Compassionate Counseling St. Louis specializes in anxiety management for kids, teens and college students.

We work with a ton of families. We love the work that we do! But we also know, even if we love working with you, that we’re not always the best fit.

If things aren’t feeling better, we want to check in with your weekly outcomes scores, to track our progress. We want to try out a few new interventions. And if we’re still not seeing the progress we want to see, we might refer you out.

The kids are at home (still), summer camps are closed, and all the ways you normally fill your summer time look a lot different, thanks to Coronavirus.

So, what’s a parent to do?

This week, we put together a list of some ways to fill up summer - while still building skills for anxiety management, frustration tolerance, and relationship building (kind of the three big things we most care about here at Compassionate Counseling St. Louis!)

What do you actually do this summer? We have 10 ideas right below!

Anger and anxiety often go hand in hand.

Rarely if ever is a person just angry. There’s usually something else going on underneath it. We may look angry on the outside, but internally we feel stressed, overwhelmed, and anxious. There may be grief, depression, or loss that is impacting our external anger. Or, we may not really know why we’re acting so angry, because we haven’t trained ourselves to figure out what else is going on. We know we seem angry to other people, so we accept that we must be feeling angry.

Anxiety can be tricky, and if you or your therapist isn’t digging underneath the surface, you might be working on fixing the behaviors, but you’re never addressing the underlying cause. That’s why you need to work with therapists who specialize in anxiety, and know that it doesn’t always look like your classic flight/freeze.

Games work as anxiety treatment and anger management, too.

As we discussed last week, when we use play interventions, we focus on three things:

1. Building our relationship

2. Following the rules

3. Practicing self-regulation

Games provide us a great opportunity to help model rule following, to process frustration as it arises, to build self regulation, and to build up our parent/child relationship.

Below, you’ll find 25 of our favorite games to incorporate at home, including a few that we use as child therapists...

You know your child’s not just angry. There’s something going on underneath the surface, too.

And a lot of times, that anger is masking anxiety, stress, and overwhelm.

When kids and teens (and even adults, too!) get anxious, their brains and bodies start to take over. Their fight/flight/freeze response gets activated.

That means for some kids, when they feel scared, they look scared.

The run away (flight) or totally shut down and clam up (freeze).

For many of us, our fight reaction takes over.

And instead of just looking scared on the outside, we look MAD. We look like we’re ready to get into a fight and defend ourselves. We’re ready to yell, or scream, or call you bad names, and we have a very, very hard time calming down.

So how can you integrate games to help your child build up their anxiety and anger management skills?

There are a lot of new stressors in our lives right now.

We’ve all had to get used to a new normal during this global pandemic. For a lot of our parents, one of the biggest challenges is moving school from the classroom to the kitchen table. Whether your kids are attending classes over Zoom or you have now been put in charge of teaching the material, no doubt this is a major adjustment for everyone. It’s okay to feel overwhelmed!

Parent-Child Interaction Therapy

Parent Child Interaction Therapy (PCIT) is based on play therapy models. It teaches parents how to work with their children in much the same way that a play therapist will build rapport and engagement. There are two components of this: Child Directed Interaction (CDI), and Parent Directed Interaction (PDI).

CDI - Learning to Become a Parent Play Therapist:

Child directed interaction is where the child leads the content of the play. This is most often what we integrate in our office as a way to build a relationship and engagement with our client.

During the CDI, or “special play time” as I often term it for kids, we play for 5 minutes. During this time, I do not take the lead at all. I let the child choose what activities they do, and the whole time, I’m engaged in the following three components:

1. Reflecting/paraphrasing the child’s speech

2. Describing the child’s behaviors

3. Specific praise of the positive behaviors seen in play

The most challenging part: not jumping in to redirect, lead the play, or make suggestions.

How we incorporate play therapy techniques for anxiety at Compassionate Counseling St. Louis:

We tailor our approach to each individual client and family we work with. That means, for some kids, we focus much more on building our anxiety and anger management skills through play.

Rather than non-directive play therapy (where therapists allow your child to free play and analyze what’s going on and themes they notice), we incorporate play in a couple of different ways.

Today, we’re talking Theraplay. In our next blog, we’ll be exploring Restorative Play. And in the following post, we’ll talk more about PCIT.

What is Theraplay?

Theraplay is a research-based type of play therapy that is focused on four main components: structure, engagement, nurture, and challenge. Per the Theraplay institute, Theraplay is “child and family therapy for building and enhancing attachment, self-esteem, trust in others, and joyful engagement.”

Every year, without failure, there are two time periods when our phones are ringing off the hook. Octoberish and Aprilish - aka parent teacher conference time.

Here we are, getting near the end of October, and once again, Compassionate Counseling is getting busy.

So, I thought we’d share a few suggestions with you, our parents, about that time of the year where you think everything is going great… and then you go “oh no.”

Because while you may think you know exactly how your child is doing at school, not every parent does. And there are a few suggestions that we can pass along to help you from feeling blindsided at parent teacher conferences. So, get ready for our suggestions on emailing teachers (ask these 3 specific questions!), talking with your kids, and making sure your emotions don’t get the best of you.

Our brains are in charge of everything we do. We take in information, and we send that information where it needs to go.

Every brain has both a relay center, and amygdala, and a pre-frontal cortex. In BrainWise, we say that your emotional response (the fight/flight/freeze response) is driven by your Lizard Brain. Your pre-frontal cortex, which helps you to stop and think, is your Wizard Brain.

The BrainWise curriculum was designed to help kids build social and emotional control and self-regulation skills. When I previously worked in the Saint Louis Counseling School Partnership Program, I received training in this program, and still use components of it in my practice today. To be clear, I’m not TECHNICALLY providing brainwise as I’m not maintaining really strict fidelity with the model. I have a whole walkthrough on the modules in an earlier post. This week, I want to walk you through how I introduce the model in my individual work with angry and anxious kids.

I strongly encourage parents, teachers or therapists to consider buying the BrainWise curriculum if these seem like helpful tools.

Does Anxiety Ever Really Go Away?

After 8 weeks of talking about anxiety at different ages, you might be feeling a little overwhelmed.

Or, maybe you just gulped down the information and are hungry for more.

But I think one of the tricky things we need to keep in mind about anxiety is that it never really goes away. It’s always there, even if it looks different from pre-school through college. As I say on my homepage, “Whether your pre-schooler has behavioral issues or your highschooler gets caught up in the small stuff…” I could include in that statement:

• Whether your child has separation anxiety or your college student is a perfectionist

• Whether your teen has anger management problems or your child gets tummy aches every other day

• Whether you feel overwhelmed and on edge, or you feel like you’re at the end of your rope parenting a child who gets so overwhelmed so quickly

Temper tantrums, conduct disorder, school behaviors, over control, fighting with siblings - all of these anger management problems can actually be signs of anxiety.

Many parents are surprised to hear that their child with disruptive behaviors could have an anxiety disorder. Anxiety and anger operate on very similar physiological responses in the body, meaning that increased heart rate, breathing, and muscle tension can lead to an anxious reaction or an angry one. It’s very important for parents to ask themselves:

Is my child angry, or just anxious?

“My child won’t go to school anymore - now what?”

Children with anxiety often have trouble in the school setting, regardless of how that anxiety is presenting. You may have a child with separation anxiety, generalized anxiety, or specific fears about the school environment. All three of these diagnoses can play out in a myriad of ways - but regardless of how the anxiety looks, it can leave you feeling helpless as a parent.

Anxiety often becomes more noticeable in elementary school, because of the environment.

There’s a huge switch from getting to stay at home or in a small daycare to having to attend school 5 days of the week.

I always recommend thy parents help to build a meditation practice together with their kids.

The trick is, though, like all other skills, meditation becomes so much easier with practice. That calm centeredness is much easier to recall and use when you’ve actually had some regular meditation practice.

Deciding between meditating in a class vs. trying meditation at home?

So, for those deciding between classes and at home, I would recommend at least trying a class to see if guided meditation feels easier than alone. Sometimes we get focused on stopping our thoughts (which is impossible) rather than just letting out thoughts gently pass us by, and a good meditation coach will help you still your thoughts in a non judgmental way, and will give you tips you can use at home.

The whole family can benefit from meditation and mindfulness practice, but it might be easier to do it together in your own space.

You can also try online or different apps for meditation

Stomach aches and headaches and anxiety in kids:

When does anxiety in children become a medical concern?

You may notice that your child is a worrier. When you schedule a babysitter, your kid has prepared a list of interview questions to ask the sitter before being ok with it. When you're 5 minutes late to picking them up, they're in tears. They need to walk through any potential problems and come up with five solutions whenever faced with a new situation. You're happy to help! But when is it too much?

Anxiety is a concern when it gets in the way of "typical" functioning.

While some kids are more prone to worries than others, anxiety becomes a concern when it impacts their day-to-day functioning. So, instead of being in tears that you're five minutes late, they've had a huge blow-up and are waiting for you in the principal's office. Or, walking in to school on the first day, they're paralyzed and can't move from your side. They have trouble maintaining friendships. They consistently experience stomachaches and headaches, due to their ongoing stress.

This week!

We’re looking at cooking together, family traditions, and gratitude.

Tip 10: Cook Together

When you cook with your kids, you teach them fundamental skills - and you get this great opportunity to teach yourself patience as well. Make something fun, and take deep breaths when they spill the flour everywhere.

When you cook together, you provide this possibility of your child having a positive memory forever. I still remember my dad letting me cut up the apples for a Thanksgiving pie when I was 8. Or my grandma letting me bake cakes with friends in her kitchen during highschool. Small things have a big impact.

Tip 7: Read Together

Some of my fondest memories of my grandmother are when we’d sit down together on the couch, teacups in hand (lots of milk and sugar in mine), and she’d read to me. Brothers Grimm or Roald Dahl or something she’d heard about from her work as a librarian. I’m 30 and I still remember the smell of her clean shirt and how safe and comfortable I felt.

Reading is a simple way to build connection with your kid. We’re not in charge of what memories really stick with them. So why not provide as many opportunities for positive, peaceful memories as you can?

Tip 8: Arts and Crafts

We’re continuing our 12 Tips for Winter Break! This week: How to actually enjoy everything.

Tip 4: Be Chill

Relaxing is kind of hard to do as a parent - you need to be on top of everything. But over winter break, there are so many great opportunities to just take it down a notch and chill out. And when you take the time to relax (and take care of yourself), you’ll feel so much more ready to be calm for your kids.

As a parent you have a million things on your to do list already, so I hate to add one more… But maybe it helps to view this more as an opportunity instead of a demand! When we’re calm, our kids are easier to calm. Which is why tip four leads directly to:

Tip 5: Relaxation Plan