When an adolescent is experiencing anxiety, it is important to consider if and how the parent’s own internalizing symptoms influence their perception of their child’s anxiety. Internalizing symptoms include anxiety and depression, as these include negative thoughts and feelings turned inward on the individual. Externalizing symptoms include aggression and bullying as these behaviors are directed outwards towards other people. Researchers have found that parents and adolescents tend to disagree more between internalizing than externalizing behaviors, as they are less visible. When parents and adolescents disagree on the severity and level of impact anxiety has on the child’s life, the disagreement can become an obstacle to psychiatric services.
Several factors can influence this disagreement, but one study in particular found that higher maternal and paternal depressive symptoms, but not anxiety symptoms, were associated with lower parent-adolescent agreement on the child’s anxiety symptoms. This means that parental internalizing symptoms may impact how they perceive their child’s symptoms, but they do not necessarily impact how the child views their own symptoms. This leads to a disagreement between how much the anxiety is actually interfering with the child’s life making the child feel resistant to treatment.
Family therapy can be beneficial in helping each member explore how the child’s anxious and depressive feelings may be linked to their parent’s mental health functioning. Family therapy is most effective when each person is present and engaged in sessions. Acknowledging that every member of the family will have a different perception on the child’s presenting problem will help identify treatment goals, skills to work on, and symptoms to address. Having each individual on the same page will allow progress in treatment to be obtainable.