On March 21, 2024, McLean Hospital hosted Anxiety and OCD in Kids and Teens, a course aimed at health care professionals, educators, and parents.
Experts Lisa W. Coyne, PhD, Fairlee C. Fabrett, PhD, and Jeff Szymanski, PhD, weighed in on topics including the fundamentals of anxiety and OCD, how anxiety conditions can be managed in a classroom setting, and how clinicians diagnose and treat anxiety, OCD, and related disorders.
Today’s young people are experiencing the fallout from a pandemic that created social isolation, reduced interaction with peers, and disrupted learning. They grapple with social injustice, climate change, and conflict.
According to a 2022 review in JAMA Pediatrics, 19% of youth worldwide experience clinical levels of anxiety—a nearly twofold increase of pre-pandemic levels.
“Acknowledging the rise of anxiety conditions in kids and teens, as well as the importance of early recognition of symptoms, we invited everyone to attend this course: health care professionals, teachers, coaches, and parents,” said Scott J. O’Brien, director of Education Outreach at McLean.
“Adults in these roles often have unique perspectives when it comes to behavior, and everyone can contribute to supporting the mental health of our young people.”
Over 2,000 people invested in the topic of anxiety in youth attended the March event, which is now available on demand.
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Continuing medical education credits are also available for a small fee.
Understanding Anxiety and OCD in Kids
In the Introduction to Anxiety and OCD in Kids and Teens session, Coyne and Szymanski outlined the most important things to know about anxiety and OCD in youth.
The experts emphasized that these conditions are extremely treatable.
Coyne discussed the importance of understanding the role of avoidance in anxiety disorders. “The thoughts and feelings that come with OCD and anxiety are not necessarily the issue,” she stated.
“The issue is they lead to rigid patterns of avoidance-based behavior, and so treating those patterns of avoidance is a critical element of care.”
Szymanski pointed out that people who have anxiety and OCD often think they shouldn’t have the emotions they are experiencing. He stated that the goal isn’t to get rid of anxiety, however.
“[Anxiety] is actually our friend,” he said. “When we avoid it, we treat something as dangerous, and it may not be dangerous, and we now have all kinds of anxiety in our life.”
The speakers discussed the importance of recognizing when anxiety is unhelpful versus helpful, and how to become curious about difficult emotions so anxiety doesn’t interfere with the lives people want to lead.
They reviewed the most robust treatments for anxiety conditions and described how treating these disorders in kids and teens is a group effort that often involves parents, clinicians, and teachers.
Anxiety conditions in kids and teens are underdiagnosed. Even when anxiety issues are recognized in children, teachers’ well-meaning efforts to provide accommodations may feed a child’s belief that they are unable to handle their anxiety.
Supporting Kids in the Classroom
In the Anxiety and OCD in the Classroom session, Coyne, Szymanski, and Fabrett discussed how teachers and parents can recognize anxiety in a school setting and foster confidence and coping skills in children.
“[Kids are] going to rise to our expectations if they have some help,” explained Fabrett.
“I think it’s better to do that than to remove all expectations and requirements from their life because we want to accommodate them. I think we do better if we keep [expectations and requirements], but we help them with therapy, with tools, and with support.”
The Importance of Accurate Diagnosis
In the Diagnostics: OCD, Anxiety, ADHD, and Phobias session, the experts outlined the diagnostic process for these conditions, which includes the use of specialized diagnostic interviews for the child and teen population.
They also described how clinicians can recognize lesser-known forms of anxiety conditions, such as PANDAS (pediatric acute-onset neuropsychiatric syndrome), whose onset is often sudden and whose symptoms involve motor and behavioral changes.
Coyne and Szymanski described how anxiety and OCD work similarly in kids and adults but can impact the two groups differently.
They emphasized that early treatment is key, since untreated anxiety can have cascading effects over time.
Evidence-Based Treatment Strategies
Treatment for anxiety conditions involves addressing the avoidance that is central to the issue. Exposure and response prevention (ERP) is the most effective therapy for anxiety conditions, though other therapies can also be a part of helping a child or teen navigate anxiety or OCD.
In the Effective Treatment for Anxiety Disorders and OCD in 2024 session, Coyne and Szymanski described how therapists use ERP to help patients gradually confront the feared situation or object while learning to tolerate the feelings of anxiety that accompany exposure.
“When you do exposure-based treatment, you allow yourself to feel whatever is going on,” Coyne stated. “As one of my teen patients described, it’s so that when you experience anxiety, it no longer has any power over you.”
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