What are effective strategies against social phobia?

Question

Our 5 years old (in a month) daughter has excessive apprehension about being immerged in new environments with people (especially children) she doesn't know. Basically, she will cry her heart out when we try to leave her in such an environment, then she will stay away from the group, near an adult if possible. I feel there is more than just timidity, I guess this qualifies somehow as social anxiety disorder ?

It has already reached a bothering level, because we cannot always prevent such situations to happen (e.g. during summer we can't afford to keep her at home so she had to follow a holiday camp, it was like sending her to Guantanamo every morning…), and because she is starting to miss fulfilling opportunities (we are cancelling a music and dance initiation program because she doesn't want to attend the class, despite her loving the topic and liking the teachers). This is less an issue in school because she already knows most children from the last two years (and she has good friends with whom she knows how to behave quite excited), yet teachers seem moderately concerned by her lack of involvement in group activities.

She went to a child psychiatrist last weeks, but he didn't help much, beside saying she was quite anxious (which was actually the reason for which we sent her to him, she is constantly and litteraly eating her fingers) and a bit egocentric, but had no strong issue (I guess he was only looking for some psychiatric disease).

What can we do to help her dealing with this issue ?

Answer 1

In the UK about 1 in 10 children between the ages of 5 and 15 has a diagnosable mental health problem. Most of these are at the "mild" end, but they still cause some distress for the child and the parents.

There are good reasons why medical diagnoses are not made over the Internet. But, if you think your child's anxiety is interfering with her day to day life then you should seek treatment.

Psychiatrists can prescribe medication, but that's not the front line treatment for an anxiety disorder. (In fact, current advice is to avoid medication). You'll want to speak to a paediatric psychologist. Find one who has some professional registration.

(In England you'd see your GP, and keep pushing because paediatric mental health services are under considerable pressure).

Anxiety disorders are very treatable. I think any clinician would recommend a course of Cognitive Behaviour Therapy. This would be a short course of therapy (about 8 to 14 sessions, one per week, for about 45 minutes each time.)

CBT can be done 1 to 1 with a therapist; or as part of group sessions; or self-guided from books.

There's going to be some difficulty finding suitable CBT courses for such a young child.

Even if your child doesn't meet the threshold for an anxiety disorder, you'll find the concepts of CBT useful.

Here's the recommended treatment in England for anxiety disorders:

Here's the pathway: https://pathways.nice.org.uk/pathways/social-anxiety-disorder

Here's the recommendations: https://pathways.nice.org.uk/pathways/social-anxiety-disorder#path=view%3A/pathways/social-anxiety-disorder/interventions-for-children-and-young-people-with-social-anxiety-disorder.xml&content=view-node%3Anodes-treatment-for-children-and-young-people

Answer 2

One common approach to phobias in general is gradual acclimatisation. So going by this principle you should start small by leaving her for a few minutes and then coming back, then increase the time gradually.