Parents are the new focus for teenage anxiety treatment, is it possible to not feel judged?

Parents are the new focus for teenage anxiety treatment, is it possible to not feel judged?

You know as an adult when you go to your mum for advice and the conversation starts off ok and you feel supported and then she says a certain thing or looks a certain way and the conversation takes a different turn. Her concern is for your children and she slips in the time when you made a bad decision or reacted in a certain wrong way. Before you know it, you want to leave but she’s made you a cup of tea and brought the Blue Ribands out…too late, you have to suck it up.

Well lots of parents’ report feeling this way when visiting the consultant paediatrician or psychologist. So you may be surprised that the new approach that has grown from a Yale study is to focus on the parents attitude to their teenager. There is a realisation from researchers that treatment for anxiety in children/teens is limited if there is not active participation from the child/teenager that traditional CBT requires. Some teenagers are too anxious to agree to take part, others are helped in the avoidance of anxiety provoking activities by the adults in their lives.

The SPACE program (supportive Parenting for Anxious Childhood Emotions) moves away from teaching parent techniques and skills and aims to focus on their ‘way of being’ in relation to their child. It focuses on the fundamental dynamics between parent and child. It is a totally parent-based program. The fundamental idea is that parental responses to a teenager’s anxiety could be considered as repeatedly triggering of the attachment system (triggering anxiety in the parent), leading them to respond in over protective ways aiding in regulating the child’s emotional and physical arousal.

It also focuses on family accommodation; this means it focuses on the behaviour and actions carried out by parents that allows the child to avoid the distress caused by the anxiety. The focus could be changes to the family routine, providing excessive reassurance, limiting social exposure in terms of family and friends.  Some of the principles of Non-violent resistance have been interwoven into the program. Instead of someone thinking and feeling “How can I make you do this” instead the person focuses on ‘How can I stand by my own beliefs, without attacking or giving in”.

This program does not teach parents skills such as problem solving or positive reinforcement, rather it focuses on the parent gradually moving away from offering accommodating behaviours. Parents learn to strengthen themselves and stand steady in the face of the child’s distress while offering a level of empathy. The programme also involves the following things

·       Parents and the therapist review in detail the family’s daily and weekly schedule identifying accommodating behaviours, then choosing target problems to address.

·       Parents are taught how to use written rather than verbal communication if relationships are strained.

·       The child is always made aware of the programme, transparency is key to success

·       Parents are taught to minimise contact in a positive and empathetic way to the teenager, if contact for reassurance seeking is excessive from the teenager. The teenager is not required to change her/his behaviour but is made aware that they are rewarded if they do.

·       The programme teaches the parents the right times to communicate and they identify and plan to use these times in a constructive way.

·       Parents identify a list of potential supporters and are guided in asking for help and assigning roles for specific support.

·       Parents are taught a set of responses for reassurance seeking from the teenager. One of them is “We understand it makes you feel really anxious and it feels more difficult than you would like it to feel. Anxiety is a normal response. Everybody feels anxious from time to time. But I also want you to know that it is our job as your parents to help you get better at things that are hard for you, and that’s what we have promised ourselves we are going to do. We are going to be working on this for a while and we know it will probably take time, but we love you too much not to help you when you need help.”

·       Parents learn relaxed breathing, muscle relaxation and other cognitive and physiological tools to target body relaxation.

So back to my point at the start. How do receive this programme in a way that doesn’t make you feel you’ve been doing it wrong for the last 13 years. The S.P.A.C.E. programme has an introductory phase where the therapist works on understanding the fears of the parents. This phase is scripted and comes with a manual. My reservation here is there is a risk with it being a tightly scripted programme with a prescribed framework is that some practitioners/therapists/psychologists will not work on the relationship bit as much as the set of tools the programme has to offer.

The healing therapeutic value in any helping relationship IS THE RELATIONSHIP. I was the anxious new mother. I, like some of you attended child development centre when my child was anxious and explosive. I got what most people got…a burnt out, ready to retire psychologist who wanted to teach me the ABC program or reward chart etc. Because the person who was helping me wasn’t ‘fully present’ in understanding me or my child it was then easier for me to dismiss any programme when the going got tough.

It is easy to say that you won’t feel judged by any help that is being offered, but it is hard not to when you have tried your hardest for the people you love the most. Carl Rogers (founder of Person-Centred Therapy) said “The Curious paradox is when I can accept myself just as I am, then I can change”

I do think the S.P.A.C.E programme has something very valuable to offer, it is right in its focus on parents’ behaviour and responses, but like with all support/treatment programmes it needs the right amount of time allocated to it. Parents need to feel heard; therapists need to be there alongside the parents and truly understand how it feels to be that parent with all the frustrations and fears. More than that, the therapist needs to voice this understanding for the parents to feel ‘got’ and become motivated for change.

I run anxiety workshops for Parents of teenagers that are struggling with their anxiety. Elements of the S.P.A.C.E programme are an integral part of the teachings on these workshops. If you wish to know more about these workshops please click the link https://www.facebook.com/pg/TalkingToTeenagers/events/