Stephen Grcevich, MD!

Director of Strategic Initiatives, Key Ministry!Awana 2014 Ministry Conference!First Baptist Church, Oxford, MS!

August 23, 2014!

Including Kids in Your Ministry Who Struggle With Anxiety

Learning Objectives:

¨  Recognize common signs and symptoms in kids who struggle with anxiety"

¨  Become familiar with contemporary understanding of the causes of anxiety"

¨  Examine the impact of anxiety on family functioning and academic, social and spiritual development in children and teens"

¨  Review strategies for helping kids overcome functional limitations associated with anxiety

Some fears are normal and age-appropriate in children and teens…

¨  Infants: loud noises, fear of being startled ¨  Toddlers/young children: imaginary creatures,

the dark, animals, strangers ¨  School-age children: injury, natural events

(hurricanes, tornadoes, earthquakes), death ¨  Teens: Fears related to school performance,

social competence, health

J Am Acad Child Adolesc Psychiatry 2007;46(2) 267-83.

Common signs of anxiety in children, teens…

¨  Avoidance"¨  Excessive need for reassurance"¨  Excessive physical complaints"¨  Sleep disturbances (especially increased sleep latency)"¨  Difficulties with concentration, attention"¨  Perfectionism"¨  “What if” questions"¨  Excessive absence from school"¨  Easily distressed"¨  Lying"

Some facts about kids with anxiety…

¨  8% of teens ages 13-18 have anxiety disorders ¨  Most experience onset of anxiety by age 6 ¨  18% of teens with anxiety disorders have ever received

treatment ¨  Girls>Boys ¨  Severity=persistence ¨  Kids often develop new anxiety disorders over time ¨  Greater risk of depression, substance abuse ¨  Genetics, parent-child interactions, parental modeling,

temperament are risk factors

http://www.nimh.nih.gov/health/publications/anxiety-disorders-in-children-and-adolescents/index.shtml J Am Acad Child Adolesc Psychiatry, 2007;46(2):267-283

Specific Anxiety Disorders in Children, Adolescents: Note: Kids may experience different manifestations of anxiety as

they progress through developmental stages!¨  Separation Anxiety Disorder"¨  Specific Phobia"¨  Generalized Anxiety Disorder"¨  Social Anxiety Disorder"¨  Panic Disorder"¨  Obsessive-Compulsive Disorder"¨  Selective Mutism"

J Am Acad Child Adolesc Psychiatry, 2007;46(2):267-283

What causes anxiety in children and teens?

¨  Genetics…alterations in amygdala circuits involved in emotion processing, disruption in functional connectivity in amygdala-based networks involved in fear-processing"

¨  The child’s/teen’s innate personality style"¨  Environment (trauma, illness, life stressors) "¨  Overprotective parents"!Bottom line…Kids with anxiety misinterpret the level of risk in their immediate environment !

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FIGURE 1

Source: Journal of the American Academy of Child and Adolescent Psychiatry 2013; 52:290-299.e2 (DOI:10.1016/j.jaac.2012.12.010 )

Copyright © 2013 American Academy of Child and Adolescent

Child Teenager

School:

Difficulty separating from parents Difficulty with class participation Frequent trips to nurse’s office Performances, presentations

Test anxiety Difficulty with self-advocacy…getting help Avoid extracurricular activities, social events Fear of failure inhibits class selection

Friends:

Challenges in making new friends Parents often initiate social activity Difficulty with sleepovers

May depend on small circle of trusted friends Challenges with group trips/activities Dating and breakups more challenging

Family:

Often sleep with parents at night Reluctant to try new activities

Slow to progress toward independence Frequently reluctant to get driver’s license Conflict-dependence on electronic communication

Community: Less involved with sports, other extracurricular activities

May have more difficulty applying for jobs Less likely to do camps, travel experiences

Functional impairment in kids and teens with anxiety…"

How do our ministry environments create barriers for kids with anxiety and their families?"

Common barriers to church participation and spiritual growth in kids with anxiety…

¨  Vulnerability to misinterpret risks in environment ¨  Differences in sensory processing ¨  Cognitive rigidity ¨  Past negative experiences of church ¨  Family stress, isolation ¨  Parents with anxiety

Child Teenager

Weekend Worship:

They prevent the family from attending… Difficulty separating from parents Visiting new church challenging

They’re reluctant to attend Reluctant to attend without friends Uncomfortable with attention of group Transitions between age-group ministries difficult

Church Activities:

Discomfort reading, praying aloud Reluctant to engage unfamiliar kids Difficulty in unfamiliar environments

Disclosure in small groups challenging Unfamiliar places, experiences may be threatening…retreats, mission trips

Spiritual Disciplines

Prone to misperceive who God is… Prayer, process of confession in some traditions challenging

More prone to ritualism Obsessions- doubting salvation, sinning against one’s will Group disciplines more challenging

Growing in faith at home:

Parents can model faith, practicing disciplines as a positive coping strategy

Parents can sensitively expose teens to new spiritual experiences

Impacts of anxiety on church attendance and spiritual development in children and teens…"

What could a church try to welcome kids with anxiety and their families? ¨  Lots of pictures and video letting kids know what to expect

on Sundays, during new experiences ¨  Promote opportunity for kids and families to tour your

campus in advance of their first Sunday ¨  Using kids from many schools as “greeters” ¨  Sensitivity to allowing “preferred” roommates on trips ¨  Reserved seating near exits for people with agoraphobia ¨  Cell phone cameras for kids with separation anxiety? ¨  Apps to help kids find friends? ¨  Technology: online church, groups, Bible studies?

Tips for church staff and volunteers: Kids with anxiety"

¨  Don’t call attention to an anxious child"¨  Avoid interventions that make them feel “different”…

buddies, being part of “special needs ministry”"¨  Train greeters to observe for problems at “drop-off” "¨  Designate a private place for kids/parents in distress"¨  Watch for kids who are alone"¨  Offer to meet with parents when a child’s anxiety

appears to interfere with ministry participation"¨  Remember…anxiety generally decreases with

experience (exposure)"¨  Remember potential areas of giftedness: administration,

organization, sensitivity to others"

A final thought…"

"“We are all anxious. We all will and do experience anxiety. Anxiety is part of our human condition. With that being said, I believe that God uses our anxiety as a tool to help us grow. It’s a catalyst that keeps us from getting stuck, as it propels us to continually follow God.”"

Rhett Smith-author of The Anxious Christian!

What have we learned?

¨  The vast majority of kids with anxiety disorders develop symptoms during their grade school years (or earlier) and receive no treatment for their condition.

¨  Anxiety can have a major impact upon a child’s spiritual development and church participation

¨  Churches can take specific steps to making their ministry environments more welcoming to kids with anxiety and their families

Provides FREE training, consultation, resources and support to help churches serve, welcome and include families of kids with hidden disabilities!

Stay in Touch!"Key Ministry Website: http://www.keyministry.org"Church4EveryChild…Key Ministry Blog: http://drgrcevich.wordpress.com"Key Ministry Training Channel: http://go.mediasocial.tv/keyministry"Front Door (Online Church Campus): http://go.mediasocial.tv/cbcfrontdoor""""""www"

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Additional Resources:"Resource page on anxiety and spiritual development: http://drgrcevich.wordpress.com/resource-page-anxiety-and-spiritual-

development/ "American Academy of Child and Adolescent Psychiatry:"http://www.aacap.org/cs/AnxietyDisorders.ResourceCenter""National Institute of Mental Health"http://www.nimh.nih.gov/health/publications/anxiety-disorders-in-children-and-

adolescents/index.shtml""Anxiety Disorders Association of America"http://www.adaa.org/living-with-anxiety/children""

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Questions?"