Overview

Feelings of anxiety are common in children and adolescents. These include fears about harm to themselves or loved ones, vague “worries,” distress or “butterflies” when they are asked to engage in a feared activity, or concerns such as a headache or stomachache, associated with fears.

A certain level of anxiety is typical in some circumstances, such as new situations (and high-stakes testing of adolescents), and naturally protects against real dangers. However, anxiety can sometimes keep young people from activities that are important to their development. It is important to help children cope with their fears instead of avoiding the things that make them fearful.

General Ways to Help Your Family Manage Anxiety

• Seek help from a trusted friend or professional counselor if your own worries may be contributing to your child’s distress.
• Be sure that both the adults and the young people in your family are getting enough sleep, which is extremely important to mental health and resilience.
• Place limits, appropriate to your child’s age, on screen time (for example, TV, computer, and cell phone time) and monitor for content that is upsetting to your child.
• Encourage healthy routines such as family meals, physical activity, and “special time” with you (see ideas in the Share Special Time section below) that help children and adolescents become more resilient to stress.
• Consider doing yoga as a family: it is a healthful, calming activity that all age-groups can enjoy together, indoors or out.
• Encourage mindfulness practices: they involve being purposefully aware of one’s emotions, senses, and thoughts at a particular time (they are techniques that can be demonstrated within 2–3 minutes). Mindfulness apps for children and adolescents include Sesame Street Count, Breathe, Relax (https://sesamestreetincommunities.org/activities/count-breathe-relax) and Inner Explorer (https://innerexplorer.org).

In addition, try one or more of the following activities:

Activities to Help Young Children

Blowing Bubbles

• Encourage your child to take slow, deep breaths to produce as many bubbles as possible.
• Do this at least once a day, or as often as needed.

Modeling Clay

• Have your child knead, roll, pound, and shape the clay.
• Do this at least once a day, or as often as needed.

Rubbing Textured Cloths

• Corduroy and silky cloths work best.
• Have your child rub a material that feels soothing.
• The material can be kept in a pocket or attached to the top or bottom of a desk.

Lotion

• Give a squirt of lotion to your child, and ask your child to calm themselves.
• Have your child give themselves a hand massage.
• Or you can give your child a hand massage.

Superpower Hands

• Ask your child to show you how to make fists.
• After a person makes fists, their hands rise up and their muscles tense.
• Have your child give a completely opposite response, by relaxing their hands.

“Big Daddy” Sunglasses

• You can help your child discuss things that are scary or embarrassing.
• Give your child a pair of big, inexpensive sunglasses to help provide some distance for the worries or fears.
• Once the sunglasses are on, no one can “watch” them talk about the “scary” thing or embarrassing behavior.

Superhero Comic Books or Movies

• Have your child choose a favorite superhero comic book or movie.
• Ask your child to describe the superhero and their superpowers.
• Have your child take on the superhero’s powers and use those to get through the scary situation.

Music

Have your child listen to soothing, relaxing, and meaningful music before a stressful situation, to calm themselves after a stressful situation, or at the end of the day to relax and help themselves get to sleep.

Glitter Jars

Fireflies and Mud Pies “How a Glitter Jar Can Help Kids Control Their Feelings” (www.firefliesandmudpies.com/glitter-timers)

STAR Breathing Charts

• Coping Skills for Kids “Deep Breathing Exercises for Kids” (https://copingskillsforkids.com/deep-breathing-exercises-for-kids)
• Conscious Discipline “Safe Place Breathing Icons” (https://consciousdiscipline.s3.amazonaws.com/Free-Resources/Printable-Posters-Tools-Activities/FREE-Printable-Safe_Place_Breathing_Icons.pdf)

Gradual Exposure

Gradually increase your child’s exposure to feared objects or activities, staying as calm and confident as possible yourself. If any step causes your child distress, coach your child to use a coping technique (above) that they have practiced.

• Help your child imagine or talk about the feared object or activity or look at pictures.
• Support your child to learn to tolerate a short exposure.
• Encourage your child to tolerate a longer exposure in a group or with you or another coach.
• Encourage your child to tolerate the feared activity alone (when appropriate) but with a chance to get help, if needed.
• If anxiety is intolerable at any step, go back to a previous step.
• Praise and celebrate success.

Share Special Time

Share special, one-on-one time with your child. Even 10 to 15 minutes daily, without interruptions or use of electronic devices, will demonstrate your enjoyment of spending time together and offer you a break from your own tensions. Examples of activities you can do together include reading, cooking (for fun), outdoor play, and acts of gratitude or kindness to others, such as making a thank-you card for a teacher or taking cookies to a neighbor. (See “Family Handout: Guidelines for Special Time and Time In.”)

Helping Older Children and Adolescents

Model Behavior

Show your child or adolescent how to reduce anxiety and stress by thoughtfully assessing a challenging situation, tackling one small step at a time, engaging in coping strategies, and making sense of confusing or troubling things.

Teach Coping Strategies

• How to plan, mentally rehearse, and prioritize activities that are worrisome (eg, schoolwork, other responsibilities)
• Mindfulness
• Deep breathing
• Muscle relaxation
• Positive self-talk (for example, saying to themselves “You got this” or “That was smart”)
• Thought-stopping (suppressing, or pushing away, unwanted thoughts)
• Imagining themselves in a safe place

Encourage

• Listening to soothing music
• Participating in physical activity
• Spending time outdoors (especially in natural environments)
• Spending time with friends who have a calming effect (virtually during the COVID-19 [coronavirus disease 2019] pandemic)
• Spending time doing hobbies
• Helping others

Share Special Time

Share special, one-on-one time with your child or adolescent. Even 10 to 15 minutes daily, without interruptions or use of electronic devices, will demonstrate your enjoyment of spending time together and offer you a break from your own tensions. Examples of activities you can do together are taking a walk or bike ride, playing a board game, chatting about their day, and planning for an upcoming fun event. (See “Family Handout: Guidelines for Special Time and Time In.”)

With all the above activities, parents should notice and praise the child’s or adolescent’s progress.

Adapted in part, with permission, from Building Mental Wellness Learning Collaborative. Helping Your Child Cope With Anxiety. Ohio Chapter of the American Academy of Pediatrics; 2013. Accessed January 27, 2021. http://www.ohioaap.org/wp-content/uploads/2013/07/Helping-Your-Child-Cope-with-Anxiety.pdf. 

Derived in part from Bridgemohan C, Weitzman C. Pediatric anxiety: tools and resources for primary care. AAP News. December 14, 2018. Accessed January 27, 2021. https://www.aappublications.org/news/2018/12/14/anxietyresources121418. 

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