McLean Hospital 115 Mill Street Belmont, MA 02478
The children and adolescents who attend the McLean Anxiety Mastery Program (MAMP) often have lives that have gone painfully off-track: the high school senior whose perfectionism crowded out everything else in her life; the boy whose fear of germs rendered him unable to attend school for months; the teenager who was petrified of vomiting; and the 12-year-old girl with social anxiety who clung to her mother and wouldn’t talk above a whisper.
Launched in April 2014, MAMP works with clients, ages 7 to 19, who suffer from crippling anxiety in all of its forms: social anxiety, phobias, panic attacks, separation anxiety, agoraphobia, and obsessions and compulsions. Clients attend the Cambridge-based program four afternoons a week, from 2-4:30pm, for at least one month. Unlike more typical programs for youngsters with anxiety, MAMP is intensive and multi-dimensional in its approach.
“When they arrive with us, many of our kids are so debilitated by their anxiety and depression that they’re no longer going to school and instead are at home, often doing nothing but sitting on the couch all day,” explains Program Director Kathryn D. Boger, PhD.
“Their social and family relationships are impaired and there’s a cascading effect: anxiety leads to depression and this results in social isolation. They fall off the developmental curve and end up with a lot of losses along the way.”
MAMP donor Tory Vallely, who has suffered from anxiety along with members of her family, said it has been very gratifying to fund an innovative anxiety treatment program in its early stages. “I like being a seed funder, helping a good idea come to fruition,” she says.
Medical Director Mona Potter, MD, said that child and adolescent programs like MAMP are dependent on philanthropy because the treatment is often complex. “We spend a significant portion of time communicating and coordinating care with families, schools, and outside providers, and insurance reimbursement is exceedingly limited,” she says. “We are very grateful to Ms. Vallely for increasing our ability to deliver excellent care.”
Philanthropic support for the program has also been provided by the John W. Alden Trust and an anonymous donor.
MAMP takes a multi-pronged approach to treating anxiety. During the first hour of the afternoon, participants learn how to combat their anxiety through cognitive behavioral therapy skills training and exercises—learning to identify and reappraise self-defeating thoughts, applying mindfulness and relaxation strategies, and practicing applying relapse prevention skills to maintain gains over time. Outdoor activities get these mostly sedentary kids moving and having fun, while helping to alleviate their depression. Even snack time has a purpose: kids have an opportunity to practice the simple act of socializing.
The remainder of the afternoon is spent doing exposures. Youngsters work 1:1 with staff or in small groups of peers with similar presenting issues, and they put themselves in situations that elicit anxiety to learn that they can handle them. The tasks can be humorous—asking a Starbucks barista where the closest Starbucks is, dancing in a crosswalk, parading around in crazy hairdos and odd clothes—or ordinary: touching “contaminated” objects or going to the school a student has avoided for months to inure him to an environment that induces panic.
“The idea is to take away the power of the feeling that comes up when they do something uncomfortable,” explains Potter. “They realize that they’re okay and that they can handle it. Soon, it’s not such a big deal. And it becomes a real bonding experience for the kids.” The youngsters also receive exposure homework to do at home or at school. For example, the perfectionist teenager was tasked with purposefully giving wrong answers in class.
Parents meet together once a week to learn about the treatment and how they can support their children as well as to share experiences. Every Tuesday is family day, when participants and their parents meet with a psychologist and psychiatrist to discuss progress, family-related issues, and medication management.
“The majority of kids get back on track and do remarkably well,” says Boger. “It’s amazing how far they come.” Case in point: the girl with social anxiety who wouldn’t talk above a whisper hosted a carnival in her backyard that was attended by 50 people. She had a fantastic time.