HELPING THE FEARFUL CHILD

Behavior-therapy techniques that parents can apply to help their children overcome everyday, yet often debilitating, anxieties—with a thorough discussion of normal worries so parents can decide when to use them. Few of the ideas advanced by Dr. Kellerman, a pediatric psychologist at L.A. Children's Hospital, are complicated in themselves, but nearly all require parents to change their own behaviors, often a difficult undertaking. Throughout, moreover, the assumption is that fears are learned and can be unlearned, and that the child must be helped to control his or her own behavior; Freudian apprehensions of symptom substitution are dismissed with "if a child is afraid of dogs, he is afraid of dogs. Period." To help children learn to take control, techniques utilizing rewards, desensitization, and relaxation are described in some detail, with illustrative case histories. Five-year-old Brian, for example, had seen a "Dracula" movie at his grandmother's, and developed a Dracula phobia that made him nervous during the daytime and kept everyone awake at night. Dr. Kellerman's treatment: letting Brian regulate the TV ("Dracula isn't real. You can handle him"); encouraging him to draw pictures of Dracula and tear them up in anger ("He was given the explanation. . . that being mad got rid of feeling scared"); allowing him to sleep anywhere in the house except in his parent's bed—their stopgap remedy—and rewarding him with a nickel (his choice of reward, Kellerman stresses) for every "good night." Other chapters—on school avoidance, hospitalization, toilet problems, compulsive habits, a death in the family, and disaster—also provide specific examples and instructions. Parents are warned, however, that they must be comfortable with the techniques for change to occur; if they aren't, or if additional assistance is needed, the information on finding professional help will be useful. One approach, only—but effectively carried through.