This workshop helps ministry leaders to recognize situations when anxiety represents a barrier to participation in Awana activities and develop strategies for welcoming and including kids with all types of anxiety into your programming.

1. Stephen Grcevich, MD!
Director of Strategic Initiatives, Key Ministry!
Awana 2014 Ministry Conference!
First Baptist Church, Oxford, MS!
August 23, 2014!
Including Kids in Your Ministry Who
Struggle With Anxiety

2. Learning Objectives:
¨ Recognize common signs and symptoms in kids
who struggle with anxiety"
¨ Become familiar with contemporary
understanding of the causes of anxiety"
¨ Examine the impact of anxiety on family
functioning and academic, social and spiritual
development in children and teens"
¨ Review strategies for helping kids overcome
functional limitations associated with anxiety

3. Some fears are normal and age-appropriate
in children and teens…
¨ Infants: loud noises, fear of being startled
¨ Toddlers/young children: imaginary creatures,
the dark, animals, strangers
¨ School-age children: injury, natural events
(hurricanes, tornadoes, earthquakes), death
¨ Teens: Fears related to school performance,
social competence, health
J Am Acad Child Adolesc Psychiatry 2007;46(2) 267-83.

4. Common signs of anxiety in children, teens…
¨ Avoidance"
¨ Excessive need for reassurance"
¨ Excessive physical complaints"
¨ Sleep disturbances (especially increased sleep latency)"
¨ Difficulties with concentration, attention"
¨ Perfectionism"
¨ “What if” questions"
¨ Excessive absence from school"
¨ Easily distressed"
¨ Lying"

5. Some facts about kids with anxiety…
¨ 8% of teens ages 13-18 have anxiety disorders
¨ Most experience onset of anxiety by age 6
¨ 18% of teens with anxiety disorders have ever received
treatment
¨ Girls>Boys
¨ Severity=persistence
¨ Kids often develop new anxiety disorders over time
¨ Greater risk of depression, substance abuse
¨ Genetics, parent-child interactions, parental modeling,
temperament are risk factors
http://www.nimh.nih.gov/health/publications/anxiety-disorders-in-children-and-adolescents/index.shtml
J Am Acad Child Adolesc Psychiatry, 2007;46(2):267-283

6. Specific Anxiety Disorders in Children,
Adolescents:
Note: Kids may experience different manifestations of anxiety as
they progress through developmental stages!
¨ Separation Anxiety Disorder"
¨ Specific Phobia"
¨ Generalized Anxiety Disorder"
¨ Social Anxiety Disorder"
¨ Panic Disorder"
¨ Obsessive-Compulsive Disorder"
¨ Selective Mutism"
J Am Acad Child Adolesc Psychiatry, 2007;46(2):267-283

7. What causes anxiety in children and teens?
¨ Genetics…alterations in amygdala circuits
involved in emotion processing, disruption in
functional connectivity in amygdala-based
networks involved in fear-processing"
¨ The child’s/teen’s innate personality style"
¨ Environment (trauma, illness, life stressors) "
¨ Overprotective parents"
!Bottom line…Kids with anxiety misinterpret the
level of risk in their immediate environment !
"

8. FIGURE 1
Source: Journal of the American Academy of Child and Adolescent Psychiatry 2013; 52:290-299.e2
(DOI:10.1016/j.jaac.2012.12.010 )
Copyright © 2013 American Academy of Child and Adolescent

9. Child Teenager
School: Difficulty separating from parents
Difficulty with class participation
Frequent trips to nurse’s office
Performances, presentations
Test anxiety
Difficulty with self-advocacy…getting help
Avoid extracurricular activities, social events
Fear of failure inhibits class selection
Friends: Challenges in making new friends
Parents often initiate social activity
Difficulty with sleepovers
May depend on small circle of trusted friends
Challenges with group trips/activities
Dating and breakups more challenging
Family: Often sleep with parents at night
Reluctant to try new activities
Slow to progress toward independence
Frequently reluctant to get driver’s license
Conflict-dependence on electronic
communication
Community: Less involved with sports, other
extracurricular activities
May have more difficulty applying for jobs
Less likely to do camps, travel experiences
Functional impairment in kids and teens
with anxiety…"

10. How do our ministry environments create barriers for
kids with anxiety and their families?"

11. Common barriers to church participation and
spiritual growth in kids with anxiety…
¨ Vulnerability to misinterpret risks in environment
¨ Differences in sensory processing
¨ Cognitive rigidity
¨ Past negative experiences of church
¨ Family stress, isolation
¨ Parents with anxiety

12. Child Teenager
Weekend
Worship:
They prevent the family from
attending…
Difficulty separating from parents
Visiting new church challenging
They’re reluctant to attend
Reluctant to attend without friends
Uncomfortable with attention of group
Transitions between age-group ministries difficult
Church
Activities:
Discomfort reading, praying aloud
Reluctant to engage unfamiliar kids
Difficulty in unfamiliar environments
Disclosure in small groups challenging
Unfamiliar places, experiences may be
threatening…retreats, mission trips
Spiritual
Disciplines
Prone to misperceive who God is…
Prayer, process of confession in
some traditions challenging
More prone to ritualism
Obsessions- doubting salvation, sinning against
one’s will
Group disciplines more challenging
Growing in
faith at home:
Parents can model faith, practicing
disciplines as a positive coping
strategy
Parents can sensitively expose teens to new
spiritual experiences
Impacts of anxiety on church attendance and
spiritual development in children and teens…"

13. What could a church try to welcome
kids with anxiety and their families?
¨ Lots of pictures and video letting kids know what to expect
on Sundays, during new experiences
¨ Promote opportunity for kids and families to tour your
campus in advance of their first Sunday
¨ Using kids from many schools as “greeters”
¨ Sensitivity to allowing “preferred” roommates on trips
¨ Reserved seating near exits for people with agoraphobia
¨ Cell phone cameras for kids with separation anxiety?
¨ Apps to help kids find friends?
¨ Technology: online church, groups, Bible studies?

14. Tips for church staff and volunteers:
Kids with anxiety"
¨ Don’t call attention to an anxious child"
¨ Avoid interventions that make them feel “different”…
buddies, being part of “special needs ministry”"
¨ Train greeters to observe for problems at “drop-off” "
¨ Designate a private place for kids/parents in distress"
¨ Watch for kids who are alone"
¨ Offer to meet with parents when a child’s anxiety
appears to interfere with ministry participation"
¨ Remember…anxiety generally decreases with
experience (exposure)"
¨ Remember potential areas of giftedness: administration,
organization, sensitivity to others"

15. A final thought…"
"“We are all anxious. We all
will and do experience
anxiety. Anxiety is part of
our human condition. With
that being said, I believe
that God uses our anxiety
as a tool to help us grow. It’s
a catalyst that keeps us
from getting stuck, as it
propels us to continually
follow God.”"
Rhett Smith-author of The
Anxious Christian!

16. What have we learned?
¨ The vast majority of kids with anxiety disorders
develop symptoms during their grade school years (or
earlier) and receive no treatment for their condition.
¨ Anxiety can have a major impact upon a child’s
spiritual development and church participation
¨ Churches can take specific steps to making their
ministry environments more welcoming to kids with
anxiety and their families

17. Provides FREE training,
consultation, resources and
support to help churches serve,
welcome and include families of
kids with hidden disabilities!

18. Stay in Touch!"
Key Ministry Website: http://www.keyministry.org"
Church4EveryChild…Key Ministry Blog: http://drgrcevich.wordpress.com"
Key Ministry Training Channel: http://go.mediasocial.tv/keyministry"
Front Door (Online Church Campus): http://go.mediasocial.tv/cbcfrontdoor"
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http://www.facebook.com/keyministry
http://www.pinterest.com/keyministry/
http://twitter.com/#!/drgrcevich
http://twitter.com/#!/KeyMinistry

19. Additional Resources:"
Resource page on anxiety and spiritual development:
http://drgrcevich.wordpress.com/resource-page-anxiety-and-spiritual-
development/
"
American Academy of Child and Adolescent Psychiatry:"
http://www.aacap.org/cs/AnxietyDisorders.ResourceCenter"
"
National Institute of Mental Health"
http://www.nimh.nih.gov/health/publications/anxiety-disorders-in-children-and-
adolescents/index.shtml"
"
Anxiety Disorders Association of America"
http://www.adaa.org/living-with-anxiety/children"
"
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20. Questions?"