Dr. Derek Singleton, a clinical social worker with the Janeway Family Centre in St. John’s, says there has been a substantial increase in referrals to treat anxiety in children over the past few years.
“I’ve been (at the Janeway Family Centre) for 15 years and over the years the referrals for anxiety have, I guess, been gradually increasing,” Singleton said. “Over the last several years we’ve seen a drastic increase in referrals. It started off that we’d see these kids individually for individual counselling, then we started doing group work. We’d run a group originally called ‘Taming Dragons’ but now we are using a program that came out of Australia and it’s called ‘Cool Kids.’ So children with extremely high anxiety, we screen them, assess them and we run groups through the year. Right now, for the first time ever, we are running two groups and each group takes four clinicians — two with the kids and two with a parents’ group that runs simultaneously.”
Singleton says there a couple of reasons for the increase in referrals to the centre: more general awareness of the condition; and children are taking part in more organized activities that brings on a lot of pressure to be the best.
“There’s a lot more promotion of mental health, less stigma for seeking help. Initiatives like Bell Let’s Talk put things out in the open so that it’s OK to talk about it. So that plays a factor,” he said.
“Another thing, kids are extremely scheduled. A lot of kids don’t have a lot of downtime. They are always doing something. There’s a lot of pressure to be the best. It doesn’t matter what it is, whether sports or music, and that brings on anxiety. Kids can also put a lot of pressure on themselves to perform.”
Singleton noted that parents — through good intentions — often protect their children from negative outcomes and that denies them the ability to develop certain coping mechanisms.
“Years ago if something bad happened, a lot of the time you dealt with it and through these life experiences you developed coping skills,” he said. “Now we see kids who don’t have basic coping skills. We spend a lot of time in individual counselling, group counselling and working with parents trying to help kids develop coping skills because sometimes parents are jumping in to protect their kids from every kind of negative outcome.”
Singleton also noted that a child having a small amount of anxiety is natural and can even help inspire them to do something. Problems arise, he said, when anxiety levels rise to a point where it negatively impacts a child’s behaviour.
“The one thing we always try to emphasize is that anxiety is normal, that it is alright to experience anxiety,” he said. “A lot of times anxiety can motivate us. If you have a test and if you are a procrastinator, that anxiety you feel the night before motivates you to cram. It is necessary and helpful. What we are seeing as a problem is when the anxiety gets so great that instead of being a motivator, they avoid doing things and participating in things. A lot of upset bellies, staying home from school because of a test or a gym class, or they are supposed to do public speaking. The more they avoid, avoidance becomes a coping mechanism for kids and then if that continues for long periods of time, that transfers to other areas of their life.”
And when anxiety reaches those levels it can, in turn, “hold families hostage.”
“When anxiety becomes problematic it affects other siblings, parents, it tends to affect everybody. We want to provide support for parents and not just the child with the anxiety,” Singleton said.
“Even in the school system we get a lot of calls. We do a lot of in-service on PT (parent-teacher) days for elementary schools because we see it in the referrals that come to the Janeway Family Centre and the Janeway psychiatry. The schools are seeing it, so we go up and we’re doing training with the teachers and school staff.”
Eastern Health recently announced an information session taking place this week called “Anxiety in children age 5-12 years old: What it looks like and what you can do to help.”
“We know kids are experiencing anxiety and if we are seeing it professionally, and the schools are seeing it, obviously parents are struggling with it at home,” Singleton said. “And one of the things we know in working with kids is the parents need support and guidance, so we run these information sessions. We’ve seen an increase in demand so the numbers of parents attending these now are higher than they were years ago.”
Not every child who develops a high level of anxiety needs therapy. The centre, Singleton noted, runs a program called ‘Parenting Your Anxious Child (PYAC)’ that helps parents understand anxiety and teaches them ways to respond through parenting. If those measures don’t alleviate the problem, he said, then the child can obtain professional intervention.
He also said that first assessing each child properly is key to determining how best to help them.
“Sometimes different types of trauma is labelled as anxiety. It could be abuse,” Singleton said. “There’s refugees and immigrants adjusting to Canadian society and they come in, a lot of times, with traumatic histories and backgrounds and it may present to look like anxiety but it is trauma, and the treatment for that is totally different.
“When we are screening and doing assessments up front, we are making sure that just because someone is presenting as anxiety … when the screenings are done it may determine the issue is something else.
Screening and assessment are critical to determining the issue and the course of treatment.”