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The stepladder approach is a step-by-step way of helping with anxiety in children. It’s based on the principle of ‘graded exposure’. This means starting off small, tackling the little things before you face the really scary things.
Anxious preschooler and her mother
 

Using the stepladder approach for anxiety in children

The stepladder approach works like this:

  • Start with a situation or thing that causes your child the least anxiety. Sometimes you might need to put your child in this situation a few times until he feels comfortable with it.
  • Move on to another situation that makes him feel a bit more anxious. Again, go through it a few times until he can handle it.
  • Gradually move through more and more challenging situations.

When using the stepladder approach for anxiety in children, it’s important to encourage your child by giving lots of praise for achieving each step on the ladder.

You can also use rewards as incentives for your child to move forward. Rewards might include an extra book in the evening, more cuddle time with you, or a trip to the park. Make sure the reward matches the degree of difficulty – for example, don’t give a small reward for the most difficult step.

Note: the stepladder approach can be used with children of all ages. Grown-ups can use it too.

Coping in difficult situations
You can help your child develop some tricks and strategies for coping in anxious situations:

  • Younger children (3-6 years): help your child to come up with a phrase she can say when she’s in an anxious situation. For example, ‘I can be brave’, ‘This is a friendly dog’ or ’Mummy will come back’.
  • Older children (seven years or older): your child might learn more quickly during the steps on his ladder if you help him to think realistically. For example, encourage your child to ask himself questions such as, ’What happened last time?’ and ‘How likely is it that it will happen?’

Being a role model
Children learn how to cope with difficult situations by watching other people (their role models) and listening to what those people say. So think about how you act and what you say in situations that you find stressful. For example, you might want to avoid saying things like, ‘A spider! You should stay away from spiders. They can kill you, you know’.

Benefits of the stepladder approach

  • Children get used to facing the situations that make them anxious. This is better than avoiding them.
  • Children face their fears and find out that they might not be so bad after all.
  • Children get to use and practise the skills and techniques that they’ve developed for coping.
  • Children get a great sense of achievement as they progress ‘up’ the stepladder.
Below you can read through some sample stepladders. The idea is for you to adapt them to your child’s age and particular fear or anxiety. If you’re unsure about how to do this, consider talking to a professional – perhaps a child and family health nurse, GP, school counsellor or child psychologist.

Stepladder 1: a four-year-old with social anxiety

This child is afraid of meeting and talking to new people. Here is a stepladder that might help her overcome her anxiety.

This child could be encouraged and rewarded to:

  1. Say ‘hello’ to one friend that she has met a few times.
  2. Say ‘hello’ to a child she doesn’t know at the park.
  3. Say ‘hello’ to the person at the supermarket checkout.
  4. Say ‘hello’ to an adult she has just met.
  5. Say ‘hello’ to an unfamiliar child at preschool.
  6. Say ‘Hello – can I play with you?’ to a child she doesn’t know at the park.
  7. Talk to a child she doesn’t know very well at preschool about what they did on the weekend.
  8. Visit a new group or class and say ‘hello’ and ‘goodbye’ to one of the children in the class.
  9. Visit the new group or class and talk with one of the children in the class.
  10. Visit the new group or class and talk with two of the children in the class.

Stepladder 2: a seven-year-old with separation anxiety

This child is fearful of leaving his mother, even for a short time. At the start of the stepladder, this child can’t sleep alone and sleeps in his parents’ bed.

This child could be encouraged and rewarded to:

  1. Stay inside and play while Mum puts the washing on the line.
  2. Stay in his bedroom and play for half an hour while Mum is in a different room.
  3. Stay at home with Dad while Mum visits the next-door neighbour for 10 minutes.
  4. Sleep on a mattress on the floor (next to Mum and Dad’s bed).
  5. Stay at home with Dad while Mum goes shopping for half an hour.
  6. Stay at home with Dad while Mum goes out to lunch.
  7. Sleep on the mattress on the floor but move it closer to the door (away from Mum and Dad’s bed).
  8. Stay at home with an aunty while Mum and Dad go out for lunch. 
  9. Stay at home with Dad while Mum goes out for the night.
  10. Stay at home with an aunty while Mum and Dad go out for the night.
  11. Sleep in his own bedroom.
  12. Stay at home with an aunty (and sleep in his own bedroom) while Mum and Dad go out for the night.

Stepladder 3: an eight-year-old with generalised anxiety

This child fears being late, especially for school. She also constantly asks questions such as, ‘What’s the time?’, ‘Are we going to be late?’ and ‘What will happen if I’m late?’

This child could be encouraged and rewarded to:

  1. Arrive only five minutes early to music class (and ask only two questions about being late).
  2. Arrive on time to a friend’s house (and ask only two questions about being late).
  3. Arrive five minutes late to another friend’s house (and ask only two questions about being late).
  4. Arrive at school five minutes before the bell goes (and ask only one question about being late).
  5. Be late to a music lesson by one minute (and ask only one question about being late).
  6. Arrive at school one minute before the bell goes (and ask only one question about being late).
  7. Be 15 minutes late to visit a friend’s house (and ask no questions about being late).
  8. Arrive at school as the bell goes (and ask no questions about being late).
  9. Arrive five minutes late to music (and ask no questions about being late).
  10. Arrive at school 10 minutes after the bell (and ask no questions about being late).
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  • Last Updated 20-08-2009
  • Last Reviewed 14-05-2014