Ask An Expert / Anxiety

Since a classmate’s family was killed in a plane crash, our daughter is terribly anxious that something bad will happen to us. How can we help her?

In kids prone to anxiety, events can trigger disorders that call for treatment

Jamie M. Howard, PhD
Jamie Howard, PhD

Clinical Psychologist, Anxiety Disorders Center, Director, Trauma and Resilience Service

Child Mind Institute

Our 6-year-old daughter has recently begun sobbing at night when it is time to go to bed. She worries that something bad will happen (a tornado, hurricane, earthquake, or fire) and that we will get hurt. She has also gotten upset about the idea that one day we will die and she will be left alone.She has periodically mentioned worries about fire and such over the last couple of years but she was usually easily comforted. A few weeks ago the mom and siblings of a girl she goes to school with were killed when a small plane crashed into their home. I imagine that this is having an impact on her reactions, but I'm just not sure whether this is a phase or whether we should try to find someone for our daughter to talk to. I feel so terrible for her and all of the worries she has lately.

When kids who are prone to anxiety hear of a traumatic event, like this plane crash, they sometimes get really stuck. Hearing about bad things can serve as evidence that terrible things are likely to happen, which is of course not true, and exacerbate existing anxieties.

It sounds like your daughter is prone to anxiety, and she could be developing an anxiety disorder, which happens when worries get so strong they start to cause functional impairment (i.e., difficulty doing day to day tasks, like going to school, enjoying fun activities, and making friends). And when it starts to become more of a disorder, your typical reassurance won’t be enough.

I’d recommend that you get a diagnostic evaluation to determine what kind of anxiety she’s experiencing. It could be generalized anxiety disorder, where you have lots of uncontrollable worries about everyday things. Worrying about weather, fires, plane crashes — that’s kind of classic GAD. Potentially, it could be OCD if she’s doing something to neutralize her fears, like thinking, “If I count to seven my mom won’t die in a plane crash.”

Once you get a diagnosis your daughter might benefit from cognitive behavioral therapy, or CBT. A CBT program called Coping Cat is the gold standard treatment for generalized anxiety disorder. It teaches kids that sometimes we feel frightened because our bodies produce a false alarm of danger, and then we expect something bad to happen, and we overestimate the likelihood that it will happen. And then we start to avoid things, because we’re overestimating the dangers, and that becomes a big problem. So we teach kids how to challenge their thinking errors and engage in helpful behaviors.

And in CBT we give kids lots of praise and rewards for being brave. Anxious kids have to learn how to deal with uncertainty. Chances are we’re not going to die in a plane crash, and we have to focus on being brave and saying it’s probably not going to happen, and that has to be good enough.

I can understand why you say you feel terrible for your daughter, because she seems truly upset by these things. And at the same time, you want to be careful to respond in a warm, gentle, and matter-of-fact way. If you let her anxiety upset you, you can inadvertently reinforce the anxiety, making it seem like she really does have something to be worried about. Also, you might want to turn off the television news until she starts to get this under control — sometimes it can stimulate anxiety in young children.