Anxiety Management Strategies for Children

As the last days of August were drawing to a close, Ashley could already see the change taking place in her 10 year old son David. All summer long he was a typical carefree child enjoying the freedom of summer vacation. Now, with September just around the corner and the beginning of school immanent, David’s adventurous and carefree attitude was replaced with complaints of feeling sick and wanting to stay home. It was always like this when school started. Ashley, feeling discouraged, wondered what she could do to help her son overcome the anxiety returning to school caused him.

Below are a few basic strategies which can be taught to children to help them better manage their feelings of anxiety.

1. FEELINGS – teach children an emotional vocabulary.

Children with anxiety often keep their fearful thoughts and feelings to themselves. In this situation, Ashley could help David express his feelings more frequently. This expression of feelings would help to relieve some of David’s worries while also giving Ashley a glimpse into his world.

Hint: For younger children, or children with special needs, cartoon facial expression charts (Google – images – cartoon facial expression charts) can be used to expand their emotional vocabulary. For both younger and older children, make discussion of feelings a regular part of daily discussion. This is done most effectively by verbally observing how your child appears to be feeling at any given moment (i.e. “You seem a little …. What’s happening?”) Asking “How are you doing?” is less useful as it tends to elicit the conditioned response “fine”, with no further elaboration to follow.

2. THOUGHTS – teach children to recognize what is positive vs. negative self-talk.

Self-talk is the ongoing dialogue we have with ourselves. It is a part of our regular flow of thoughts. Learning to manage our thoughts, especially negative self-talk, is essential to controlling our feelings. Our thoughts stimulate our imagination and fuel our emotion. Unchecked, our thoughts can lead us down paths which are often unproductive. This is especially true when the meaning we attach to a situation is laden with negative self-talk and catastrophic expectations. These catastrophic expectations are the result of “thinking traps” which we fall into. Thinking traps are often characterized by all-or-nothing thoughts which distort the way we see and interpret situations and events, causing us to become fearful and avoidant.

In David’s situation, Ashley could help him recognize when he is engaging in negative self-talk. She would do this by paying attention to his behavioiur and verbalize what she believes he may be thinking and feeling:

“David, you look worried, are you thinking about school again?” “I wonder if maybe you’re thinking scary thoughts about going back. Could you tell me about them?”

…”Thank you for sharing”. “I wonder if you might be falling into some thinking traps {identifies them]. ” What are some more positive and realistic things you could tell yourself which might help you to feel a little less worried” [helps David list them].

By helping David to catch and change his self-talk, Ashley has given David a means of reducing his level of fear. This catching of thoughts is a form of what is known as mindfulness. (i.e. learning to think about your thinking, notice what you notice), and is perhaps the most effective strategy we can teach our children to help them manage their feelings of anxiety.

Hint: anxietybc.com is an excellent website which offers free information and exercises to help manage anxiety. Make sure to check out the self-help toolkit which provides tools to recognize “thinking traps” and to change negative self-talk to positive self-talk. Another excellent resource produced at BC Children’s Hospital is Taming Worry Dragons which also has a companion workbook available.

3. COURAGE – teach children to build their courage muscles by facing their fears in small, incremental steps.

Courage has been defined as “feeling the fear and doing it any way”. When we practice courage we consciously force ourselves to do something we fear doing. This goes against our instinctual desire to avoid a perceived danger. This instinctual desire is known as the “fight or flight response” and is, generally speaking, normal and healthy. The problem with the fight or flight response is that for some people it can be triggered even when there is no real danger – like a false alarm. Under these circumstances, what tends to cause these false alarms is negative self-talk and an active imagination which perceives danger where none exists. By practicing courage we face the fear and prove the threat to be hollow. By doing this repeatedly, in small incremental steps, we become less fearful as a whole so that what used to scare us no longer has the same punch.

For David, Ashley should start preparing early. If possible, she could explain the situation to the school and have him meet his new teacher and visit his new classroom before the first day of school. She could learn more about what will be happening in the first term and give David a jump on what to expect. Once school starts, she may be able to make arrangements for him to come into the class early to help out, thus avoiding some of the worry he would be likely to experience waiting in line. This would only be a temporary measure so as to help him transition back into the school routine.

Hint: to face a fear in incremental steps a fear ladder can be used. A fear ladder is a type of chart which lays out the steps one can take to systematically move out of one’s comfort zone and overcome a fear. See anxietybc.com self-help tool kit. When using a fear ladder with younger children, consider using stars or tokens – each time the child makes an effort to move one rung up the ladder, a star or token can be added to the chart showing their increased courage.

Additional strategies exist which, in addition to the three basics strategies already mentioned, are very effective in helping children overcome their fears. These additional strategies will be discussed in part two of this article, which is to appear in the next issue Psychealth.