three, and it’s normal for toddlers and young children to feel anxiety when a parent leaves the room. It’s also very common for young children to feel anxiety and cry when being left at day-care or school for the first time. For most children, this eventually passes as the children become engaged in new surroundings and activities.

The problem occurs, however, in about 4% of children when this separation anxiety does not subside and is, thus, classified as a disorder. Children with this type of disorder typically experience extreme anxiety when away from home and separated from mom and dad. This usually manifests via extreme homesickness and even misery, and such children often have intense fear regarding the health and safety of their parents.

As a result, such children will often:

- Try to avoid going anywhere by themselves.

- Refuse to go to places such as school or camp.

- Refuse to participate in sleepovers.

- Follow a parent around all the time.

- Request that mom or dad stay with them at bedtime, or show up in their parent’s bedroom during the night.

- Have nightmares about being separated from loved ones.

Closely related to separation anxiety disorder is social anxiety disorder, or “social phobia.” This disorder involves an intense fear of social and performance situations, such as starting a conversation, performing in front of others, speaking up in class, participating in peer activities, etc.

As a result, children with social phobias tend to withdraw and avoid such activities, which in turn greatly diminishes the quality of their lives. It can also hinder their performance and attendance in school, and impair their ability to form necessary social skills and relationships. Research has also shown that, if left untreated, children with such anxiety disorders are more vulnerable to substance abuse, depression and comorbidity (two disorders or conditions that appear together).

So, what should parents watch for and what should they do if they suspect an actual phobia or disorder? Part of the problem, of course, is that young children are often shy, and even adults can have anxiety about performing in front of others. Signs to watch for include:

- Reluctance or discomfort being in the spotlight.

- Avoiding eye contact.

- Speaking in a very quiet voice or mumbling.

- Avoiding conversations with peers, never inviting friends to get together, never ordering food in restaurants.

- Being isolated from groups, not participating in group activities.

- Being overly concerned and affected by negative feedback or embarrassment.

- Fear of being called on in class, reading aloud or public speaking.

When put into these situations, children with social anxiety disorder will typically have symptoms such as:

- Racing heart

- Sweating

- Dizziness

- Stomachache

- Crying

- Tantrums

For parents of younger children, experts advise the following tips to help children overcome or cope with social anxiety disorder:

- Don’t speak for your child, but encourage the child to speak up, order his/her own food, etc.

- Encourage children to get involved in birthday parties, play groups, school activities, family gatherings, games, activities, etc.

- Reward and praise children for speaking up, starting conversations, etc.

- Role model the desired social behavior.

For older children, as is the case with the mother and her son who’s away at school, panic disorder is a more intense form of social anxiety disorder. It is not very common in young children, but usually begins in adolescence and in the early to mid-twenties.

People with this disorder have “panic attacks,” which are abrupt episodes of intense fear or discomfort and usually include at least four of the following:

- Palpitations

- Sweating

- Trembling

- Hot flushes or chills

- Tingling sensations

- The need to escape

- A feeling of imminent danger or doom

- Shortness of breath/feeling of choking

- Nausea or stomach discomfort

- Chest pain or discomfort

- Lightheadedness or dizziness

- Fear of losing control or “going crazy”

If children, or adults, have had such panic attacks, they will typically avoid situations where they have had previous attacks. When children and adults begin avoiding public places (places from which escape might be difficult), “agoraphobia” can develop, severely hindering normal participation in situations such as school, work and life.

The bad news is that, because the symptoms of such disorders often mimic conditions such as heart attacks, thyroid and breathing problems, the true disorder is often difficult to diagnose. People who suffer panic attacks often make numerous trips to the doctor or emergency room.

The good news is that, once properly diagnosed, treatment can be highly effective. Therapists often use a combination of cognitive and behavior therapies, referred to as Cognitive-Behavioral Therapy (CBT), in which the patient is involved in his/her recovery, has a feeling of control, and learns skills that are useful throughout life.

Relaxation techniques – such as breathing retraining and exercise – are also used and help people with anxiety disorders to cope more effectively. Medications, including some antidepressants and anti-anxiety medications are often used in combination with the previously mentioned therapies. And, of course, the understanding and support of parents, family and friends can go a long way in helping people with anxiety disorders to cope and overcome them.