TheraTree Pediatric Therapy - TheraTree Blog #Mental HealthTheraTree Pediatric Therapy - TheraTree Blog #Mental Healthhttps://www.theratreepeds.com/blogs/tag/mental-healthWed, 12 Nov 2025 18:55:01 -0800http://zoho.com/sites/<![CDATA[Animal Assisted Therapy]]>https://www.theratreepeds.com/blogs/post/AATOur Animal Assisted Therapy program has begun with Bo the Certified Therapy Dog!]]>

Animal Assisted Intervention

Our Animal Assisted Therapy program has begun with Bo the Certified Therapy Dog! 


Animal Assisted Intervention (AAI): An alternative or complementary type of therapy intervention that includes the use of animals as a means to deliver therapeutic intervention in a treatment. Animal-assisted interventions are goal-oriented and structured interventions that intentionally incorporate animals into health, education and human service for the purpose of therapeutic gains and improved health and wellness. There are  three specific delivery methods of AAI: 

  • Animal-assisted therapy (AAT)

  • Animal-assisted education (AAE) 

  • Animal-assisted activities (AAA)

Animal Assisted Therapy

Animal Assisted Therapy (AAT) is a complimentary type of therapy intervention; meaning, it’s added and incorporated into the child’s existing therapy plan of care and goals. The therapy clinician determines if using AAT will help forward progress of your child’s current established goals. If the clinician and family agree that AAT could be beneficial for the child, the clinician will create the therapeutic interventions within their scope of practice that are goal-oriented, planned, structured, documented, then invite the certified Therapy Dog and it’s certified handler to the appointment. 

Examples of AAT:

  1. A child learning to button dresses up the dog in a button down shirt.

  2. A child working on speech skills gives the dog commands like “sit” or “stay”.  

  3. A child who is afraid of heights jumping with the dog from a platform. 

Key Features of AAT:

  • Must be overseen by a health and human service provider as part of their profession. 

    • A wide variety of disciplines might incorporate AAT include physicians, occupational therapists, physical therapists, certified therapeutic recreation specialists, nurses, social workers, speech therapists and mental health professionals. 

  • Must incorporate the animal as part of his or her own specialty. 

    • Clinicians acknowledge and work within their own level of competence, education, licensure, and skill set.

    • Example: A social worker must incorporate the animal in the context of social work. If the same social worker takes the animal to visit a group of children on an informal basis, the visit would be considered AAA, not AAT. 

  • Interventions are planned and goal-directed. 

    • Activities and interactions with animals are goal-specific and measurable, such as improvement in range of motion or fine motor skills. 

    • The goals must be identified and defined in the plan of care before the session or the session can't be considered AAT.

    • The activities may or may not include direct contact with dog. 

    • The focus of treatment is on the therapeutic process and outcomes. This may include the set-up, planning, and organizing of activity, additional preparation for dog, rather than just completion of a task.

  • Documented and Billed. 

    • Each session is documented in the client's record, with the activity and progress noted. 

    • Because AAT is incorporated into an existing skilled therapy treatment (not a separate service) the intervention is billed as usual to insurance reflecting the purpose of the intervention.

Animal Assisted Education

Animal Assisted Education is a goal-oriented, planned and structured intervention directed by a general education or special education professional. The focus of the activities is on academic goals, prosocial skills and cognitive functioning, and student progress is both measured and documented. 

Key Features of AAE:

  • Overseen by a credentialed general or special education teacher.

  • Planned and goal-directed. 

  • While any visit with an animal might be beneficial for a student, unless the goals are identified and defined before the session, the session is not considered AAE.

  • Documented in an educational setting this may mean it is part of a specific lesson plan or has an associated assessment which documents student progress. 

  • In special education, it may be part of an Individualized Education Plan.

Examples of AAE: 

  • Classroom presentation as part of a unit on responsible pet ownership.

  • An elementary school coordinates a reading program for youth with speech impediments to practice reading aloud to animals. The session is supervised by the speech therapist who records student progress.

Animal Assisted Activities

Animal Assisted Activities provide opportunities for motivational, educational and/or recreational benefits to enhance quality of life. Although these activities are more informal in nature, they’re delivered by a specially trained professional, paraprofessional and/or volunteer in partnership with an animal. 

Key Features of AAA:

  • This does not occur during a healthcare type setting - this is not the type of intervention completed at TheraTree
  • Specific treatment goals are not planned for each visit 
  • Content is spontaneous and may only last a few minutes 
Examples of AAA:

  • Volunteer type situations at events, or meet and greets 

  • Animal interacts with a non-patient in a healthcare setting

  • Although the term “pet therapy” was widely used several decades ago, it should be avoided, because it’s inaccurate and misleading. The currently preferred terms imply that the animal is acting as a motivating force to enhance the treatment provided by a well-trained person. 

  • Animal-Assisted Crisis Response (AACR) A subset of animal-assisted activities, animal-assisted crisis response provides comfort to those who have been affected by natural, human-caused or technological disasters. The response environment has the potential to be complex and unpredictable. 

  • Animal-Assisted Workplace Well-Being (AAWW) A subset of animal-assisted activities, animal-assisted workplace well-being incorporates therapy animal interactions in workplace settings, for benefits that range from stress reduction and decreased blood pressure to socialization and community building, along with the potential for increased productivity. 

Benefits

The goal of animal-assisted intervention is to address and improve a patient's goals which may including but not limited to the following: 

The Human-Animal Bond (HAB)

A mutually beneficial relationship between humans and animals. Animal-assisted interventions exist because of the power of the bond which has beneficial psychological and physiological outcomes for participants. While we often focus on the benefit to humans receiving AAl, it's important to remember that animals also experience benefits from their relationship with humans. It has been found that companionship and social support helps pets and animals live longer, healthier lives. 

Physical

  • Fine and gross motor skills

  • Wheelchair skills

  • Standing balance

Cognitive

  • Attention skills

  • Sequence

Empathy

Identifying with and understanding the feelings and motives of others. Studies report that children who live in homes where a pet is considered a member of the family are more empathetic than children who live in homes without pets. Children might see animals as peers. It's easier to teach children to be empathetic with animals than with humans, because most animals have such straightforward body language. As children age, their ability to empathize with animals generally carries over into their experiences with people.

Outward Focus

Bringing individuals out of themselves. Interactions with animals can help people who tend to focus on themselves pay more attention to their environment. Instead of thinking and talking about themselves and their problems, they can watch and talk about the animals.

Educational

  • Increase vocabulary

  • Aid in improving long- or short-term memory

  • Improve knowledge of concepts such as size and color

Nurturing

Promoting the growth and development of another living thing. Nurturing skills are learned. By being taught to take care of an animal, children who haven't learned nurturing skills through other channels can develop them. Furthermore, a person who is engaged in nurturing activities is also, to some extent, fulfilling his or her own need to be nurtured.

Rapport

Building a relationship of mutual trust or a feeling of connection or bonding. In therapy settings, the presence of an animal in the therapist's office can help clear a path through the client's initial resistance and open a channel of emotionally safe, nonthreatening communication between the client and the therapist. Children are especially likely to project their feelings and experiences onto an animal.

Acceptance

Offers favorable reception or approval. Animals have a way of accepting without qualification. They don't care how a person looks or what the person says. An animal's acceptance is non-judgmental, forgiving, uncomplicated and unconditional.

Socialization

Seeking out or enjoying the company of others. Studies have shown that when dogs and cats come to visit a care facility, there's more laughter and interaction among residents than during any other entertainment or therapy time. In an inpatient setting, the presence of animals encourages three types of socialization:

  • 1. Among clients

  • 2. Between clients and staff

  • 3. Among clients, staff, and family members or other visitors

Mental Stimulation

Occurs because of the opportunities that animals provide for communicating with other people, recalling memories and entertainment. In situations that are depressing, the presence of animals serves to brighten the atmosphere, increasing amusement, laughter and play. These positive distractions might help decrease people's feelings of isolation.

Physiological Benefits

Much has been written about the correlation between touch and health. Infants who are touched very little might have difficulty developing healthy relationships with other people and might fail to thrive and grow physically. For some people, the touch of another person isn't acceptable, but the warm, furry touch of a dog or cat is. In hospitals, where most touch tends to be painful or invasive, the touch of an animal is safe, non threatening and pleasant. In many programs for people who have been physically or sexually abused, staff members and volunteers aren't allowed to touch the clients. In these places, having an animal to touch, hold and hug can make a world of difference to people who would otherwise have no positive, appropriate physical contact.

Motivational

 Positive effects on the basic functioning of the body. Some consider a biopsychosocial framework for AAT, since it affects clients on biological, psychological, and social/environmental levels (Blazina, Boyraz, & Shen-Miller, 2011). An extensive amount of research shows the medical benefits of spending time with animals. The Centers for Disease Control and Prevention list some benefits as: Lowered blood pressure, Lower cholesterol, More likely to exercise, Lowered risk of diabetes, Lowered cortisol (Fine, 2019a). In fact, oxytocin (the “love hormone”) plays a large part in our connection to animals. Oxytocin is the hormone that is released to help parents bond with their children and when people fall in love. It helps us feel good and allows us to feel emotionally secure, content, and happy. Oxytocin also increases in humans when we spend time with animals; we naturally feel better when they are around (Compitus, 2021a). Tests have shown that the decrease in heart rate and blood pressure can be dramatic. 

Request Animal Assisted Intervention

If you would like to Animal Assisted Therapy to be included in your child’s therapy: 

  1. Email Contact@theratreepeds.com

  2. Discuss AAT with your child’s therapy clinician at your next appointment. 

Qualifications of Animals & Handlers 

At TheraTree we have a commitment to excellent and evidence based care. Therefore, it’s our policy for clinicians to first complete a 5 hour Animal Assisted Therapy continuing education training which is free, internal, a credit toward required state CEUs, and at their own pace before incorporating AAT into treatment. 

Handler Standards: 

  • Must be the active handler during the dog's certification tests and maintain certifications.  
  • Handlers must be able to act quickly enough to remove themselves and their dogs without assistance from a facility in the event of an emergency. 
  • Must maintain Current Animal First Aid Certification 
  • Must maintain professional liability insurance.

Animal Behavior Standards:

  • Must complete the following standardized behavior certificates.
    • AKC Canine Good Citizen Certified 
    • AKC Community Canine Certified 
    • AKC Urban CGC Certified 
    • Alliance of Therapy Dogs Certified
  • Must pass on site competency by TheraTree’s AAI Coordinator 
  • Affect: enjoyment, relaxed, confident, focused 
  • Interactions: welcomes attention from stranger, interaction in suitable ways, neutral when encountering other dogs, maintains good communication with handler, 
  • Obedient: exhibits self control, reliable, predenticle, controllable, responds to basic obedience cues. 
  • Safe: maintains loose leash, stay close to handler, licks only when cued, doesn’t vocalize, 
  • Equipment: Must have all the required equipment to promote safety and wellbeing. 
  • Leash: Maintains safe and close leash walking behaviors. 


Animal Health Standards:

  • Current on vaccination and certification of health by their veterinarian including: Bordatella (kennel cough) vaccine, Distemper, Adenovirus, Parvovirus, +/- Parainfluenza, Canine influenza, Leptospira, Lyme disease, Rabies (Titer levels of 0.5 IU or greater are acceptable and must be measured every two years to ensure levels are acceptable.)
  • Must be free of any signs of ill health while in the clinic. Animals with physical and medical disabilities must have veterinarian approval documentation that their disability does not pose harm or a safety risk to themselves or any other staff or patient in the clinic. Participation must not compromise the animal’s health and wellbeing. 
  • Dogs must be clean and well groomed. (See AAI requirements for specific definitions) 
  • Must be non-shedding.

The goal of animal-assisted intervention is to address and improve a patient's goals which may including but not limited to the following: 

]]>Mon, 29 May 2023 13:08:00 -0500<![CDATA[New Year's Resolutions and How to Actually Achieve Them]]>https://www.theratreepeds.com/blogs/post/new-years  The most common resolutions people typically make are to lose weight, to save money, to learn a something new, to become more organized, to stop ]]>

 The most common resolutions people typically make are to lose weight, to save money, to learn a something new, to become more organized, to stop smoking/drinking, and to become overall healthier (eating homecooked meals versus fast food, buying a gym membership, going to bed earlier, finding a new, less stressful job, etc.). One on-line poll in 2020 showed that by about 68% of people give up on their goals after approximately 32 days. The most common reason: lack of discipline. Other factors for abandoning these resolutions included busy schedules, not having “enough time,” and even peer pressure. So the question is: How does one make a New Year’s Resolution and actually follow through with it? Generic answer: Hard work and commitment. 

Don't Think it - ink it!

Every New Year’s Resolution that a person makes is an attempt to fulfill something within their basic needs; To satisfy quality world pictures. Something to make their lives a little bit better. No one ever makes a resolution to make things worse. However, having another commitment to fulfill is often times very stressful and ultimately discarded because one already has “too many irons in the fire.” But these Resolutions should be viewed as a form of self-care and most people tend to put taking care of themselves at the bottom of that list. As this list continues to grow with other obligations, eventually, the resolutions are taken off the list. In order for these resolutions to be achieved, resolutions must become a priority! (Using concepts of Dr. William Glasser’s Reality Therapy and Dr. Robert Wubbolding’s WDEP system, this is where I tell you how!)

By Jacob L. Wright, M.Ed., LPCC-S, NCC

Reviewed and Edited by Michael Fulkerson, LPCC-S and author of Treatment Planning from a Choice Theory Perspective



Well, it’s that time of year again. The Time of year people start thinking about those promises to themselves that they’re not really going to keep. Every year, many people create a New Year’s Resolution with good intentions of keeping them, but soon throw them out along with all the boxes and wrappings of the holidays. In the beginning, these people are very determined and motivated to make changes in their lives. Why? By the end of the year, most people are stressed and overwhelmed and tired of being stuck in a rut. Tired of being broke. Tired of being stressed. Tired of being fat. Tired of being… tired. I know this all too well. I have been one of those people!

Take a few minutes to think about what your resolution would be for the new year. What is something that you feel would improve your outlook on your life? Or improve the quality of your life? Write it down. Don’t’ just think it, INK IT! Chances are, this is something you’ve wanted for a long time. It may also be a resolution you’ve tried to achieve before and didn’t follow through with. Now think about the impact this would have if you were to achieve this. Can you describe it? How would you feel if you could make this happen? Now ask yourself how badly do you want it? Do you just kind of want it? Or do you really want it? There is a big difference in your motivation depending on how you answer this question!

Overcome Past Efforts

Once you know what you want and how badly you want it, think about what you’ve tried in the past to achieve this goal. Write it down! If this is a brand-new want, you may not have tried anything before. And that’s ok! If this is something you’ve wanted before, and did not follow through with, that is okay, too! If this is something you’ve wanted for a long time and have tried many things, how well did it work out? What are some of the things that did work and what are the efforts that did not? Again, write this down. 


By now, you know what you want and how badly you want it. You are also aware of your past efforts, what has worked and what did not. Now ask yourself “What can I do differently and what am I willing to do to make sure this works this time.” This is your plan of action. Be as detailed as possible. If your resolution is to lose weight, write down how you’re going to do this. Example: 

  • I will commit to exercise 3 days a week for 1 hour (Monday, Wednesday and Friday)
  • I will cut down to only having fast food 1 day per week and eat home cooked meals the rest of the week
  • I will drink 72 oz water per day. (Break this down into how many ounces per hour.)
  • I will cut down on sodas to 1 per week and replace with water or unsweet tea.


Dr. Robert Wubbolding, author of Reality Therapy for the 21st Century, attests that for a plan to be effective, it must be “Simple, Attainable, Measurable, Immediate and Controlled by the planner (SAMIC).”


It can be whatever steps you feel you need to take to make this happen. If you find yourself not knowing what steps need to be taken, make a step to include researching or talking to someone who knows more about what it is that you want.  Again, be specific and realistic. Don’t set standards too high. Committing to working out 3 hours a day 7 days a week can be overwhelming and set someone up to fail. If you can do more on certain days than usual, do it. But only write down what is manageable and what you’re willing to commit to. 

Commitment

If you’ve gone this far, why not go ahead and sign it. Put your signature and date somewhere on this as a written contract to yourself. Now take it a step further and post it somewhere where you will see it every day, or maybe several times a day. Put it on the fridge if you have to. This can help you hold yourself accountable for your goals. 


My personal recommendation is to document your progress once a month until you’ve reached your goal. Review your contract. Are you still reaching for the same goal? What have you been doing to make this happen? Is it working? Why or why not? And if it’s not working as well as you’d like, are there modifications to make to your plan? If so, write it down. Sign it. Date it. And keep going!! If you say you can, or say you can’t, you’re right!! You are in control! You are the only one that can make this happen for yourself. You’re worth it!! If you want it, go for it! You got this!! 

Cheers!

Want more support to life your best life? We offer counseling for both children and parents! Not sure if counseling is right for you? Do a free screening to see if it's the right fit!

Get Started Now!
]]>Fri, 03 Dec 2021 14:42:20 -0600<![CDATA[Children's Mental Health: Experiencing a Life They Love]]>https://www.theratreepeds.com/blogs/post/children-s-mental-health-experiencing-a-life-they-love

Mental Health Therapy is not the easiest for parents to discuss. Mental health continues to be an area most are hesitant to ask for help with. Nobody wants their child to “need therapy”. Whether a child has a history of trauma or is simply struggling with being human, we can help.


It makes sense that parents and guardians need and benefit from professional insight. This is especially true for sensitive subjects or developmentally appropriate issues of growing up. Growing up is hard work! Many assume therapy is only reserved for big problems like abuse, neglect, and trauma. However, therapy can be focused on positive growth, strengths, and experiencing a life they love without one specific life event causing the interruption.

Almost 4 million children and youth experience mental health challenges. Mental, emotional, and behavioral disorders in childhood can cause long-term problems affecting  development, health, education and well-being. If left untreated, these delays may persist and greatly effect adulthood.  A 2009 study found only half of children and youth with anxiety, disordered eating, depression, and ADHD received care. That's why we've added this way to help.

When to Get Help

Many times these “glitches” in a child's  life may not be glaringly obvious to the people closest to the child. The good news is you can play an important part in your child’s mental health by being observant and seeking a professional evaluation to determine if help is needed. Children and youth need mental health therapy when they have mental, emotional, or behavioral challenges that they are not effectively cope with alone. This means their challenges are affecting how well they do, feel, or act. 

We get that as a parent, you want nothing but health and happiness for your child. When your child is distressed, that can be hard to cope with as a parent. Particularly when you feel like nothing is working or there’s nothing you can do to “fix” it. Sometimes you simply can’t “fix” it on your own – especially when you are emotionally invested in the situation yourself. That’s when it’s best to ask for professional help.

Red Flags

It is important to understand that children who are experiencing distress, may not directly share it with their parents. That doesn’t mean your child doesn’t love or trust you.  The truth is many children are unable to fully process and explain the complexities that accompany the emotional and/or psychological challenges they are experiencing. Sometimes children even withhold communication in fear of disappointing their loved ones. Therefore, caregiver observation is key to getting help.


Treating mental health challenges as soon as possible can help children reduce problems at home, school, and healthy development into adulthood. It truly sets them up to experience a life they love. 

Behavioral Signs

  • Unprovoked aggression
  • Unusual, unexpected, or sudden changes in behavior
  • Distressed easily and quickly over little things
  • Low grades or a sudden academic decline
  • Refusal/strong resistance to attend school
  • Repetitively performing rituals and routines like hand-washing
  • Your child responds to voices he/she hears in his/her head
  • Alcohol / drug use, abuse, or addiction
  • Excessive neglect of personal appearance or hygiene
  • Dangerous or illegal thrill-seeking behavior
  • Paranoia and excessive secrecy
  • Excessive perfectionism 
  • Excessive avoidance to protect self


Emotional Signs 

  • Worry, anxiety, or fear
  • Anticipating worries well in advance
  • Feeling down, or sad more often than not
  • Suicidal ideations (thoughts) or attempts
  • Not feeling worthy, or “good enough”
  • Having “rollercoaster” moods
  • Feelings of hopelessness 


Cognitive Signs 

  • Difficulty concentrating on important tasks
  • Problems with memory 
  • Intrusive, obsessive, or racing thoughts
  • Unable to communicate feelings; shutting down
  • Delusions or hallucinations

Social Signs

  • Difficulty adjusting to social situations and/or new situations
  • Social withdraw from activities your child once liked or loved to do
  • Marked decrease in enjoyment and time spent with friends and family
  • Spending most of his/her time alone or engaging in voluntary social isolation
  • Trouble starting and maintaining relationships 
  • Overly suspicious of others
  • Constant Need for Reassurance


Physiological Signs

  • Too much/little sleep, nightmares, bed wetting
  • Changes in eating patterns, too much/little, weight loss/gain
  • Changes in their energy levels, energetic vs fatigued
  • Stomach aches, nausea, headaches, backaches without a medical explanation (constantly going to the nurse - but a legitimate need for medical care is ruled out)

Environmental Factors 

  • Grief and the death of a loved one, pet, home, etc.
  • Bullying
  • Sexual, emotional, and/or physical abuse
  • Witnessed abuse and/or intimidation
  • Relocation issues (i.e. changing schools, homes, families, and/or cities/states)
  • Family substance abuse or addiction

Keep in mind that children of all ages and abilities, from toddlers to teens and verbal to non-verbal, can benefit from mental health therapy.

Who Can Help?

Mental health Therapists include: Licensed Professional Counselors, Licensed Clinical Social Workers, and Licensed Marriage and Family Therapists. These professionals offer invaluable insight into your child’s social and emotional development and mental health. Mental health specialists have the knowledge and expertise to recognize, identify root cause, assess, diagnose, and treat a wide range of mental health conditions, adjustment issues (divorce, new school, bullying, grief, etc.), and psychological distress.

Their purpose is to help children better interpret what they are dealing with and/or the trauma that occurred – in a way they can process and understand. This helps children work through their emotions and experiences so that they can live life without the lasting effects of fear, confusion, anxiety, or trauma. Ultimately, Mental Health Therapists help your child to resolve his/her challenges and resume a healthy and productive life.

How Therapy Works

Children learn by doing and therapy is no different. While therapy greatly differs based on the age of the child, most therapy sessions work through problem-solving skills and talking about feelings. With younger children, this looks like working with the whole family, drawing, playing, and talking. For older youth, they work through sharing and directly learning to develop the skills needed to work through problems. Therapy looks different for each patient; there is no one-size-fits-all treatment. Therapy is designed to identify the root cause of the child’s challenge. Then, the therapist can work with the child/family to develop skills to cope, problem-solve, and create healthy thinking patterns. 

Therapy will usually be future-oriented. Meaning there will be little looking back or digging up the past. Instead, they will be working towards an optimistic future, developing positive coping methods, as well as boosting self-esteem, self-confidence, and other positive states and traits. Therapists give praise and support as children learn. They help children and youth believe in themselves and find their strengths. Therapy builds helpful thinking patterns and healthy behavioral habits. Therapy can provide them with opportunities to not just survive after trauma but thrive in life.


A therapist might meet with the child and parent together or meet with the child alone. It depends on the child's age and their specific situation.  When children are young, it is common for therapy to include the parent. Parent-focused approaches typically mean that parents talk with the therapist about the child’s behavior and feelings then the parent implements with their child at home. Regardless of the age or structure established, therapists do want to meet with the parent/caregiver within the appointment to give tips and ideas for how to help their child at home.  Therapists may also observe parents and children together and then make suggestions for finding different ways to react. Sometimes, entire families need support while trying to communicate, learn, and create boundaries. Sometimes  other important adults in the child’s life (for example, a teacher) are included as well.


Parents are usually concerned with how long treatment will take and how soon they will see progress. How quickly your child makes progress will depend on the complexity of his challenges, how long the problem has had to take root, and the established goals of therapy. Being aware of the factors that affect results can help you form realistic expectations and avoid frustration. For example, a child who is severely anxious may have difficulty participating in therapy. A teenager with depression may resist treatment, and need help to see how they might benefit from it. Missed appointments and conflicts between parents over the need for therapy can also undermine and limit progress. One overwhelmingly positive influence is having a supportive and involved family and regularly kept appointments.

What's Next...

If you have any questions or concerns about your child please reach out to us at TheraTree. We provide free screenings and full mental health evaluations. You can reach us by phone/text at 270-688-8449 or email at newpatients@theratreepeds.com.

Get Started Now
]]>Tue, 19 Oct 2021 23:09:17 -0500<![CDATA[Anxiety in Children ]]>https://www.theratreepeds.com/blogs/post/anxiety However, some children consistently demonstrate difficulty adapting because of a perception of danger surrounding a task. Particularly if there is un ]]>

By Jessica Hatfield, Ms, OTR/L

Children are constantly learning, growing, and adapting to their environment. Even when we give the most stable and routine environment, things still always and inevitably change. Change is normal and children seek to feel safe and secure.


It is important to note that some worry and stress is normal and even needed for survival. The primary purpose of our ‘fight or flight’ response is to keep us safe. Stress and worry are also useful to our growth because we are challenged to try different things. We want our children to grow and adapt for the ever changing pace of life.

However, some children consistently demonstrate difficulty adapting because of a perception of danger surrounding a task. Particularly if there is uncertainty or there has been a previously negative association. At time several less intense events can build up to cause an overwhelm. Both of these negatively affect their daily living. Pediatric anxiety has grown to be one of the major mental health issues facing children. Anxiety is experienced in the pediatric population at increasing rates. 7.1% of children aged 3-17 years (approximately 4.4 million) have diagnosed anxiety. (Ghandour 2018) 

What is Anxiety?

Anxiety is apprehension about the future. Behaviors will also begin to affect thinking processes. For example an expectation is unrealistic and in turn leads to ruminating or negative thoughts. Anxiety can cause negative mood and physical tension. There are many different types of anxiety including separation anxiety, OCD, perfectionism, social phobias, or generalized anxiety etc. Anxiety is different than fear and panic, although a person can experience these as well. Fear is an immediate alarm to current danger, physical arousal, and avoidance. Panic is fear at an inappropriate time. It’s abrupt, intense, and physically arousing.

What Causes Anxiety?

A variety factors can contribute to anxiety in children. Children may observe and replicate anxious behaviors of others. Life experiences may also trigger anxious feelings and behaviors. For example loss, serious illness, bullying, or other types of abuse. Genetic factors that effect brain chemistry can cause a child to be more predisposed to developing anxiety. 

What Causes Anxiety?

  • Agitation, jittery, or restlessness
  • Sleep Deprivation or nightmares
  • Easily upset or crying on a regular basis
  • Panic Attacks, heart pounding, palms sweaty, trouble breathing
  • Somatic symptoms of physical pains, e.g. headaches, tummy aches, nausea
  • Repeated behaviors or phrases that are familiar
  • Tantrums, including meltdowns before school about inconsequential issues like socks
  • Clingy to the point it is disruptive
  • Constantly seeking the reassurance from others
  • Tries to get others, particularly adults, to do things for them
  • Asks for assistance for tasks they can complete independently

Children  may say phrases like: 

  • Something terrible will happen. 
  • I don’t have any control over it. 
  • It will be my fault if it happens. 
  • I don’t know what to do!
  • I have to get out of here!
  • I need to know for sure that it’s okay
  • I can’t make any mistakes
  • Always on the lookout for danger and checking to make sure things are safe.
  • Dislike or avoidance of new or difficult tasks
  • Avoidance behaviors or trying to stay home from school
  • High expectations of self
  • Low self-esteem and confidence 
  • Delayed social skill development and difficulty maintaining relationships
  • Decreased motivation for certain tasks

Child might demonstrate a few of these behaviors occasionally and some of these signs may be cause by other factors not related to anxiety. However when negative, anxious behaviors become more common or intense, your child may qualify for an anxiety diagnosis. When experiences these frequently or at extremes, the natural protective responses triggered no longer serve as protective and become debilitating. High levels of anxiety can make it difficult for a child to participate everyday activities including school, play and friendships. When anxiety interferes with your child’s ability to play and learn, it’s time to talk to a professional.

What Causes Anxiety?

For children experiencing anxiety, it is a natural response for parents to want to step in and solve the problem. However this is not the best long term strategy to actually help your child with their anxiety. By removing or allowing your child to avoid, you are unintentionally reinforcing their anxieties and removing opportunities to develop coping skills and resilience. Therefore it is important to give your child the opportunity to work through their fears in order to develop these highly important skills. This is best done by working with professionals. There are several profession who help with anxiety: 

  • Occupational Therapists to apply concrete strategies. 
  • Psychiatrists and nurse practitioners to prescribe medication. 
  • Psychologists, social workers, and counselors to provide emotional support.

How Occupational Therapy Helps

Occupational Therapy (OT) can be thought of as the therapy of taking action! There are many ways we can talk to our children about their worries and fears, but by teaching them concrete strategies we empower children to become independent in their own lives! Occupational therapy providers step in to bridge the gap so children can learn to function and feel how powerful they really are when it comes to their thoughts and abilities. Occupational Therapy intervention addresses anxiety through the followings ways:


Proactive strategies

The purpose of proactive strategies is to prevent the anxiety from occurring. This provides a short term benefit but is not helpful long term as our environment is always changing and adaptability is a survival skill. Some proactive strategies include establishing routines, visual schedules, and adapting the environment (ex sensory-friendly environments, fidget toys, quiet corners etc). 


Teaching, Thinking, and Applying Strategies 

The purpose of these strategies are to increase both interoception and communication strategies so children can manage themselves to identify and prevent anxiety. These provide the most long term benefits in their life. These strategies include interoception, effective education, cognitive restructuring, and communication to adults about what they are experiencing and their wants/needs. 


Reactive Strategies

The purpose of reactive strategies is to help in the moment while a child is experiencing anxiety. This has both short and long term benefits. However the difficulty with teaching reactive strategies is bridging the concept of “what to do” with actually being able to recall and apply them in the moment. Generally these skills take longer to develop because of this. These strategies include Guided Imagery, deep breathing, distraction, quiet time, calm/comfort techniques


Parenting Strategies

As with all Occupational Therapy intervention, parent education is important. Parents have a big influence on how their child with learn and respond by the tone they set. Occupational Therapy Providers teach parents how to be both proactive and reactive with their child. They teach what not to do. Often parents need to utilize calming strategies of their own when interacting with their child who is in a heightened state of arousal. When children are in a heightened state, they may have difficulty understanding complex language. So simplifying the words spoken to them can have a big impact on their reaction. Occupational Therapy Providers also teach parents by example and self reliance. 


What's Next?

If you have any questions or concerns about your child please reach out to an occupational therapist at TheraTree. You can reach us by phone at 270-688-8449 or email at newpatients@theratreepeds.com.

Get Started Now

References:


Ghandour RM, Sherman LJ, Vladutiu CJ, Ali MM, Lynch SE, Bitsko RH, Blumberg SJ. Prevalence and treatment of depression, anxiety, and conduct problems in U.S. children. The Journal of Pediatrics, 2018. Published online before print  October 12, 2018 


Gobrial, E., & Raghavan, R. (2017). Calm child programme: Parental programme for anxiety in children and young people with autism spectrum disorder and intellectual disabilities. Journal of Intellectual Disabilities, 1744629517704536.

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