As a parent, you can help your child or teen learn techniques to manage his or her anxiety. Although it is always advisable to seek professional help, especially in more severe cases, help is not always readily available. Even if you do decide to seek help in managing your child's anxiety, you can still play a key role in helping your child.
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Although there are different types of anxiety problems and specific strategies aimed at helping children cope with different types of fears, there are some general strategies that can help any child who is experiencing anxiety problems.
Listen! Make sure you take the time to listen to your child's thoughts and feelings. Simply feeling heard can be very helpful to your child.
Normalize! It is important to let your child know that he or she is not alone. Lots of children have problems with anxiety.
Educate! Let your child know that anxiety is normal, harmless, and temporary.
Model it! Model facing fears and provide support and encouragement. Motivate your child through supportive coaching. However, be careful not to push your child too far too fast. Let your child work at his or her own pace.
Avoid Giving Excessive Reassurance! Resist giving excessive reassurance, instead encourage your child to use his or her coping strategies (for example, calm breathing or challenging scary thoughts)
Praise! Don't forget to praise your child for his or her efforts! Remember, facing your fears is not easy!
Step One: Learning about anxiety
This is a very important first step as it helps children and teens understand what is happening to them when they experience anxiety.
What they need to know about anxiety:
Anxiety is normal. Everyone experiences anxiety at some point in time. For example, it is normal to feel anxious when on a rollercoaster or before an exam.
Anxiety is adaptive as it helps us prepare for real danger (such as a bear jumping out of the woods) or performing at our best (for example helps us get ready for a test or big game). When we experience anxiety it triggers our "fight-flight-freeze" response and gets our body ready to defend itself (for instance, our heart beats faster to pump blood to our muscles so we have the energy to run away or fight off danger). Without it, we would not survive. Anxiety can become a problem when our body reacts in the absence of real danger. It can be helpful to think of anxiety as a smoke alarm. We don't want to take the batteries out of the alarm in case there is a real fire, but we do want to fix the alarm so that it doesn't go off every time we make toast.
For more information see the Talk to Your Child about Anxiety module.
Step Two: Learning to relax
The second step involves helping your child or teen learn to relax. Two strategies can be particularly helpful: calm breathing and muscle relaxation.
1. Calm Breathing: This is a strategy that your child or teen can use to calm him or herself down quickly. You can explain to your child that we tend to breathe faster when we are anxious. This can make us feel dizzy and lightheaded, which can make us even more anxious. Calm breathing involves taking slow deep breaths. Encourage your child to breathe in through the nose, pause, and then breathe out through the mouth, pausing several seconds before taking another breath. For younger children, have them imagine that they are blowing huge bubbles that slowly rise and float away. Make sure your child's breathing is slow and gentle.
For more information see the How to Teach Your Child Calm Breathing module.
2. Muscle Relaxation: Another helpful strategy is to help your child or teen learn to relax his or her body. This involves having your child tense various muscles and then relax them. You can also have your child use "the flop," which involves having your child imagine that he or she is a rag doll and relax the whole body at once.
For a detailed description of muscle relaxation see the How to do Progressive Muscle Relaxation module.
Step Three: Challenging scary thoughts
The next step is specifically targeted to older children or teens. When we are anxious, we tend to see the world as very threatening and dangerous. However, this way of thinking can be overly negative and unrealistic. One strategy for helping your child manage anxiety is to help him or her replace "anxious" or "worried" thinking with realistic thinking. This involves learning to see things in a clear and fair way, without being overly negative or focusing only on the bad. These strategies are aimed at older children or teens because some of these ideas can be more difficult for younger children to understand. However, remember that learning to think realistically can be difficult at any age, so give your child some time to learn and practice these skills. For more information on helping your child identify and challenge scary thoughts see the Realistic Thinking for Teens or Healthy Thinking for Younger Children modules.
Note: Younger children may have a harder time identifying exactly what they fear; however, they can benefit from coming up with some coping statements that they can say to themselves to help them deal with feelings of fear or anxiety. For example, "It won't go on forever, it will end."
Step Four: Facing fears
The final step in helping your child manage anxiety involves helping your child face his or her fears. If your child has been avoiding certain situations or places due to fear, it will be important for him or her to start entering those situations or places. However, it can be easier for your child to start with something that is not as scary and work up to situations and places that cause a great deal of anxiety. Working with your child or teen, make a list of feared situations or places, such as going places alone, entering a crowded grocery store, or riding the bus. Once you have made a list, try and arrange them from the least scary to the most. Starting with the situations that cause the least anxiety, encourage your child to repeatedly enter the situation and remain there until your child notices his or her anxiety start to come down. Once your child can enter that situation without experiencing much anxiety, he or she can move on to the next thing on the list.
For more information please see the Helping Your Child Face Fears - Exposure module.
Reduce Stress! Excessive stress and tension in your home (for example, arguing, fighting, too many lessons/activities, etc.) can have a negative effect on your child. Look at ways to reduce stress. For instance, plan some fun time each day (even if it is only five minutes) to read a story, go for a walk, watch a favorite TV program together, or listen to music. Also, try to deal with conflict between family members when it arises (have family meetings to discuss problems). Parents also need to be careful not to express frustration or anger by arguing or raising voices around their children.
Make a Routine! Establish a routine by setting specific times for meals, homework, quiet time, and bedtime. Help your child establish a bedtime routine, which may include a bath and reading a story, or just time to chat. This can set the stage for helping your child develop better ways to manage anxiety.
Work Together! It is important that you and your partner work together to help your child manage his or her anxiety. If parents are not consistent, it can be very confusing for your child. Try to agree on ways of handling your child's anxiety (for example, both agree to limit giving reassurance or both follow through on setting limits, such as not having your child sleep in your room), and be consistent in terms of rewards.
Give Consequences! Although your child may have problems with anxiety, that does not give him or her the green light for inappropriate behavior. It is important that you set expectations and limits for your child, and follow through on consequences for inappropriate behavior (such as losing television privileges for not completing chores). Set clear limits and consequences for inappropriate behavior, and discuss this in advance with all family members at a calm time. Children are happier when they know the rules and what happens when they break them! Be sure to give rewards and praise when your child is adhering to expectations.
Be Supportive! Recognize that it is difficult for children to face their fears. It is important not to laugh at your child or minimize his or her fears (for example, "don't be silly" or "you're being stupid"). Rather, let your child know that it is normal to have fears (we're all afraid of something), and that it is possible to "boss back" your fears. When your child is upset, make sure to listen to him or her, to send your child the message that it's okay to talk about feelings. Let your child know that he or she is understood, and help him or her figure out ways to cope with upsetting situations (for example, "I know you feel scared to go to Pam's place by yourself, but you're working on getting comfortable being away from home. How can we make this easier for you?"). It can also be helpful to use some humor when dealing with the world. We all benefit from finding the humor in things and being able to laugh at life's mistakes.
Encourage Independence! Although it is tempting to want to do things for your child, especially when he or she tends to be nervous and fearful, it is better to let kids do things for themselves! How else will they learn the skills and abilities to cope with life? Encourage your child to try things on his or her own, take some risks, and do things for him or herself. This can include giving him or her responsibilities around the house (cleaning own room or setting the table). It can also include helping your child brainstorm ways to deal with problems or difficult situations (such as how to handle an argument with a friend or make up marks at school for missed assignments). Encouraging independence does not mean you can't be supportive, but it means that you shouldn't take over or do everything for your child.
Avoid Giving Excessive Reassurance! It can be hard not to give your child reassurance, especially when he or she is scared or anxious; however, giving constant reassurance prevents your child from learning how to cope on his or her own. Teach your child to answer his or her own questions. Model how you think through problems or challenges, which helps your child learn to do it him- or herself.
Build Self-Confidence! It is important to praise your child for his or her accomplishments and for facing fears! Involve your child in activities that help him or her feel proud. Find activities that reinforce that he or she is good at something (sports, music, or art) and helps instill a sense of belonging and pride (such as cadets, scouts or girl guides, school helper). You can also give your child responsibilities around the house and let him or her be in-charge of something at home (for example, making sure the dog gets a long walk everyday).
Realistic Expectations! It is important to have expectations for your child and help him or her meet those expectations; however, understand that an anxious child will have some trouble doing things, and may need to go at a slower pace. Help your child break down goals into smaller steps that he or she can accomplish. It is important that your child is taking steps forward, even if the steps are small. Try not to push too hard or too fast, but let your child go at his or her pace.
Reactions! Although it is important to be understanding and caring, do not overreact or let anxiety trick you into thinking that something is too hard or impossible for your child (for example, thinking it's too hard for your child to sleep alone). Keep things in perspective. Yes, it might be challenging, but it can be done! On the other hand, sometimes we have a hard time understanding our child's anxiety or why something is so difficult for him or her. When we don't acknowledge that our child is having a hard time with anxiety, the child may try to hide it (and suffer alone) or the symptoms may become more pronounced, in order to get the attention he or she needs.
Dealing with Your Reactions! It can be very difficult dealing with an anxious child. Make sure you manage your own reactions. Do some things for yourself (call a babysitter, run a hot bath, read a book when the kids go to bed, talk to a friend about how you're feeling, go for a walk, or whatever helps you keep a positive perspective). Remember the basics: eat well, get enough sleep, and exercise! Also, give yourself permission to take time off. You can't be helpful to your child if you don't take care of yourself. You also need to be careful not to pass fears on to your children. Try to present a neutral reaction to situations and let you child know it's safe to explore things.
Take Risks! Anxious children need to try new things and take some risks, in order to build confidence and develop the necessary skills for dealing with the world. Encourage your child to try some experiments, such as making a phone call, talking to an unfamiliar classmate, or asking a question to a store clerk. Remember, you can model brave behavior by trying new things too!
Avoid Avoidance! Anxious children tend to want to avoid things that cause them anxiety. Although avoiding things temporarily reduces distress, it also allows fears to grow and makes things more difficult in the future. Avoid letting your child avoid things. Instead, encourage him or her to try things and take small steps towards facing fears!
Anxious children and teens prefer to have a sense of control in their lives. They do not cope well with a disorganized, "spontaneous" family style. They feel calmer when:
life is predictable
they know what is expected of them
they know what the consequences will be
Two ways to help make life more predictable for everyone in the family are setting limits and creating routines.
Setting limits is a challenge for parents, especially when the anxious child or teen becomes upset, moody, or has a 'meltdown'. If limits are repeated and enforced, they help everyone feel more secure and, usually, a child or teen's behaviour will improve. It can be a relief to have adults in charge!
Routines also help to reduce anxiety. But anxiety tends to disrupt routines. You need to work hard to build family routines so life is more predictable for your child. Help your child adjust to new family routines by preparing him or her in advance. Ask your child to help plan the new routine, and introduce it gradually. Making an attractive schedule for the fridge provides a sense of control and order.
This includes bedtime routines! A bedtime routine involves doing the same things, in the same order, at the same time, just before going to bed. This ritual helps your child gradually relax and wind down. For both your child and the rest of the family, a routine that lasts about 15 to 30 minutes is best. However, stimulating activities should start to wind down about an hour before bed (e.g. turning computer games off).
Some activities you can include in a routine:
some warm milk or a snack
a warm bath
let your child choose what pajamas or nightdress to wear
read or tell a story
with young children, you can tuck your young child in with a blanket, teddy bear or some other thing that makes him or her feel secure
For older children and teens, you may want to include:
some one-on-one time to talk about the day
listening to some soft music
reading magazines together
practicing some relaxation tools (e.g. progressive muscle relaxation)
It is important you do not get into the habit of permitting your anxious child to sleep in your bed. This becomes a habit which is hard to break. For more information on how to handle this situation, see Sleepling Alone or Away from Home for what to do when your child insists on sleeping in bed with you.
Plan time for homework and projects: This needs to be a regular part of the schedule, as anxious children tend to put things off. Anxious children can easily become overwhelmed with a task. Thus, it can be helpful to:
Break the task into small, manageable steps
Set a specific time and place to work
Praise and rewards for each step completed
Often the hardest part is getting started, so knowing that the TV program is on afterwards, or having computer time to look forward to can help motivate your child.
If your child is anxious about an upcoming event or project, you can adapt the Climbing My Fear Ladder form to break down the "goal" into manageable steps. Goals that work well with this activity are events that require preparation and/or performance (e.g. test, oral presentation, recital, job interview etc...).
Encourage physical activity: For the anxious child or teen, exercise may help reduce stress and induce relaxation. They often feel "tired all the time" because they are always exhausting themselves with worry, and don't feel like exercising. But exercise will improve energy and reduce worry. Try to find something fun to do together rather than making this a chore. Ongoing participation in a physical activity program encourages self-discipline, leadership, as well as opportunities to socialize with peers. Get the whole family involved!
Food and Nutrition: No one copes well when they are tired or hungry. Anxious children and teens often forget to eat, don't feel hungry, or have upset stomachs. They rarely eat a large full meal. It's okay for your child to "graze" as long as the snacks cover the basic food groups in a day. Offer frequent, nutritious snacks. Instead of stocking up on chips and soda, have fresh fruits and vegetables and low-fat dairy foods available in your fridge or kitchen. As much as possible, make meal time "family time" and sit down and eat together.
Last but not least, be a good role model! One of the first steps in creating a positive and predictable environment is to take stock of your own daily habits and ways of coping with your own anxiety. Use the coping tools to manage your own anxiety and share appropriate examples with your child. After all, you are the single biggest influence on your children!