PHILADELPHIA -- Anxiety among children and teens is on the rise, and that concerns clinical psychologist and Temple University professor Philip Kendall.
Kendall directs Templeâs Child & Adolescent Anxiety Disorders Clinic, which treats kids ages 7 to 17. The clinic charges low treatment fees in exchange for enrolling children in research to better understand what works best.
Kendall said neither he nor his two children (now adults) were overly anxious growing up, but everyone experiences some anxiety as a normal, self-protective reaction to an unfamiliar situation. He gravitated toward helping children and teens manage their anxiety, in part because anxiety disorders are often treatable, which he finds professionally rewarding.
Kendall spoke to The Inquirer about how parents can better recognize unhealthy anxiety in their children and help them âdial it down.â
This conversation has been edited for length and clarity.
What is the best way to help children manage anxiety?
You donât get kids to overcome or manage anxiety by talking about it. The way to get over anxiety is to practice through behavioral experiments, also called exposure tests. If youâre afraid of a dog and you donât change your behavior, thatâs not a big deal. But if youâre afraid of a dog and you wonât go to a friendâs house or you wonât walk home from school because thereâs a dog in the neighborhood, then itâs interfering.
The best way to overcome interfering maladaptive anxiety is through exposure. You start by petting a small dog and you work your way up to petting the big dog. And when itâs over the kids kind of strut, âWow, I can do it now.â
How do you tell the difference between everyday worry and an anxiety disorder?
Itâs hard for some people to recognize. And the reason itâs hard is that parents in particular will sometimes adjust their own behavior to reduce their kidâs emotional distress. So the kid has social anxiety and theyâre afraid to order their own meal in a restaurant, so when the waiter comes over and says to the kid or teen, âWhat will you have?â and the kid doesnât say anything, the mom or dad says, âOh, heâll have blah, blah.â
In the moment, the parents reduce the distress. In the long run, they make it worse for the kid. The key is to recognize the tricks that anxious kids will engage in to avoid doing something. Avoidance doesnât allow them to learn mastery.
Youâve written 35 books. Can you recommend one on anxiety for parents or teens?
âThe Resilience Recipe: A Parentâs Guide to Raising Fearless Kids in the Age of Anxiety.â Part of the take-home message of the book is how parents can back up a little bit. Parents will be overly involved with their kids. Now, if youâre a conduct disorder, delinquent kid getting in trouble with the law, more parental monitoring is good. For anxious kids, sometimes less parental monitoring is preferred. We learn from taking little risks.
How has social media affected anxiety among children?
Social media is not good or bad. There are studies that show social media can be good â keeping up with your peers, chatting with friends. On the other hand, access to inappropriate material can be bad. Constantly scrolling and looking at pictures and making social comparisons and not really interacting with anybody except the media itself, thereâs some pathology associated with that.
The American Psychological Association and the American Association of Child and Adolescent Psychiatrists both have recommended that there should be some education about social media use. One feature of that is teaching adolescents how to deconstruct photos they see on social media.
What do you recommend for kids who use computer gaming as social avoidance?
A teenager needs autonomy and agency. So Iâd have the teenager be active in picking which way they want to try to cut back. I wouldnât say somebody should impose cold turkey or impose overarching rules. Talk about options and let them pick the one they want to try.
Can you talk about the link between anxiety and substance abuse?
Socially anxious teens will use substances to self-medicate. Iâd be cautious about vaping, beer, whatever it is. You donât want to get excessive. It shouldnât be a crutch. If you talk to friends, if you can make friends, if you can approach situations and not avoid without the substances, that means you can do it. Teens should increase interactions and challenges without relying on a substance.