Why did my anxious child's good work in therapy wear off?

In this episode of the Child Anxiety FAQ Podcast, Dawn Friedman addresses a listener's question about why a child's progress in therapy can seem to wear off over time. Dawn explains that anxiety in children is often reinforced by family patterns, termed 'Parenting Pitfalls', which unknowingly support avoidance behaviors. She discusses the importance of continuous practice and parental involvement in managing anxiety and reinforces that setbacks are a normal part of the learning process. Listeners are encouraged to revisit therapy if needed and to apply the skills learned consistently across different contexts and developmental stages. For submitting questions, visit ChildAnxietySupport.com/podcast.

00:00 Introduction to the Child Anxiety Fact Podcast

00:28 Listener Question: Why Did Therapy Stop Working?

01:21 The Role of Parents in Managing Child Anxiety

01:40 Understanding Anxiety Patterns and Accommodations

04:29 Therapy Success and the Need for Continuous Effort

07:25 Practical Tips for Parents to Support Anxious Children

10:46 Conclusion and How to Submit Your Questions

Mentioned in this episode:

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Episode Transcript

(01:36):
Hey, everyone.
Welcome to the Child AnxietyFAC Podcast.
My name is Dawn Friedman andI've been working with kids and families
for more than 30 years as apreschool teacher, parent educator,
family case manager, clinicalcounselor, and now as the owner and
operator of Child AnxietySupport, where I help parents of
anxious kids.

(01:57):
FAC stands for FrequentlyAsked Questions.
I answer listener questionsabout child and teen anxiety.
This episode's question is,why did my child's good work and
therapy wear off?
I recently gave a talk at aschool about child anxiety and someone
in the audience said thattheir child had previously worked

(02:20):
with a therapist and made awhole lot of strides and really had
overcome their anxiety.
And now it seemed like theywere backsliding back into their
anxious, avoidant behaviorsand they wondered if I had any insight
about it.
Now, obviously I was not thischild's therapist.
I don't know how therapy went,but this is what I shared with the
parent and this is what wetalked about in their experience

(02:44):
of therapy.
So, first of all, therapy is agreat option for anxious kids.
It's terrific.
If you can find the righttherapist for your child, go for
it, absolutely, 100%, and theycan make a lot of progress there.
However, unless you do yourbit as the parent, your child is
likely to backslide.
Why the heck is that?

(03:05):
That's because we know thatchild anxiety is perpetuated by family
patterns of anxiety.
Let's go even further backabout this.
When we first started lookingat these anxiety patterns called
accommodations.
And as many of you know, Idon't use the term accommodations
when I'm talking about them,because accommodations in the context

(03:29):
of IEPs are good things.
Our children who struggle withlearning, who have learning disabilities,
maybe our autistic kids mightneed some accommodations to be successful
at school.
Accommodations in the contextof anxiety are not a good thing.
It means we're accommodatingthe anxiety that is creating patterns

(03:51):
that enforce avoidance.
And I call those parenting pitfalls.
Those pitfalls can happen alsoin school and they can happen in
other intimate relationships.
When we were first looking atthis in the research we were examining
the way couples accommodate anxiety.
Accommodations are present inpretty much every relationship that

(04:14):
someone has with an anxious person.
That is in that relationship.
We start helping the anxiousperson avoid the things that makes
them anxious, avoiding theirdiscomfort with anxiety.
Unless we stop doing this,that loved one does not learn how
to go towards the anxietyprovoking stimuli.

(04:37):
They do not learn how toacclimate to the feeling of discomfort
and uncertainty.
And so the anxiety is perpetuated.
What my Guess is, with thisfamily, and this is what I shared
with them, is that their childwas able to make good progress in
therapy around whateverspecific anxiety challenge they were

(05:00):
working on.
And we didn't get into that inthis presentation.
I don't know what theyspecifically were working on in therapy,
what their child was workingon, but let's say that they were
working on a, oh, I don'tknow, speaking up in class.
Maybe that's what they wereworking on.
And so they were working onthat in the context of the therapy.
The child is learning their tools.

(05:22):
They're learning more aboutcognitive behavioral tools.
They're probably coming upwith some exposures, that is ways
for the child to practicedoing the thing that scares them.
And maybe that would start byjust raising their hand.
Maybe they were just going toraise their hand.
They weren't going to answerwhen called on.
Maybe they arranged with the teacher.
I'm just going to raise myhand and you can call on me, and

(05:44):
then I'm going to shake my head.
And that's enough.
You know, that's enough tostart with.
And then as I get comfortablewith that, then I'm going to raise
my hand and say out loud,never mind.
Those are the kinds ofexposures we would be building on
to slowly acclimate the childto anxiety.
And it was successful.
According to the mom, thistherapy was successful.

(06:04):
But when it comes to anxiety,our anxious brains will find things
to be anxious about.
If we're anxious aboutspeaking up in class, we might start
getting anxious about showingup to a birthday party.
Or we might get anxious aboutgoing to bed alone at night, or we
might get anxious about goingto a school dance.
Anxious brains are going to be anxious.

(06:26):
This child learned how to dealwith the anxiety in the context of
this particular event, butthey were unable to take that learning
and out into the rest of the world.
There are lots of reasons whychildren struggle to transfer learning
from one context to another context.

(06:46):
And part of it is, that's hardfor all of us.
That takes the ability to seethe similarity between the two situations.
But also, kids are growing allthe time.
They are relearning things innew ways because their brains are
growing and they're laying newneural pathways.
So the child may have learnedthese skills in the context of, okay,

(07:08):
this is how I handle learninghow to speak up in class.
But then to transfer that,that big, complicated learning to
a completely differentsituation, like going to a birthday
party where I may not knowpeople, that's a whole new kind of
learning.
Even Though it's the same sortof face your anxiety, overcome your

(07:31):
anxiety.
Kids need to learn thesethings over and over again in those
new contexts, but also atdifferent developmental stages because
their brain is relearning things.
Kids also sometimes forgetthings on their way to learning things.
So you'll see this happenreally obviously when they're infants
and toddlers and they'relearning to talk and they're learning

(07:54):
to walk, and they willsometimes drop skills as they're
picking up new skills.
So a child that is learninghow to make certain sounds will make
those sounds for a while.
You see this in infants.
They'll say, ba, ba, ba, ba ba.
And then they don't say thatagain for a while because they're
too busy saying, na, na, na,na na.
And then they bring those bothtogether later on in their talking.

(08:19):
This is true throughout their learning.
You'll see them drop skills asthey gain skills.
You'll see.
You'll see them keeping theirroom clean, but their backpack is
a mess or whatever.
Same with anxiety.
What this means is twofold.
The first is that wasn't afailure of therapy, that was a success

(08:39):
of therapy.
And now, you know, you couldgo back to that therapist.
If that therapist knows yourchild well, then it'll be easier
for them to pick that back up.
So going back to therapy afterhaving been in therapy and graduated
is not a failure.
It is leaning on a resourcethat, you know works.

(09:00):
So that's one.
The other thing is you, theparent, can learn the skills to teach
your child.
So if you learn what it lookslike for your child to speak up in
class, if you're working witha clinician to understand what that
looks like, you can take thatlearning and bring that into other
situations for your child.

(09:21):
You can also learn, what was Idoing that helped my child?
And what was I doing thatdidn't help my child?
Where am I getting stuck inthose parenting pitfalls?
Where am I helping my child to avoid?
How can I learn to disruptthose patterns for myself so I can
recognize them?
As soon as I look around andsay, my kid's getting stuck in anxiety

(09:44):
again, I know what to look for.
I'm going to look for it.
I'm going to interrupt it.
I'm going to support my child.
When we're working on copingwith the reality of having an anxious
brain, there are certainthings that we need to do to help
us overcome our anxiety.
And that starts withunderstanding anxiety, understanding
how it works.

(10:04):
You need to understand it,your child needs to understand it.
And again, your Child will berelearning that at different times
of their life.
So whether or not they go backto therapy, whether or not they start
with therapy at all, you needto know this because you're going
to be helping your child learnthat therapists share information

(10:25):
and teach skills.
But parents are obviously theones who are going to continue to
supply their child withinformation and practice those skills
with their child.
So one reason that child endedup kind of falling off the anxiety
coping wagon is that theparents didn't realize, oh, we got

(10:47):
to keep doing this.
We got to keep working on it.
We got to keep trying.
We got to keep our eyes outfor those pitfalls.
Anxiety treatment is not oneand done.
It's not one and done for kids.
It is ongoing.
It's not one and done for us.
We need to, if we are anxious,continue to practice those skills,

(11:09):
to notice when we're kind offalling off our own wagon and jumping
back on.
That's part of learning tolive with anxiety, is learning how
to continue to confront it, tocontinue to overcome it, to continue
to face it, and to continue totake care of ourselves when we're

(11:30):
struggling.
In those anxious times.
We can expect anxiety toincrease whenever something new is
happening.
If your child is going tosleepaway camp for the first time,
if they're about to start at anew school or go up a grade when
they're headed off to college,or getting their own apartment the
night before they get married,when they become parents, on and

(11:54):
on and on, we continue topractice those skills of taking care
of ourselves and facing our anxiety.
In short, when your child'sgood work in therapy wears off, that
means, well, we need to getback on that wagon.
We need to start working onour skills again.
We need to start identifying avoidance.

(12:15):
Maybe we need to go back tothat therapist and revisit the things
that we have learned.
If you have a question for meon the podcast, please go to my site,
childanxietysupport.com choosepodcast in the menu.
You can submit your question there.
And while you're there, youcan sign up for my Sunday newsletter

(12:35):
where you will get lots ofuseful information about supporting
your anxious child.