Hi I am reading Breaking Free of Child Anxiety and OCD and keen to adopt the principles of the SPACE program with my son who is 9 years old. He worries about vomiting at school and feeling sick, it is getting worse as he avoids milk in the morning and sometimes avoids eating. He visits the loo before he leaves for school about 2 times with the hope that it might prevent him from getting sick. He is beginning to refuse to go to school on time. We are often now 20 - 30 min late every morning as he does not want to get out of bed and complains of a sore tummy. He says he does not want to go to school all day for fear of feeling sick. When he is at school, he is usually fine. This is becoming very difficult for me and often a dread each morning as I face the constant anxiety with the pressure of trying to get him to school on time. School refusal linked to his anxiety is the difficulty here. any suggestions on SPACE based accomodations would be helpful. I am wondering what I can do in addition to supportive statments along with acceptance but am feeling puzzled how I can reduce accomodations of delaying school in the morning?
Thank you in advance
Hi Mary, I hear your struggle and I'm so happy that you've found the book to help you understand the cycle of accommodation and the importance of using supportive statements to give a consistent message of validation + confidence, rather than sending mixed messages of "you'll be alright, there's nothing to worry about" but then letting him stay home from school, for example.
The difficult part of implementing this is just that- it's hard! Dr. Eli Lebowitz discusses how much of accommodation is 100% natural (at first) and it isn't easy to recognize it by yourself, and it is especially not easy to change the habits that have been building over the years. This is certainly possible, just more difficult to do it alone. That is one of the reasons we'd encourage coaching or parent support with a trained SPACE provider to partner alongside you.
If you are limited on resources or time or just prefer to still do it by the guidance of the book (which is essential and I always ask parents to buy if we are doing SPACE together!), My advice would be to start collecting detailed data. Before trying to change anything start looking at the details of your day and ask the questions: would I like to change this behavior (parent's behavior, NOT child's behavior), would I do this if my child have 0% anxiety, did I do this with other children, and lastly, what would happen if I didn't do this? These are all questions Dr. Eli recommends exploring to discover which behaviors are accommodations and you're likely so used to doing them, that they're hard to pinpoint. Then, choose the one thing you feel would benefit you and your child the most. ("If my child could handle this ONE thing better, I'd be happy I did this challenging endeavor") This will be your target problem to tackle. The rest of the process requires further planning, preparation, and additional support to implement. I believe in you!
If you're looking for additional support and you're in any of the states participating in PSYPACT, I would be happy to help you with this process via telehealth. If you're looking for other providers you can look for some SPACE-trained providers via this website SPACE Providers | SPACE Treatment and I encourage you to invest in some parenting coaching/support through this process. No one was meant to do this life alone :)
Wishing you the best!
-Amanda Mendez, Psy.D.
amendez@nashvilleneuropsychology.com