Little Brown & Company, 2012

Growing Up Brave begins with the author arriving to deliver a talk a couple of years ago, shocked that the modest attendance she had expected was a crowd of 700 people in a high school auditorium.

The audience was comprised of parents, caregivers, guidance counselors, school nurses, pediatricians, psychologists and clergy members.

Afterwards, more than 50 attendees stayed to speak about specific concerns, from older children who were still afraid of the dark to children who had been diagnosed with a variety of psychological disorders.

These concerns are much more widespread than even Donna B. Pincus (Director of the Child and Adolescent Fear and Anxiety Treatment Program at Boston University) realized.

What distinguishes her work is the following message:

“Parents — not therapy, not prescription medications — can be the key ingredient in how successfully a child or adolescent begins to approach the world with greater joy and confidence.”

(This is the primary tenet of Marilyn Wedge’s Pills Are Not for Preschoolers as well, although anxiety is only one of the symptoms that troubled children in her practice might exhibit. Thoughts here.)

Growing Up Brave attempts to offer what those attendees craved, a combination of broad stroked reassurances and encouragement, general information, and specific how-to advice and suggestions.

The author’s tone is informal and inviting and she uses case studies (from toddlers to adolescents) to briefly outline the developmental issues associated with childhood anxiety, so that the reader can move from the informational portion of the narrative to the strategic part of the book.

“What matters is to recognize when your child could use some help. When you understand how anxiety works, and can accurately identify it as the source of your child’s ‘acting out’ or other issues, you can promote brave behavior and confidence at any age and in any situation.”

This doesn’t necessarily mean a formal diagnosis. Pincus believes that “the label is useful only if it leads us to the right treatment. State-of-the-art cognitive behavioral techniques are similar no matter which diagnosis a child receives. For all kids with anxiety disorders, we examine thoughts, feelings, and behaviors in terms of whether they promote or hinder a child’s progress.”

In fact, she points to the diagnostic category “Anxiety Not Otherwise Specified” to illustrate her point. The existing categories might not adequately capture each child’s difficulties, but that child can still benefit from basic changes that parents can make in the child’s home environment.

The changes that Donna B. Pincus recommends are practical and rooted in commonsense.

One primary tenet is rooted in a specific kind of parent-child interaction which is employed for only five minutes each day (no more, no less). She also suggests specific and simple changes surrounding the child’s bedtime routine. And there is a graduated program of responses designed to gradually reduce your child’s anxiety in specific problematic situations.

By using specific case studies, sometimes in such detail that actual dialogue is included, the reader quickly grasps the subtle differences that a parent’s tone and response can make in reducing a child’s fears and anxieties.

Whether the anxiety is connected with being alone in the dark, a parent’s absence, passing a dog on the sidewalk, or peer pressure, the basic principles described will show an improvement even in situations in which professionals have already made the decision to medicate or enroll the child in therapy.

“What makes it work is consistency, predictability, and follow-through.”

Attentive parenting, a focus on building problem-solving skills, and small adjustments to a child’s daily routine: change within the reader’s reach.