Think of the last time you felt anxious. Whether you were dreading an upcoming work presentation, worrying about finances, or thinking about an impending doctor’s appointment, you likely experienced an urge to avoid the stressor in some way, perhaps by procrastinating, thinking about something else, or putting off the appointment. Avoiding anxiety provoking situations is a hard-wired human instinct that can be very helpful at times, such as keeping us from walking down an isolated dark alley alone at night. However, avoidance can also be a slippery slope-particularly when it is a child’s primary way of coping with worry.

Avoidance can become very problematic because it operates in a vicious cycle with anxiety. When a child avoids an anxiety-provoking situation, they experience short-term relief from their worry. In the long-run, however, this avoidance deprives them of the chance to check out the feared situation, assess if it’s as scary as anxiety predicts it will be, and to test if any of their fears came to pass. The child also does not get the chance to learn that they can probably handle the challenging situation.

Avoidance is often fueled by unhelpful thoughts or anxious predictions about what might happen in the feared situation. For example, children worried about attending a birthday party might fear that they will have no one to talk to, will miss their parents too much, or will say or do something embarrassing. By avoiding going to the birthday party, the child does not have to experience uncomfortable anxiety; however, they also do not get the chance to test out if any of their anxious thoughts were accurate. In the absence of evidence to the contrary, children often assume that the birthday party is just as scary as anxiety says it will be–which leads in turn to further avoidance!

Here’s how you can help your child avoid avoidance:

Start Low, Go Slow

If your child is avoiding a situation, gently explain to them how avoidance can actually strengthen their worry. Help them think through the things that they would enjoy doing if anxiety wasn’t bullying them, such as spending time with friends, having fun, or playing sports. It is also helpful to get curious with them about what makes that situation feel challenging. Once you have a sense of how their anxious thoughts are contributing to their avoidance, you can collaboratively make a plan to help them slowly approach the things they have been avoiding.

Start with the smallest, easiest steps and slowly working up to bigger challenges. For example, if your child worries about riding in the car due to fears they will feel nauseous, they might start by just sitting in the car for a few minutes. As they feel ready, they can work up to sitting in the car for longer periods of time, and then going for short and then increasingly long drives.

Think Like a Detective

As your child tackles each new fear, help them be a detective and “gather evidence” for or against their anxious thought. In the driving example, they actually did they feel nauseous? If so, how long did it last? Do they feel nauseous every time they drive? Was it as bad as anxiety predicted it would be? Could they handle it? Research shows that reflecting on what happened after facing fears is a key component of helping children learn to approach rather than avoid their fears. With repeated practice approaching rather than avoiding, the child learns that anxiety tends to make worse-case predictions that are often not true. They also learn that they can handle challenging situations.

Reward Efforts

Reinforce your child for each brave step they take towards situations they have been avoiding. You can reinforce with labeled praise (“I am so proud of how you tried out 30 minutes of that birthday party!”), nonverbal praise such as hugs, thumbs ups, and high fives, and tangible reinforcers like small treats the child can work towards.

It can be very helpful to map out a bravery reward plan with children to incentivize them to face their fears. For example, if a child is avoiding eating lunch in the school cafeteria, they might earn stars for each minute they stay in the cafeteria each day. They can later “cash in” stars for rewards like choosing the family’s dinner one night or having a special outing with a parent. As a child conquers their fears, the reward plan can slowly be phased out.

Seek Support

If your child’s avoidance If you’re child’s avoidance has a negative impact on their physical well-being, such as sleep and appetite disturbances, or causes them to miss school, social events, or extra-curricular activities, may should consult with a licensed psychologist or other mental health professional who specializes in cognitive behavioral therapy (CBT) for children. Find more information on therapy for children here. You may also want utilize our Psychologist Locator

by Julia Martin Burch, PhD

This Article's Author

Julia Martin Burch, PhD is a staff psychologist at the McLean Anxiety Mastery Program at McLean Hospital in Boston. Dr. Martin Burch completed her training at Fairleigh Dickinson University and Massachusetts General Hospital/Harvard Medical School.She works with children, teens, and parents and specializes in cognitive behavioral therapy for anxiety, obsessive compulsive, and related disorders. Outside of her work at McLean, Dr. Martin Burch gives talks to clinicians, parent groups, and schools on working with anxious youth.

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