How Therapy Can Help Your Child Overcome Phobias and Specific Fears
At LifeSpring, we work with children and adolescents and adults at our office. And one of the things that we are going to be talking about is an issue that Caroline does see come up with children. And that is the issue of specific fears that come up for children and specific fears that bring them into therapy. One of the things that Caroline specializes in at our office is anxiety.
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Melissa Wesner, LCPC: Hi there, and thanks for joining us today. Today I'm talking with Caroline Masucci, who is a therapist here at Lifespring. Up until about a year ago, we only worked with adults at our office. But now that we have Caroline and a few other therapists who have experience in training and working with children and adolescents, we now work with children and adolescents and adults at our office. And one of the things that we are going to be talking about today is an issue that Caroline does see come up with children. And that is the issue of specific fears that come up for children and specific fears that bring them into therapy.
Melissa Wesner, LCPC: So thank you for joining us today, Caroline. Thank you for having me. So one of the things that you specialize in at our office is anxiety. And there are different forms of anxiety as we know, but sometimes people are coming in with specific fears in general. So if you can just talk with me generally about your work with children, children and anxiety or children and fears.
Caroline Masucci, LCSW-C: Yeah. So fear, right, is just a part of the human experience. But sometimes I have parents come in with children where fear is impacting daily functioning, right? They're having trouble at school. They're having trouble at home. Maybe it's impacting sleep, appetite. And so that's when we end up wanting to address that fear through cognitive behavioral therapy. I often use exposure and prevention treatment to get to the root of that fear and get them back to the functioning that they were once having. Sure.
Melissa Wesner, LCPC: And talk a little bit about what made working with children and anxiety or helping children navigate specific fears. Tell us a little bit about what made that a topic of interest for you personally as a provider.
Caroline Masucci, LCSW-C: I mean, I have my own personal connection with anxiety. And then I, you know, I was a school teacher before becoming a therapist. And so I love working with children. It's a passion of mine. And I was just having this reoccurring presenting issue of anxiety and then specific fear within kids. And I've found that I have pretty great success in my work with clients in addressing specific phobia. And it's a comfortable area of mine and a passion of mine.
Melissa Wesner, LCPC: Yeah, well, and I'm really glad that you mentioned your teaching experience and what you noticed as an instructor. So can you talk with us a little bit about some of the things that you did notice in the classroom when students were experiencing anxiety or a specific fear so that way parents who might be observing their children in different settings or teachers who might be listening to this, if they see these things show up, they know to pay attention to them.
Caroline Masucci, LCSW-C: Yeah, I think that self-isolation can be a sign, right? Like, you know, not being active with peers, playing, being social. I mean, of course, some kids are shy, but I think if it becomes out of the norm or unlike them, you know, that's something to kind of pay attention to. I also have noticed that it usually affects sleep or appetite. And then of course, affects their ability to perform in the classroom, right? It's hard to work when we're hungry or tired. Sometimes there's a desire, there's some separation anxiety, right? Maybe from caregiver or not wanting to be alone, wanting the companionship of other children or maybe the teacher.
Caroline Masucci, LCSW-C: These are all things that I kind of have noticed. Oh, and I don't want to forget irritability. That is, that is a really common sign. I mean, we as adults become irritable when anxious, but it's particularly common in children and adolescents. And so we'll think, oh, they're just in a bad mood when the truth is they're actually very, very anxious inside.
Melissa Wesner, LCPC: Yeah, I think that that's a really good point, right? As therapists, we think about irritability and how that can show up with anxiety, but I think that generally speaking, that that's not common knowledge.
Caroline Masucci, LCSW-C: Right, right. You know, that acting out or being irritable isn't necessarily just should be taken at face value, right? There may be underlying anxiety, maybe even depression underneath that. worth exploring?
Melissa Wesner, LCPC: Yes, absolutely. So you mentioned that, you know, fear in general, or being afraid from time to time is just a part of the human experience, right? Just like any emotion, right? Emotions are part of what it means to be human. But there are times where something like fear does warrant treatment. So if we're thinking about parents who are observing their children, maybe they have some concerns about things that their children are afraid of or the intensity of their fear, how exactly would a parent know that their child's fears do in fact warrant treatment or professional help?
Caroline Masucci, LCSW-C: Yeah, so I think, so we're talking about a large span of time, right? So, you know, way in the early years all the way up until 18 years old. And so we want to think about developmental milestones, developmental norms. So it's not all too unusual for a toddler to want to be by your side all day long, right, or to worry when they can't see you. But maybe it isn't developmentally appropriate for a 12-year-old to not be comfortable being alone or being away from you. And so maybe then, is there a little bit of anxiety, separation anxiety present?
Caroline Masucci, LCSW-C: And so I think it's your, you need to consider developmental norms and milestones when determining if it's something to be concerned about. And then again, how is it impacting their functioning? Are they able to achieve all that they'd like to? Are they living comfortably and happy and feeling secure? All things to take into account. And then also if you're totally unsure, but your gut feeling tells you there's an issue, come in, make an appointment and a professional therapist can also kind of help you determine whether or not that's a normal typical fear or something that's worth pursuing treatment of.
Melissa Wesner, LCPC: Yeah, and that's a good reminder too, is that if someone isn't completely sure if what their child is experiencing is something that requires treatment, that people can always come on in and talk to a counselor just to get some so they can gather information and help the parent understand whether or not that is something that is, you know, typical for a particular stage of development or a particular child's experience, or if it is something that needs treatment that a parent maybe doesn't have to know for sure. If they're unsure, they can seek guidance as well.
Melissa Wesner, LCPC: And, you know, if they find out that, no, actually, that's pretty typical. Okay, well, then that parent's mind can be set at ease and we don't have to worry too much about that maybe.
SPEAKER_02: Yeah, you're not alone.
Melissa Wesner, LCPC: Yeah. So talk with us about some things that a parent might see. If in fact, like they do need to pursue treatment, are there other things that they might notice about their child, their day-to-day functioning that would be indicators that maybe we should seek some help?
Caroline Masucci, LCSW-C: Sometimes I'll have children come in and they've developed a set of pretty extensive coping skills to manage, right? Like, well, you know, they're running away whenever anxious or avoiding a situation or seeking a great deal of comfort or utilizing fidgets or whatever it may be. And without those coping strategies, there's just emotional dysregulation. They need them to function properly. And so I think kind of noticing that or acknowledging that because there may not be a time where they can run away or whatever it may be.
SPEAKER_02: And so that's also something I've noticed. Okay.
Melissa Wesner, LCPC: And You know, some fears that come to my mind that I think about, right? Like we hear children being afraid of the dark or like you said, afraid of leaving the parents or being separated from parents or we hear people who are so very afraid of needles or so very afraid of heights or here in Maryland, I think about hearing people talk about being afraid of like crossing bridges. Let's, you know, even people who are afraid of, I hear people who are afraid of throwing up, right? So sometimes the fears that people have are very specific, although some of them can be really common.
Melissa Wesner, LCPC: If that were the case, right? For someone that you were working with, they come in and say, or maybe I'm afraid of flying, right? These are some specific fears that people have and they were to come in and say, hey, this is, a specific fear that I have. This is a specific fear that my child has. This is what I'm noticing. This is how it's showing up and impacting them, even impacting our family and our families functioning on a day-to-day basis, or this is how it's showing up at school. Talk with us a little bit about what the treatment process might look like.
Caroline Masucci, LCSW-C: Okay. Yeah, so I think it would be easier to take one specific fear, right? So let's say that the child is afraid of bees. I think that we're now in May. It's the spring. There are a lot of bees around. And I'm sure that they're on the playground as well. So I'm first going to start out with building a strong relationship with the child, right? And then we're going to work on emotions identification, right? Being able to express themselves, tap into their bodies, bring awareness around their feelings. We may also work to build coping skills, although sometimes coping skills can solidify that there's a reason to be scared, right?
Caroline Masucci, LCSW-C: They can kind of, kind of, validate the fear. And so this is kind of the case by case thing. But with these, we may work on, we may utilize exposure therapies. So I'll team up with the child and caregiver, and we'll think of gradual steps to take that induce just a little bit of anxiety, not a lot, just a little bit, step by step, until that level feels good, they feel secure in it, and then they'll do the next And so maybe with bees, it's just talking about bees. And then next it'll be looking at pictures of bees.
Caroline Masucci, LCSW-C: And you can imagine, higher and higher up the scale until they're flying on the playground and the bees are flying around and everything is just fine. But I want to emphasize that requires their buy-in, and that's why we need to develop that relationship, because they're in charge within their therapy work. Yeah.
Melissa Wesner, LCPC: Now, well, and I can imagine that that's hard, right? Like if we're talking about we are gradually going to Do things that produce fear or anxiety? We're going to talk about bees and I hate them. I can't stand them. I'm so afraid of them. What are some strategies that you use to get that buy-in or to support the client in being willing to approach something that's scary?
Caroline Masucci, LCSW-C: I think that it can be valuable to kind of start to think about, well, what would life look like if I weren't so afraid of these? What could I accomplish or what could I do? Or how is my fear of these affecting you negatively? So maybe the child would say, hey, yeah, I don't play on the monkey bars because I'm, you know, I saw it be there once and I'm just worried that there will be a be there again. And so, okay, well, would you like To practice using the monkey bars. Yes. Okay. Well, then that is an incentive to to do our work together.
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