Case Study >   Generalised Anxiety

Zoe2

zoe’s STORY

 

Zoe is 9 years old and she worries about almost everything.  She worries that we will be late to pick her up from school or forget to pick her up altogether. She worries about trying new things in case she is not good at them and consequently doesn’t try anything new. Since having food poisoning a year ago, she worries about getting sick and is very fussy about where and what we she eats.

Zoe constantly seeks reassurance and asks many questions when faced with a new or potentially fearful situation. This was happening every day when we dropped her off at school. In fact the questions and comments would start as soon as she got up in the morning, such as; “who is picking me up this afternoon?, make sure you get to school early this afternoon, what would happen if you had an accident and couldn’t pick me up” The questions went on and on.

We started to get quite frustrated with Zoe and decided to get her to start thinking more realistically (detective thinking). When she would begin questioning, I asked her to think about:

  • How many times I had been late before
  • If I’d ever forgotten her
  • What would happen if I was late?

The first few times we tried this she struggled to think of realistic answers, but with practice she was able to more logically think about how unlikely it was that I would pick her up late (or not at all) and what the consequences might be if that did eventuate.

The next time we had the same discussion I reminded her that we’d already done detective thinking about this and I asked her to explain it to me. From this point on I just reminded her that she has all the answers from previous detective thinking we have done together.

Detective thinking was an important first step in managing Zoe’s anxiety. It didn’t end there though as she still had a large number of worries and a general lack of confidence that was affecting her at school. Each year she had to prepare and present a speech to her class which was part of the Public Speaking competition. This caused a great deal of anxiety and resulted in many stressful and tearful days. Consequently, we decided to begin to help her overcome her anxieties by first tackling her fear of public speaking.

We set up a goal and broke it down into achievable steps so that she could experience difficult situations gradually and learn to cope with them. I was hopeful that by encouraging Zoe to try things that were frightening that she would gain confidence and break the cycle of automatically responding with fear and worry.

 

Step Description

Reward 

Step 1:  Prepare a talk that doesn’t have to be delivered

Bike ride with Mum

Step 2: Prepare a talk on a topic of my choice and practice in front of the mirror without presenting to anyone else

Treat of my choice after school

Step 3: Write a short talk (1 minute) and deliver it to my parents

 Play-date with a friend

Step 4: Give the same talk to my Grandparents and leave a word out 

Go out for dinner with grandparents

Step 5: Prepare a longer talk (2 minutes) and deliver it to Mum, Dad and my Aunty and Uncle

 Buy a movie of my choice

Step 6:  Deliver the same talk to some of my extended family and pretend to lose my place

 Go out for an ice-cream

Step 7:  Ask a question in class

 Hire a movie of my choice

Step 8:  Answer a question in class

 Go to a café with Dad

Step 9:  Prepare the speech for the Public Speaking Competition and practice in front of Mum and Dad

 Play-date with a friend

Step 10:  Invite my best friend from school over and present the speech to her

 Smiggle pen pack

Step 11:  Practice the speech in front of my neighbours who are good friends of ours

 Go to see a movie with a friend

Step 12:  Present the speech to the class

 Go on a camping weekend with two friends (with mum and dad too!)

 

Zoe was quite hesitant to start this goal as this was her biggest fear. Starting slowly where she didn’t have to present to anyone helped build her confidence so that when she got to step three and delivered the speech to us she didn’t completely freak out. As she worked through her goal step by step, she began to build a familiarisation with the activity and we could see her confidence growing.

With small increases in difficulty, she was able to tackle each new challenge with a positive attitude. We encouraged her to journal her feelings throughout the process, which broadened her perspective, helping her to realise that her worries were over thought and unrealistic.

By the time Zoe had reached the final step, she went into the class with more confidence than we could have imagined her having. She delivered her speech clearly and concisely and came home from school beaming with pride.

The Fishwah tool provided an effective structure, a clear and collaborative process for Zoe and her parents and an engaging platform to motivate Zoe to achieve her goal. It was a great tool to keep track of her goal progress and provide Zoe with a sense of accomplishment, confidence and success.

Fishwah has been designed to empower parents to help their own children. However, it may be appropriate, particularly where the anxiety is severe, to see a health professional in addition to using Fishwah.