Q: Please recommend how to help a child deal with anxiety. My daughter gets herself very worked up, throws up and suffers until she finally works through her problem over the course of several weeks.

A: It does seem I am receiving more frequent questions about anxiety in children. Perhaps more parents have become sensitive to their children's feelings, and that is a good thing. Your daughter's anxiety seems to be more extreme than that of most children. Throwing up about fears can put both parents and children over the edge. Physical involvement always complicates even simple issues.

When children worry about outcomes, we often ask them about what they think is the best thing that could happen and what is the worst thing that could happen. Then we talk about how likely each of those is to happen to help them be realistic about their fears. Once we decide together about their realistic goals, we help them set a path toward accomplishing their goals and together agree on some tools that will help them to get there. For example, if they are behind in their homework and they fear they will fail, we can help them map out a time and a place to accomplish what they need to. We help them to break down their assignments into parts and place those parts on the calendar so that they can accomplish them one at a time. The final tools they may need are related to whom they might ask for appropriate help if they don't understand some material.

Some examples of issues that kids get anxious about are friendships, going to the dentist, preparing for recitals or plays, mean or bullying kids, going to new places, and being left out of parties. After parents have helped them to set a step-by-step plan toward accomplishing a reasonable goal several times, the children can learn to plan those steps on their own and gradually become brave and strong.

Though it is true that children are born with different temperaments and some children may be more fearful than others, all children can gradually learn to cope with their worries and fears, at least somewhat. Obviously, there are some fears that are more difficult to cope with than others. Parents' role is to help their anxious children to gradually become stronger. The difficulty is that anxious children often have at least one anxious parent. That parent sometimes makes the mistake of overprotecting an anxious child, but I know that does not describe you, so I'm glad you asked for help.

Dr. Sylvia B. Rimm is the director of the Family Achievement Clinic in Cleveland, a clinical professor of psychiatry and pediatrics at the Case Western Reserve University School of Medicine, and the author of many books on parenting. More information on raising kids is available at www.sylviarimm.com. Please send questions to: Sylvia B. Rimm on Raising Kids, P.O. Box 32, Watertown, WI 53094 or srimm@sylviarimm.com. To read features by other Creators Syndicate writers and cartoonists, visit the Creators Syndicate website at www.creators.com.