When your child struggles with an anxiety disorder it is natural to want to protect him/her from negative feelings and negative interactions, but we know this is not possible. Doing so can actually make the feelings of anxiety worse long-term. Rather than isolating anxious children from situations we know are hard for them we should prepare them to properly cope with their anxiety. This is why Preventive Teaching is such an important skill to use with your children who have anxiety.

The steps of Preventive Teaching are:

1. Say something positive about your child’s behavior or express empathy as to how they may be feeling.
2. Describe how you want your child to act. Avoid telling your child what you don’t want.
3. Give you child a meaningful reason to behave that way. Must be meaningful to your child.
4. Practice the expected behavior. This is the most important part of Preventive Teaching.
5. Find something positive they did during role-play. Correct only if necessary.
6. Continue to practice. Once the child has done it correctly, practice it at least four times.

Preventive Teaching can be used in two ways:

1. Teaching a general skill that can be applied in all types of situations well before those situations occur (e.g. Coping with Anxiety).

2. Practicing what to do do right before a situation occurs. (e.g. preparing for a birthday party).

Using Preventive Teaching to teach a social skill ahead of time

When using Preventive Teaching in this setting, ensure that it is a neutral time when your child is not feeling anxiety and is in a positive mood to learn and role-play. The first step of Preventive Teaching is to praise your child or express empathy, both of which help to start the teaching interaction in a positive way. Step 2 is describing how you want your child to act. These specific behaviors should be prepared ahead of time based on the individual needs of your child. Here are some example behavioral steps that could be included in helping your child reduce their anxiety:

• Recognize an anxious thought and identify the emotion as anxiety
• Recognize the cues your body is giving you that you are feeling anxious-racing heart,sweaty hands, racing mind
• Collect evidence of what is actually happening; not what may happen
• Challenge irrational thoughts-have a debate with yourself
• Plan for the worst case scenario
• Find a way to calm down-mindfulness exercises, deep breathing, going for a walk

Once you have taught the way you want your child to act, role-playing is the most important step in solidifying the new skill. Encourage your child to verbalize what situations create anxiety for them, trying not to give suggestions unless they really need help. Then show them how to use the skill by acting out one of the situations yourself. Your child will then role-play the skill at least 3 times. Give praise and feedback between each role-play to strengthen use of the skill.

With this type of Preventive Teaching, your child is prepared to use the skill in any type of situation that produces anxiety.

Using Preventive Teaching right before a situation occurs

If a situation is coming up that often causes your child anxiety they will have more success reducing their anxiety in the moment if they review that particular event and role-play how they should act and ways to reduce anxiety if they feel it. Since anxiety is feeling heightened fears about the future, use this type of Preventive Teaching only a short time before the actual event.

Discussing the situation hours before it occurs may produce more of the anxiety you are helping your child reduce. Once your child understands how to behave, role-play a variety of scenarios until they feel comfortable that they can cope with their anxiety if it arises. It is also helpful to discuss with your child what they can do if their worse fears came true. What can they do if a child laughs at them at a party? Or what if you are unable to pick them up at the party on time?

As your child learns how to find options in troubling situations on their own they will be more equipped to manage their anxiety.

Extra tips

• Normalize their anxious feelings. Remind your child that everyone feels anxiety sometimes. Try to explain in a simple way the amygdala’s release of adrenaline and other hormones and how that produces a response in our body such as a fast heartbeat and dizziness.
• Praise and reward when they cope with their anxiety in a positive way by using Effective Praise. When I first started using Preventive Teaching with my oldest child she had a lot of anxiety around role-playing and refused to practice skills. We started by offering small rewards for role-playing and she would often agree to role-play so she could earn the reward, but was still too nervous to act out the skill. Eventually I went in a room alone with her and talked her through what to say and she earned the reward with lots of praise. Over time she has gotten used to role-playing because we continue to role-play despite the anxiety she feels doing it. Although she still often hesitates, the anxiety is not as strong and is short-lived. We continue to praise and reinforce each time she is able to role-play.
• Model how to cope with your own anxiety in a positive way. Children learn most from watching how other people act. If they hear you expressing that you can’t handle your own stress or anxiety they will learn to do the same. This doesn’t mean that you should pretend you don’t feel anxiety, in fact that is the opposite of teaching your child how to cope. Show them how to appropriately express your emotion and then do something to calm down so they see that it can be done.
• Anxiety disorders often co-occur with other disorders. Watch for signs of depression, eating disorders, ADHD, and other disorders that often accompany anxiety.
• Anxiety is treatable and many children with anxiety disorders can succeed with additional help through therapy and occasionally with medication for a brief time. There are many resources online for parents and children in dealing with the different types of anxiety disorders that can enhance your use of Preventive Teaching.