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Helping Children With Big Worries (Part 2)

Welcome to the second in a multi-part series about how to help children with big worries. Please check out Part 1 to learn where to get started. This post will cover what to do next, after you’ve accomplished those initial steps. Part 1 recommends additional reading, offers four easy lessons, and will get you started.

I am a speech-language pathologist. If you are too (or if you are a parent) remember that mental health professionals can be extremely helpful when worries move into the anxiety territory. And as a parent or a helping professional, it’s your responsibility to know when to refer or seek this help. For today, I’ll be sharing some tips I’ve learned along the way for when we need to address a big worry (or little worry!) a child might have so that we can move into our plan for the day (and our speech-language session).

What is a big (or little worry)?

A big (or little) worry happens when a child share something with us they are worried about, and the worry is big enough that it needs to be addressed.

Step One: Link Thoughts and Feelings

As SLPs, we are familiar with creating visuals for our learners so that they can process through social situations or perspective taking activities. For example, one such task that can help link thoughts and feelings is a graphic with three vertical columns:

Think about what…

  • Happened (for a visual for pre-readers and early readers, I’ll draw a square here)
  • I was thinking (I usually write this out and draw a thinking bubble underneath)
  • I was feeling (I write this out and draw a heart underneath for a visual)

Here’s an example (without visuals):

What Happened What I Was Thinking How I Was Feeling
My teacher wanted to talk to me after class I was in big trouble Nervous, worried
I talked to my teacher later, and she wanted to talk to me about being a math buddy to help another student Wow, she must think I’m good at math Relieved, excited, accomplished

 

Why do this activity?

The purpose is to link our thoughts and feelings to what happened to increase our emotional processing for these situations.

How long should you do this activity?

Keep going until the whole process gets easier, in which case you may be ready for the next step.

Step Two: Teach Realistic Thinking/Detective Thinking

Have you ever noticed that worried thinking seems to be the worst possible situation?

Let’s take travel (which can be a stressful situation for anyone) as an example…we might worry our flight will be delayed, we will miss our connection, we will arrive late to that event… (and so on, it’ll just snowball from here).

Teaching detective thinking (which is more realistic thinking) can help children begin to process their thoughts and feelings so they can feel more in control, and by changing our thoughts, we can change our beliefs. Through being a detective, we can look for evidence that the worst-case-scenario is not the most realistic one. Here’s an example.

Event My Thoughts and Feelings Evidence
My teacher asks to talk to me after class I must be in trouble, I feel worried Evidence I might be in trouble – well, I’m usually not in trouble. When I am, it’s usually something small. Ms. Smith is a kind teacher, and she usually just reminds me what I should be doing instead.
Different Thought #1:

I might not be in trouble, this helps me feel only a little bit worried

Think of all the times I’ve talked to Ms. Smith about things, which is a lot. This has hardly ever been me getting in trouble.

We could be talking about something exciting, or I could even get a compliment!

Different Thought #2

Even if I am in trouble, it’s probably a small problem, and Ms. Smith just wants to give me a reminder, this makes me feel only a little bit sad or worried.

I can handle small problems. I can listen to Ms. Smith if there is a problem, say sorry, and do better next time.

This is a small problem, and is something I have handled before and can handle again.

 

Step Three: You Can Think Calm Thoughts

As thinking different thoughts gets easier, remember that you can change your thoughts. And that you can think calm thoughts. Consequently, thinking calm thoughts can lead to feeling calm feelings.

Step Four: Enlist Your Favorite Superhero Persona To Help You Be a Detective

Having trouble finding evidence that your big worry might not be true? For younger children, enlist your favorite character or superhero persona to help. For example, maybe Hermione Granger can help you think about evidence that your worried thought may not be true and come up with other solutions. What evidence would Hermione see in this situation to help?

Be a detective (like Spiderman!) and find evidence:

Ask what…

Has happened before in this situation?

General things do I know about this situation?

Sorts of other things could happen in this situation?

Is more likely to happen?

Has happened to other people?

Step Five: What to do with nagging thoughts?

Once you’ve processed through a thought, as a helping professional or parent, it’s your choice what to do next. It is important to provide this support. However, sometimes we can over help, which can lead to a negative feedback loop.

For example, let’s pretend a child is worried about a party he/she is going to. You’ve processed through it, identified thoughts, come up with alternate solutions, and you’ve identified a calm thought that can help lead to calm feelings.

What do you do when a child continues to repetitively ask about the party, and has trouble moving forward?

At some time or another, you may realize this is leading to a negative feedback loop. The more a child voices his/her worry (after problem solving it and talking it through it), they can start to get more and more actively worried. As a result, sometimes this repetition can lead to a Big Worries feedback loop that doesn’t seem to be helping your learner.

If this happens, you may want to consider at first going over the detective thinking again. After that, empower your learner – you’ve already done the detective thinking. Then remind your learner that they already have the strategy and thoughts they need to work through this situation. Sometimes by over relying on adults, children can lose confidence in themselves to solve their problems and think calm thoughts.

What are some examples of nagging thoughts?

Any repetitive thinking like:

what will we do when we get there

why is mom late from work, there must be something wrong

what if I don’t do well on the test

…and many more.

Do we still give children support?

Absolutely. But we also look for times when we are “over helping” so that they can gain confidence – and therefore feel more control – over their own thoughts and ability to problem solve.

These repetitive thoughts can also be called nagging thoughts, so we want to help children process, and then remind them that nagging thoughts don’t have to take over.

Can you add in a positive behavior support element?

Of course! After 5-10 minutes later, if there aren’t further nagging questions you may say something like:

“I noticed you haven’t asked me a worry question after we did the detective thinking, and it has been ___ minutes. You are learning that you can use your detective thinking to think calm thoughts.”

Some parents or helping professionals decide to add in an extra element of a fun activity here (like extra movie time or time to watch a favorite YouTube video), while others have found that the positive verbal feedback is enough.

Big Worries Part 2: Next Steps

If you just start with one activity, you may want to begin with creating a what happened/what I was thinking/what I was feeling chart (Step One).

It’s important to start to link thoughts to feelings. Once that become easier, we can all get more flexible in our thinking and as detectives find evidence for alternate solutions.

Remember as a parent or helping professional, you aren’t alone in this. Seek support as you need it – it really does take a group of adults working together to help some children. Ultimately, try some of these activities you think may be helpful for your learner, and know when it’s time to seek further help with worried thoughts.

 

Sarah Lockhart is a private practice SLP in Ashland, Oregon. For more information, you can visit her clinic Instagram page here. If you’d like to get an email notification of when new blog posts go up, enter your email into the bar on the right hand side of this page.