When your child is anxious, every instinct tells you to make the bad feeling go away. You reassure them. You let them skip the party. You sit with them until they fall asleep. These are loving responses, and in the moment they often work.
The trouble is that anxiety tends to grow when we keep stepping around it. The good news is that parents have a lot of power here. Some of the most helpful changes happen at home, in small everyday moments.
What does anxiety look like in children?
Anxious children don’t always say “I’m worried.” Often it shows up sideways. According to the Child Mind Institute and the CDC, you might see:
- Body complaints. Stomachaches, headaches, a racing heart, tiredness. A child might feel sick every Sunday night or before every test.
- Avoidance. Refusing to go to school, to birthday parties, or to sleep in their own bed.
- Clinging and reassurance-seeking. Asking the same question again and again (“Are you sure you’ll be there at pickup?”), or needing you close.
- Irritability and anger. Anxiety isn’t always quiet. It can look like tantrums or meltdowns, especially when a child feels cornered.
- Trouble sleeping or trouble concentrating.
Some worry is a normal part of childhood. The Child Mind Institute describes it becoming a concern when it’s out of proportion to the situation, doesn’t fade over time, or leads a child to avoid things most children their age enjoy.
Why “just avoid it” makes anxiety stronger
When a child avoids something scary, they feel relief right away. That relief teaches the brain, “Good thing we got out of there. That really was dangerous.” Next time, the fear is a little bigger.
Parents get pulled into this cycle too. Researchers call it family accommodation: the ways families change their routines to reduce a child’s anxiety. Answering the same question ten times, ordering for a child at restaurants, or letting them sleep in your bed every night are all examples. It comes from love. But over time, it can keep the anxiety going.
Research on changing how parents respond
One of the most interesting studies here tested a program called SPACE (Supportive Parenting for Anxious Childhood Emotions). In SPACE, the therapist works only with parents, not with the child. Parents learn to respond to their child’s anxiety with support, and to gradually reduce accommodation.
In a randomized trial of 124 children ages 7 to 14 with anxiety disorders, Lebowitz and colleagues (2020) compared SPACE with CBT delivered directly to the child. The parent-only program worked about as well as CBT at reducing children’s anxiety, according to independent evaluators, parents and children. Both treatments reduced family accommodation and parenting stress, and SPACE reduced accommodation more.
This doesn’t mean parents are to blame for their child’s anxiety. It means you are a powerful part of the solution.
What helps at home
Validate the feeling, then show confidence
A helpful habit is to give two messages together: “I understand this is really hard for you” and “I know you can handle it.” The first on its own can confirm the fear. The second on its own can feel dismissive. Together, they tell your child that their feelings make sense and that you believe in them.
A parent might say: “I can see you’re nervous about the sleepover. That makes sense, it’s new. I also know you can do hard things, and I’ll be right here in the morning.”
Don’t remove every scary thing
The Child Mind Institute puts it simply: the goal isn’t to eliminate anxiety, but to help a child manage it. Avoiding everything that makes a child anxious helps in the short term and strengthens the fear in the long term.
Face fears in small steps
Instead of all or nothing, break a hard thing into smaller steps. A child afraid of dogs might first look at pictures, then watch a dog from across the park, then stand near a calm dog on a leash. HealthyChildren.org recommends encouraging children to face feared situations gradually rather than avoiding them, and praising their effort along the way.
Watch how you ask questions
“Are you worried about the test?” can plant a worry. Try something open: “How are you feeling about the test?” Also try to keep the waiting time before a hard event short. Talking about a scary appointment for a week can make it bigger.
Show them how you handle worry
Children learn a lot from watching us. You might say out loud, “I’m nervous about my presentation, so I’m going to take a few slow breaths and remind myself I’ve prepared.” Taking care of your own stress helps too.
Calming skills to practice together
Calming skills work best when you practice them at a calm time, not in the middle of a meltdown. A few that many children like:
- Slow belly breathing. Pretend to smell a flower, then blow out a birthday candle. Or breathe with a stuffed animal on the tummy and watch it rise and fall.
- Five senses check-in. Name five things you can see, four you can hear, three you can touch.
- Brave self-talk. Help your child find a short phrase, like “I can do hard things” or “This feeling will pass.”
- Movement. A run around the yard, jumping jacks, or a walk can burn off some of anxiety’s energy.
For more ideas, see my article on grounding techniques for anxiety. Many of them can be adapted for children. Everyday basics matter as well: regular sleep, physical activity and predictable routines can all lower a child’s overall stress.
When is it time to get help?
Talk to your pediatrician, and consider a counselor, if your child’s anxiety:
- Keeps them from school, friendships or activities they’d normally enjoy
- Is getting worse, or hasn’t eased after a few weeks of trying these ideas
- Is disrupting sleep, eating or family life
- Comes with other changes, like withdrawal or low mood
- Leaves your child, or you, feeling stuck
The American Academy of Child and Adolescent Psychiatry notes that evaluation is worth seeking when anxieties become severe and interfere with things like separating from parents, going to school and making friends, and that early treatment can help prevent later difficulties with friendships, school and self-esteem.
Your pediatrician can also rule out physical causes for stomachaches and headaches. If your child ever talks about hurting themselves, call 911 in an emergency, call or text 988, or call the Washington County Crisis Line at 503-291-9111.
How therapy helps anxious children
Cognitive behavioral therapy (CBT) is one of the best-studied approaches for childhood anxiety. The CDC describes how CBT helps children change worried thoughts into more helpful ways of thinking and coping, and notes that parent involvement is key for younger children.
With younger children, I often bring these ideas into play therapy. In my playroom, a child can act out a scary situation with figures in the sand tray, practice brave steps through a game, or draw what their worry looks like. Play gives young children a way to work through feelings they can’t yet explain in words. Older children and teens usually prefer to talk, and I use CBT and mindfulness with them.
I also work closely with parents. I’ll share the themes I’m seeing and help you with the day-to-day part: what to say at bedtime, how to handle the morning school battle, and how to step back from accommodation without leaving your child feeling alone. You can read more about my approach to anxiety.
Talk it through with me
If your child’s worries are taking over more of family life than you’d like, you don’t have to figure it out alone. My office is in King City, a few minutes from central Tigard, and I offer a free phone consultation so we can talk about what you’re seeing and whether I can help. Call me at 503-495-5072 or send me a message.
Sources
- Lebowitz ER, Marin C, Martino A, Shimshoni Y, Silverman WK. (2020). Parent-based treatment as efficacious as cognitive-behavioral therapy for childhood anxiety: A randomized noninferiority study of Supportive Parenting for Anxious Childhood Emotions. Journal of the American Academy of Child and Adolescent Psychiatry, 59(3), 362-372. https://doi.org/10.1016/j.jaac.2019.02.014 (PubMed: https://pubmed.ncbi.nlm.nih.gov/30851397/)
- Centers for Disease Control and Prevention. Anxiety and Depression in Children. https://www.cdc.gov/children-mental-health/about/about-anxiety-and-depression-in-children.html
- Child Mind Institute. What to Do (and Not Do) When Children Are Anxious. https://childmind.org/article/what-to-do-and-not-do-when-children-are-anxious/
- Child Mind Institute. What Are the Signs of Anxiety? https://childmind.org/article/what-are-the-signs-of-anxiety/ ; and When to Worry About a Child’s Anxiety. https://childmind.org/article/when-to-worry-about-an-anxious-child/
- American Academy of Pediatrics, HealthyChildren.org. Help Your Child Manage Anxiety: Tips for Home and School. https://www.healthychildren.org/English/family-life/family-dynamics/Pages/help-your-child-manage-fears-and-anxieties.aspx
- American Academy of Child and Adolescent Psychiatry. The Anxious Child, Facts for Families No. 47. https://www.aacap.org/AACAP/Families_and_Youth/Facts_for_Families/FFF-Guide/The-Anxious-Child-047.aspx