In many ways, Jessica and Chris Calise’s son Joe was a happy little boy. That is, except when his anxiety flared up.
“Bedtime was such a big issue,” the Norwalk, Conn., mother said. ”It was never just, ‘Go to bed.’ ”
Joe, afraid of sleeping alone, couldn’t rest unless he was in bed with his parents or his twin sister, Bella, even though he had his own bed in a room he shared with his older brother, Nicholas. It was a near nightly household disturbance — for Joe, for his siblings, for their parents. They all did what they thought would make Joe feel better. Yet each bedtime, his anxiety was back to torment him again.
Flash-forward to the present. Joe, 10, rests easy in his own bed now. The fourth grader also used to need his parents to post themselves outside the bathroom while he showered. But he’s learned to manage that anxiety, too.
What brought about this change? Jessica Calise credits a clinical trial she heard about last winter at the Yale Child Study Center. It was part of a study aimed at testing a new way to deal with childhood anxiety. But her son Joe didn’t go.
“It was really just our behavior and our actions and our words that helped him,” Calise said. “It was absolutely incredible.”
Calise is talking about SPACE — Supportive Parenting for Anxious Childhood Emotions — a do-it-yourself approach for parents to help their children deal with the epidemic of youthful anxiety. In a study published in March, which found a broad and enthusiastic audience via the internet and social media, Yale researchers found that teaching parents how to lovingly reduce the accommodations they make for their kids’ anxiety symptoms was as effective in helping youngsters learn how to manage their fears as cognitive behavioral therapy (CBT) for the child. Up to then, CBT, often with medication, had been the gold standard for treating children with anxiety.
The Yale folks knew SPACE had promise, but they hadn’t expected the kind of response the program has received.
“It has been quite intense, honestly,” said Eli Lebowitz, lead study author and director of the Yale center’s Program for Anxiety Disorders. “Hundreds of providers and teachers have reached out. Also, very many parents.”
Since word about the study results has gotten around, Lebowitz heard from many parents, psychologists, social workers, and others who want to learn the program. They’ve significantly expanded training sessions for clinicians interested in learning the behavioral approach that had already been brought to several other countries.
SPACE is appealing for a number of reasons. For starters, CBT doesn’t work for all children, and not all children with anxiety are willing or able to try it. SPACE teaches parents how to help their children. In that way, it can alleviate parental frustration and feelings of helplessness.
SPACE principles can seem simple. According to Lebowitz, the vast majority of parents with anxious offspring accommodate them. Letting a socially anxious tween stay home from school, ordering for a nervous teen in a restaurant, replying instantly to endless, worried texts, or permitting an anxious child to sleep in the parents’ bed are all typical examples.
SPACE teaches parents how to reduce and eventually stop accommodations in a supportive way so the child learns that they can cope.
Participants in the SPACE study got 12 weeks of instruction and guidance. But some principles can be tried by anyone eager to ease the strain that anxiety creates in a household.
“We know that even halfway through the treatment — meaning weeks — we had very marked, significant improvement,” Lebowitz said.
Steps to try at home
Pick one anxiety accommodation you want to change and focus on that. “But let your child know in advance. Don’t surprise them,” Lebowitz said. “Surprises don’t work that great for anxious kids.” And have that conversation in a kind, supportive way when the child isn’t upset.
Make sure your child knows you trust their anxiety is real, and that you will help them learn to cope. “Understand that trying to ensure your child doesn’t feel anxious is the wrong objective,” said Lebowitz. “The best thing a parent of an anxious child can do is not make them less anxious but make them better at being anxious.” Instead of adding to the child’s tension and even triggering their anxiety, you want to convey that you know they can learn to manage their feelings of fear and nervousness.
Praise and celebrate even incremental progress. “So much of what we’re asking parents to do is believe their child is stronger than they may have thought,” Lebowitz said. That confidence will become a message that the child hears, too.
Be patient but also be consistent. For example, say you’re focusing on helping your child order in a restaurant. While you can’t make the child order, you can calmly make it clear you will not do it for them. “If that means they don’t eat in that particular restaurant that particular time, maybe they’ll do it next time,” Lebowitz said. “Or maybe they’ll do it after three times.”
Remember that your job is to help your child, not win a popularity contest. As you gently but consistently reduce an accommodation, your child might not like it, and you might have to calmly accept some of their anger. “It’s important to remember that children feel loved when they get what they need,” Lebowitz said, “not necessarily what they want.” Remember you are trying to help your child overcome a difficulty. “If you do that,” he said, “your child will feel loved even if they’re angry at you in this moment.”
Don’t blame yourself for your child’s anxiety. Often parents will look for what they did wrong to create an anxious child. However, Lebowitz said, you may have another child without anxiety who was raised similarly. Beating yourself up doesn’t help you help your child.
Siblings can help. As parents practice reducing accommodations for an anxious child, siblings could need guidance so they don’t make the accommodation you’re trying to avoid: “’I know you want to help your sister. We don’t think that’s a good way to do it. So we’re telling you not to.’”
Validating his fear
The Calises worked with Joe gradually, gently, with lots of praise and encouragement to reduce and eventually give up the accommodations they were making. They started seeing improvements in a few weeks. Nowadays, Joe can even sleep over at a friend’s house.
“As a parent you want to make your child happy, and you want to do what you think is best for them,” said Jessica Calise, a family law paralegal. “It took me a long time to realize [making accommodations] definitely was not what was best for him."
Rewarding and encouraging Joe for his progress definitely helped, she said. Jessica and Chris, a heavy-machine operator, also found it helpful to let their son know they believed his anxiety was real to him.
“Something I never did before that they taught me was to validate his feelings of anxiety,” Jessica Calise said. “I think it was an important thing for both my husband and I to say to him we recognized and understood how he was feeling.”
For clinicians interested in SPACE training, the next session will be in Chicago on July 14 and 15. For more information on that workshop, visit https://www.eventbrite.com/e/space-training-workshop-chicago-july-2019-tickets-62824245008.
For anyone who wants to be informed of future workshops, visit spacetreatment.net.
For parents who want to get more detailed information about implementing the SPACE program, Lebowitz’s book, “Treating Childhood and Adolescent Anxiety: A Guide for Caregivers,” is available on Amazon.
For therapists, Lebowitz’s book, “Addressing Parental Accommodation When Treating Anxiety In Children,” is also available on Amazon.