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Growing your Child’s Motivation to Challenge Anxiety
Dear SMA Community,
Engaging in therapy or completing communication goals on your own is hardly ever easy. Its not easy for caregivers to see their loved one struggle, and it’s certainly not easy for individuals with anxiety of any sort to face their worst fears. Nevertheless, research on treatment strategies for anxiety including Selective Mutism indicates that the facing of one’s fears at a gradual pace, called exposure therapy, is exactly what needs to happen to overcome anxiety (Zakszeski & DuPaul, 2017; Compton et al, 2010). For many individuals with Selective Mutism, building up their motivation is an important early step before they can get into exposure goals in earnest.
For some, learning more about anxiety and about exposure therapy is a great way to enhance motivation. Its easier to act if you know the “why.” The “why” in this case is that the anxiety response is an essential system that humans have; anxiety exists to keep us safe in potentially risky situations, acting like a “danger alarm.” However, some people experience danger alarms in response to situations that aren’t actually dangerous (such as talking to their teacher) and this can cause discomfort (e.g., racing anxious thoughts, stomachaches, sweatiness, shakiness). Those uncomfortable feelings, however, are often temporary and by purposefully putting ourselves in anxiety-provoking situations, we usually learn that we can persevere through the discomfort and that it wasn’t as scary as we expected. Try this simple exercise: grab a piece of sour candy and think about the tastes you notice as you eat it. Often, its really sour at first, but if you stick with it, a sweet taste takes over. Participating in exposure goals feels similar—it can be uncomfortable or sour at first, but eventually gets easier and sweeter.
Caregivers will also want to think about internal motivators and external motivators. Internal motivators are the “big picture goals” we have for ourselves and can keep us looking forward through hard work and discomfort. Talk to your child about what things get in the way of them trying to talk to new people (e.g., fears such as someone making a big deal about hearing them talk or uncertainty about what to say) as well as the goals that they have for themselves that might include talking (e.g., making new friends, having a job some day in the future, getting a driver’s license, etc.) Try to keep this conversation focused on your child’s goals for themselves (as opposed to your goals for your child or the goals that family members, teachers, therapists, etc. might have for them). One simple way to start this conversation is to make two pros and cons lists: one representing “staying the same” and another representing what would happen if there was a “change” and the child/tween/teen were to start talking to more people through completing exposure goals.
External motivators can be almost anything—tangible things like a candy bar or a new toy or privileges like being able to stay up past bedtime or a visit to the local bakery for a treat. Setting up a reward system can really help an individual to find the motivation to do something that is hard or scary. Reward systems aren’t just for little kids; for example, a tween or teen would likely be fairly motivated to get a gift card to their favorite online retailer and paychecks help motivate adults to work hard at our jobs. It’s important to note that a well-planned reward system is different than a bribe. Bribes are often considered acts of desperation (e.g., “if you just stop whining, I’ll switch the channel to your favorite show”) where reward systems are careful and methodical (e.g., “after we get X amount of points, I get to load more money to your video game account”).
Considering these ways to enhance motivation can lead to better treatment success. For further information about ways to increase motivation, especially in teens/tweens, view these videos:
Part 1:
Practical Applications to Enhance Motivation in the Treatment of Adolescents with Selective Mutism
Part 2:
Sincerely,
Katelyn Reed, M.S., LLP
SMA Board of Directors
References:
Compton, S.N., Walkup, J.T., Albano, A.M. et al. (2010). Child/Adolescent Anxiety Multimodal Study (CAMS): Rationale, Design, and Methods. Child Adolescent Psychiatry and Mental Health, 4(1). https://doi.org/10.1186/1753-2000-4-1
Zakszeski, B.N., & DuPaul, G.J. (2017). Reinforce, Shape, Expose, and Fade: A Review of Treatments for Selective Mutism (2005–2015). School Mental Health, 9, 1–15. https://doi.org/10.1007/s12310-016-9198-8
