Areas › Worry and anxiety › The cost of avoiding
Anxiety is the most common mental health difficulty of childhood, with something like a third of young people meeting the threshold at some point and a smaller group badly held back by it. Both halves of that are worth saying.
The first half is for the shame: this is ordinary, and keeping it secret is its own kind of avoiding. The second half is so that nobody hears everyone gets anxious and decides your child needs nothing. Say them together, especially to relatives who mean well and to schools that have heard it all before.
Qur’an and Sunnah
My servants who have harmed yourselves by your own excess, do not despair of God's mercy. God forgives all sins (Quran 39:53). If shame is what keeps a family quiet, this is addressed precisely to shame.
۞قُلۡ يَٰعِبَادِيَ ٱلَّذِينَ أَسۡرَفُواْ عَلَىٰٓ أَنفُسِهِمۡ لَا تَقۡنَطُواْ مِن رَّحۡمَةِ ٱللَّهِۚ إِنَّ ٱللَّهَ يَغۡفِرُ ٱلذُّنُوبَ جَمِيعًاۚ إِنَّهُۥ هُوَ ٱلۡغَفُورُ ٱلرَّحِيمُ
Say, ‘[God says], My servants who have harmed yourselves by your own excess, do not despair of God’s mercy. God forgives all sins: He is truly the Most Forgiving, the Most Merciful
Qur’an 39:53read it in the library
Translation: M.A.S. Abdel Haleem, The Qur'an, Oxford University Press, 2004.
What the research says
A meta-analysis of 39 randomised trials with 1,821 patients found acceptance and commitment therapy helped across a range of mental and physical health problems, while a later cumulative analysis focused on anxiety and depression found the evidence building steadily but with modest effect sizes. Put side by side they support a plain claim rather than a large one: treatment of this sort helps a good many people, moderately. That is enough reason to go looking for it, and not a promise about any one child.
A-Tjak JG, Davis ML, Morina N, Powers MB, Smits JA, Emmelkamp PM. (2015). A meta-analysis of the efficacy of acceptance and commitment therapy for clinically relevant mental and physical health problems.. Psychotherapy and psychosomatics doi
Hacker T, Stone P, MacBeth A. (2016). Acceptance and commitment therapy - Do we know enough? Cumulative and sequential meta-analyses of randomized controlled trials.. Journal of affective disorders doi
Strength of evidence: one line of research. A single study, or a theoretical account.
Why it works
Knowing a difficulty is common makes it speakable, and knowing it can be serious keeps it from being waved away.
This one is still a draft. It is waiting on a scholar and a clinician to read it before it is published.
Near this one
The target is getting through the door, not feeling calm about it. Calm tends to arrive afterwards, and mostly for people who went.
Listen for the moment a young person starts explaining why home is better. A preference with reasons attached is much harder to shift than plain distress.
With an older teenager the pull is often not fear at all. The day at home is better: sleep, screens, and friends who are also not going.