Your child’s teacher calls you saying that she’s concerned. She explains that your child rarely participates in class and never asks questions, even when they’re visibly confused. When she asks your child if they need help, they look down and say that they don’t need help. The teacher explains that even though it’s well into the school year, your child hasn’t made any friends and spends lunch and recess alone.
You’ve always considered your child to be shy, but this is the first time any of their teachers have expressed concern. You remember a recent trip to the grocery store in which you ran into a coworker who greeted your child. Your child looked like a deer in headlights, hid behind you, and mumbled, “hi.” You didn’t think anything of it at the time, but now you’re starting to worry.
What is Social Anxiety?
Many parents describe their kids as shy and slow to warm up to new people. If the shyness is so intense that it impacts their ability to make friends or to be successful in school, for example, your child may be suffering from social anxiety disorder.
Social anxiety disorder is characterized by fear of being judged by others. Many kids and teens who have social anxiety fear that they will do something embarrassing or that their peers will think they are stupid or weird. As a result of the fear, they avoid asking or answering questions in class, trying out for a sports team, or even eating in front of others. Young kids may have tantrums prior to social interactions or remain close to their parents when around others.
When a child with social anxiety is in a social situation or is anticipating being in one, they feel nervous and worry about others’ perceptions of them. In these cases, they experience a high degree of anticipatory anxiety. In an effort to reduce anxiety, they avoid social interactions or engage in other behaviors (speaking softly or avoiding eye contact, for example). This alleviates symptoms in the short-term because the child feels relieved when their anxiety immediately decreases. However, avoidance ultimately maintains the anxiety over time, as continued avoidance of social situations results in missed opportunities to face their fears and experience first hand that the situation did not play out as poorly as they anticipated. Parents can get pulled into the cycle of avoidance. Examples include speaking for their child to reduce the child’s discomfort, making excuses for them so they don’t need to attend social activities, or allowing them to stay home from school when they have a presentation in class.
Whereas many kids will typically grow out of being shy, the fear of judgment that is characteristic of social anxiety disorder rarely goes away without intervention.
How is Social Anxiety Treated?
A cognitive-behavioral approach called exposure and response prevention (ERP) is the gold-standard, evidence-based treatment for social anxiety disorder. It involves a series of exposure-based activities of increasing difficulty (often called a hierarchy) that change your child’s avoidance of social situations into approach. The exposure activities are collaboratively developed with the therapist and your child and are accompanied by discussions of anxious thoughts (cognitions) and strategies for changing these thoughts (behaviors).
An ERP therapist guides you and your child through various activities in different settings and situations to expose your child to their fears, while also providing support and guidance to you about how to support their progress. The exposure activities are tailored specifically to your child’s anxiety and often include practicing specific social skills, such as role plays that involve interacting with new people or going to new places, during therapy sessions in the security of the office setting. These planned exposures are eventually extended into the community under the support and guidance of the therapist. An effective ERP plan also includes practice exercises for you and your child to complete between therapy sessions.
What Can I Do?
If you are concerned that your child may be experiencing social avoidance or social anxiety, contact us today to schedule an appointment with Dr. Anna Martinez-Snyder, who specializes in ERP for social anxiety disorder and other anxiety disorders.