Anxiety: Treatment with psychotherapy and lifestyle changes

Learn how psychotherapy and lifestyle changes can help your child cope with anxiety.

Key points

• Psychotherapy can help a child deal with anxiety by offering support, teaching coping skills or exploring relationships.
• Cognitive behavioral therapy is one type of effective psychotherapy. By focusing on the relationship between thoughts, feelings and behaviour, can help patients recognize signs of anxiety, develop coping strategies and gradually face their anxieties.
• Other forms of psychotherapy include family therapy, behavioral therapy and mindfulness- and acceptance-based therapies.
• Children and teens may also benefit from at least eight to 10 hours of sleep a night, eating a balanced diet and getting regular exercise. Your child’s doctor can offer advice if a child has difficulty making lifestyle changes.

1- Introduction

If your child or teen is diagnosed with anxiety disorder, they may be prescribed medications and/or be advised to have psychotherapy or make lifestyle changes. The type of treatment(s) your child receives depends on the severity of their anxiety.

2- Treatment

A- How psychotherapy can help treat anxiety

Psychotherapy, also known as “talk therapy”, involves a trained therapist working one-to-one with a patient or with a group of people on common objectives. Depending on the type of psychotherapy, the therapist can offer support, teach coping skills or help a patient explore their relationships.

2- How to access psychotherapy?

You can access psychotherapy in a range of ways, for example through

• a mental health agency
• A recommendation from a doctor, private psychologist or other healthcare provider
• a recommendation from a trusted friend or family member
• an employee or family assistance program.

Fees for psychotherapy vary. Some costs – but not all – might be covered through public health plans or through private insurance.

The therapy that has been shown to be most effective for childhood anxiety disorders is cognitive behavioral therapy.

Cognitive-behavioral therapy

Cognitive-behavioral therapy, or CBT for short, is a structured form of therapy involving one session a week for, on average, 10 to 16 weeks. CBT can be effective for a range of mental health issues.

How does CBT work ?

CBT is based on cognitive theory, the idea that our thoughts influence our feelings and our behaviors. If we are thinking worrying thoughts, these thoughts will lead us to feel anxious, and then act in an anxious or avoidant manner.

The goal of CBT is to help anxious children:

• recognize their anxiety as a symptom
• identify their anxious thoughts
• Develop cognitive strategies (different ways of thinking) to challenge anxious thoughts and replace them with adaptive (more constructive or realistic) thoughts
• learn behavioral strategies, such as relaxation techniques to manage the physical symptoms of anxiety

Over time, CBT may also include exposure therapy. This involves experiments that gradually expose a patient to the source of their anxiety to help them learn to face their fears and see that they can conquer them.

CBT can be individually done with a therapist or in a group of children with one or two therapists. Parental involvement is an important part of treatment, especially with younger children.

With individual CBT, children are often seen by a therapist for most of the session and then the parent(s) or caregiver(s) are brought in for a portion of the session. With group CBT, parent and child groups may run separately but at the same time.

Teens and parents can also work through self-help CBT resources on their own.

Other forms of psychotherapy to treat anxiety

CBT has a lot of evidence to support its use in children and teens, but sometimes other psychotherapies may be recommended. These include:

• supportive or psychodynamic psychotherapy
• family therapy, if there are a lot of family tension or conflict
• behavioral approaches, for example, if a child or teen has anxiety with attention deficit hyperactivity disorder (ADHD) or oppositional defiant disorder
• mindfulness and acceptance-based therapies. These are new forms of therapy that can help a person manage their anxiety disorder by learning to live in the moment and experience life without judgment.

Importance of patient/therapist relationship

Psychotherapy is more helpful when there is a good relationship between the therapist and the child. If there is a poor fit, you may need to talk to the therapist or else choose to switch to another therapist.​

3- Helping your child

Lifestyle changes that can help treat anxiety

Children and teens with certain anxiety disorders may experience a drop in symptoms by following some general healthy lifestyle routines.

These include:

• getting at least eight to 10 hours sleep​ a night
• eating a balanced diet, following Canada’s Food Guide
• getting regular exercise in line with the physical activity guidelines for children and youth.

If your child’s anxiety symptoms prevent them from sleeping or eating well, your child’s doctor can offer advice.