Many children can become upset or worry when they separate from their parent(s) or caregiver, particularly when going into a new setting or situation with unfamiliar people (e.g., starting childcare or going to a new school). This is common and generally this initial worry passes after a consistent time in the setting, some regular visits and discussion with their parents.
In Separation Anxiety, the child’s main fear is of being separated from a parent, family member, or loved one. In particular, a child worries and believes that something bad will happen to their loved one when they are separated. Children may become very distressed when they have to separate or are even thinking about separating from their loved ones. They may avoid activities that require separation and may try to ease their own anxiety by checking on their loved ones by frequently by calling them or repeatedly questioning or seeking reassurance that they and their family will be safe.
For children with Separation Anxiety, the worry and distress at the time of separation is well above what would be expected for their age and developmental level. The worry and distress continues despite warm-up periods and repeated experiences in the setting, and despite parents’ attempts to reassure and talk with their child. In Separation Anxiety Disorder, the persistent anxiety and distress significantly impacts a child’s ability to engage in everyday activities, daily routines and developmental tasks. The excessive worry and distress at separation is consistently present for at least four weeks and occurs consistently in a range of situations and experiences.
Common worries/fears in Separation Anxiety include:
- That they might not see their loved one again.
- That they might be kidnapped, hurt or killed AND/OR that this may happen to their loved one.
- That they could get lost.
- Parents might disappear or not return home.
- Parents might forget about them or not love them any more.
Common physical symptoms or complaints at separation or when separation is anticipated include:
- Stomach aches
- Nausea or vomiting
- Dizziness or fainting
- Muscle tension or body ‘freezing’
- Cramps or muscles aches
- Heart racing/palpitations and associated over-breathing, sweatiness, over-heating (e.g., hot flushes, red face/cheeks, clammy hands)
Children with separation anxiety also commonly experience:
- Dreams or nightmares about separation (especially young children).
- Difficulties settling to sleep or remaining in their own room/bed.
- Avoidance of and refusal to enter into situations that require separation such as the following:
- Going to childcare/school
- Going to sleepovers
- Going on camps
- Going on public transport
- Going to bed
- Being in a separate room of the house
- Visiting friends or relatives
- Staying home when a parent/loved one goes out
- Being left with a babysitter
- Moving house or changing daycare/school
Treatment for Separation Anxiety
Research has demonstrated that Behaviour Therapy and Cognitive Behaviour Therapy (CBT) are the most effective intervention models for Anxiety Disorders, including Separation Anxiety.
These therapies will often include teaching strategies or techniques to the child and parent(s) such as:
- Education about anxiety in general, and separation anxiety, triggers and things which might be maintaining the child’s worries and fears.
- Emotion discussions: Talking opening about anxiety and other feelings, up-skilling parents or caregivers to do this effectively through listening, validation and problem- solving.
- Behaviour management: Relaxation (e.g., deep breathing) and coping strategies; anticipating and planning how to manage future changes and transitions (i.e., predictability reduces anxiety); parenting in a consistent way; implementing routines; modelling coping behaviours; problem solving; use of rewards and behaviour charts to encourage coping and brave behaviour.
- Gradual Exposure to Separations: helping children gradually face their fear of separations using a step by step approach which involves exposing them to situations which cause them to feel anxious. When small, realistic and achievable goals are set children learn to sit with their anxiety and cope with it, and also learn that their fears often do not come true or that they were not as bad as they had thought they were. Each step is practised frequently and consolidated before moving on to a more difficult step. The use of reward charts can be very helpful and involving children in choosing their goals and rewards is helpful for treatment and their motivation and responsibility.
If you would like to find out more about our treatment for Separation Anxiety, or to book an appointment with one of our child clinical psychologists who provides treatment for this condition, please email or call the clinic on 0405 430 530.