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Summary:

  • Parental Accommodation of a child’s anxiety is when parents change their behavior to relieve distress related to their child’s anxiety disorder or OCD. 
  • Parents may be more inclined to accommodate their child’s anxiety during times of high stress. 
  • This can worsen and expand their child’s anxiety
  • Breaking the cycle involves moving from accommodating the anxiety to supporting the child 
  • Support is validating the child’s anxiety and simultaneously demonstrating belief that the child could handle it. 
  • Parents can work to adapt principles on their own or work with a therapist who is trained in SPACE to systematically increase support, decrease accommodation, and effectively treat their child’s anxiety or OCD. 
  • The treatment can be delivered effectively online.

 

Each night, your child expects you to say ‘I love you, I’ll see you in the morning,’ ten times, preceded and followed by 3 kisses. If this routine is not done perfectly or you have to start all over again. You’ve tried to say no, but it resulted in a tantrum and the child refused to go to sleep. This is what parental accommodation of a child’s anxiety disorder or OCD looks like.

Parental accommodation of childhood anxiety and OCD perpetuates, expands, and worsens their anxiety disorder. These accommodations may manifest in behaviors parents must do for their child, such as, repetitive reassuring that they will be OK or behaviors they are instructed not to do, such as refraining from touching any silverware the child uses. During these challenging times of the Coronavirus pandemic, parents are stressed and their child’s anxiety may be spiking. Parents are around their children more and understandably may forego efforts to reduce accommodation, feeling that it’s too hard to address. Here are some ways to flip that script.

 

How Accommodation Works

Children are hard wired to signal distress to their caregivers when in danger. Parents are similarly hard wired to respond by protecting their child from danger, and in doing so, parent and child experience relief. This is a healthy and normal process designed to keep children safe. When children have anxiety disorders or OCD, however, they will signal distress in the absence of danger  and seek parental protection. For example, children with a fear of vomiting, may demand parents not cook certain foods in the house. 

 

In following through on the accommodation, parents unwittingly reinforce the notion that the objectively safe situations are dangerous and require parental intervention. Children are then more likely to repeat the distress signal when confronted with the situation in the future – it worked the last time, didn’t it? Parents are reinforced to continue the accommodation because they are relieved to see their children soothed and do not need to deal with a tantrum when they feel drained to begin with. 

 

Consequences of Accommodation

Unfortunately, this cycle tends to get worse over time: the child experiencing feared situations, more frequently, and lasting longer. Parent’s attempts to reduce the accommodation will often be thwarted by a distressed child who knows exactly the fever pitch to scream or behavioral reaction they need to do to get their parents to capitulate. 

 

Breaking this cycle is crucial during a time when anxiety will likely ramp up. During social distancing or quarantine, parents are more physically present and more opportunities for parental accommodation exist. But how can this cycle be broken?

 

Breaking the Cycle with SPACE

The good news is that research demonstrates that parents can play a huge role in addressing their children’s anxiety using a treatment called SPACE (Supportive Parenting for Anxious Childhood Emotions). Through SPACE parents learn to shift from accommodating the child’s anxiety to providing support for the child. 

 

Support is understood as the combination of accepting and validating that the child is experiencing anxiety while simultaneously demonstrating belief that your child is able to handle that anxiety. In doing so, parents neither belittle their child for being anxious, nor send the message that the child is incapable of handling anxiety independently.

 

Practically, this involves charting out all the accommodating behaviors over the course of a given typical day and selecting one that you (and your partner if applicable) will decide to eliminate. Parents will have a sit-down discussion with their child and even provide a written letter explaining the circumstances, expressing belief in their child, and preparing them for the cessation of a particular accommodation. 

 

In working with a therapist trained in SPACE, the parent is guided along the process. They get help determining which accommodations to prioritize, how to deliver the message, and most importantly, how to deal with reactions of the child which can range from crying, screaming, and various iterations of threats to others and even self. 

 

It takes a firm, all-in, commitment from the parents so as not to send the message to the child that if she protests enough, she can scrap the accommodation reduction plan. It also takes a predetermined strategy to deal with possible reactions from the child. For extreme reactions, parents may enlist the help of family supporters whose involvement may inhibit the child from acting out aggressively.

 

For mild anxiety in children, parents can try to implement these steps independently: 

1) Identifying all accommodations, 

2) targeting accommodations to stop, using supportive statements (e.g. I know this is hard for you, but I really believe you can use the silverware that daddy touched) instead of accommodating behaviors, 

3) Preparing for and addressing the various forms of protests that the child engages in once realizing you are stopping the accommodation, 

4) moving on to the next target.

 

For parents who have tried this in the past unsuccessfully, parents who do not feel confident in their ability to handle their child’s reaction to accommodation cessation, or parents who believe their child’s anxiety is too much to handle independently, a therapist trained in SPACE can guide you through this systematically.

 

SPACE is a therapy which is empowering to parents of children with anxiety. Research shows it is as effective as specialized cognitive behavioral therapy for anxiety therapist and child. What’s particularly helpful is that children do not need to be willing to engage in the therapy (which they often are not) in order for it to work. Most importantly, during the current Coronavirus (Covid-19) health emergency , the treatment can be delivered completely online.

Elliot Kaminetzky, PhD is a licensed Clinical Psychologist in NYC. He specializes in cognitive behavioral therapy for anxiety and OCD for children and adults. He was trained in SPACE by Dr. Eli Lebowitz of Yale University Child Study Center. He also works with children between the ages of 2-7 who experience challenges with 

 Dr. Elliot Kaminetzky is a licensed Clinical Psychologist in NYC. He specializes in cognitive behavioral therapy child and adult anxiety and OCD, as well as disruptive behavioral issues in children. He was trained in SPACE by Dr. Eli Lebowitz of Yale Child Study Center, who designed the treatment. 

If you live in New York State and are interested in seeing if SPACE is right for your child. Schedule a free consultation or email Dr. Kaminetzky elliot@myocdcare.com

For more information on SPACE visit spacetreatment.net

 

Watch Dr. Kaminetzky’s interview with Dr. Lebowitz below.

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