Child Anxiety Disorder: Clinical Features and Treatment

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SEAN'S MOTHER: Sean was, and is, always a very easy child. Except for when he gets stressed, and then you deal with that.

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SEAN: Having anxiety is definitely a hard situation. Just wanting to go away and wanting everything to stop, and just kind of crawl into a dark hole, and then have everything just be over with kind of thing.

SEAN'S MOTHER: Sean is a perfectionist with everything. For example, it takes him four times longer to do his homework than it might take anyone else, because he has to form everything just perfectly. Getting dressed, for example, everything has to be just right. And he's very precise about the way things feel on his body. Whether it's shoes, or a shirt, or his socks, they have to feel a certain way or he'll take them off and not wear them.

SEAN'S FATHER: [LAUGHS] Good job.

SEAN: My parents remind me on a regular basis that I don't have to be perfect. But I just can't help but thinking that I didn't do well enough.

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SEAN'S MOTHER: We chose to move east after having lived in Montana for eight years. And we found Lebanon, Pennsylvania. It's a nice place. It's beautiful. It's rural, but it's close to the cities.

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SEAN'S FATHER: I know, but they want to separate that section.

SEAN'S MOTHER: Honestly, I think we've always known that Sean's had anxiety issues. But then after moving to Pennsylvania and starting sixth grade, he had a really, really rough go of it—partially because a lot of the natural accommodations that have been made for him in his previous school couldn't be made from here because we didn't have paperwork. They kind of had to treat him the same as every other child, but he does have specific needs. And so we found Dr. Grisolano.

LEE ANN GRISOLANO: Anxiety's irrational, you know? It supersedes the rationale. So if you can reframe what you are anxious about, sometimes it's possible to say, you know what? I'm not thinking about that in quite a rational way. And then also to use and teach coping strategies that can help bring about behavioral change that makes it a little bit easier.

SEAN: Hi.

RECEPTIONIST: Hi, Sean.

SEAN: Therapy definitely helps me with my anxiety because we can talk about worst case scenarios that probably won't happen, best case scenario is probably won't happen, then kind of in the middle, which will probably happen.

MS. STEPHANIE: Hey, Sean. Ready for you.

SEAN: OK.

I really like Ms. Stephanie. I feel like I can always talk about things with her that I wouldn't normally say.

MS. STEPHANIE: Now, your mom had mentioned something about playing a game in math?

SEAN: Oh, yeah. My teacher calls it the 24 challenge. And it's a mental game where I have to add, subtract, divide, and multiply all of those numbers in order to get to 24, and you have to use all of them.

MS. STEPHANIE: Mmhmm.

SEAN: I'm not very good at that, mainly because other people are just faster when it comes to mental math.

MS. STEPHANIE: Mmhmm.

SEAN: And the same thing. I get stressed and stuff to the point where I can't think and stuff. And after I get a certain amount behind, it's just kind of, like, why bother?

MS. STEPHANIE: Wow. That's a lot of pressure.

SEAN: Yeah.

MS. STEPHANIE: It's a lot of pressure in that moment.

SEAN'S MOTHER: Since working with the Grisolano Center, Sean has become much more confident and self-aware, and feels like he has a right to say no to things, and to ask for things that he needs. So, for example, if he needs to leave class because it's just too overwhelming, he knows that he can.

MS. STEPHANIE: So, Sean, let's talk about dance for a little bit. Just tell me what dance means to you.

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SEAN: Dancing, I can just use it as an outlet to let out my feelings. It just feels really good to just expose myself to something a little bit different.

SEAN'S MOTHER: Some people maybe go for a run when they're upset. He dances—dance in the backyard. He will dance on the streets.

LEE ANN GRISOLANO: Dance is a very beneficial supplement to Sean's therapy, a very liberating activity for him emotionally.

DANCE INSTRUCTOR: It's the motivational tool for Sean to continue in any efforts that are outside of the dance classroom.

SEAN'S MOTHER: To just continue pushing himself, getting better than he was before and finding new things to get better at. Dancing really became the way for him to deal with his anxiety and his uniqueness.

DANCE INSTRUCTOR: Sean will look at himself and say, I can do this. I have conquered this. And if I can conquer this fear, what else do I have to fear?

SEAN'S MOTHER: When I watch Sean dance, I feel like he is whole and I feel like I have been able to help him find what makes him happy and what fills his heart.

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