Signs of Panic Disorder in Children (And How You Can Help)

Learn how to help your child cope with Panic Disorder in this handy guide for parents and caregivers. Photo by Ron Lach via Pexels.

“The only thing we have to fear is fear itself.” We’ve all heard this famous quote from Franklin Roosevelt before. And it’s a great message, right? Often, our fear holds us back from doing things that really wouldn’t be so scary, if only we faced our anxiety head on. But when a child is dealing with Panic Disorder, the “fear itself” is pretty terrifying! Sweaty palms, a racing heartbeat, rapid breathing, and lightheadedness can make kids feel like the world is about to end.

Fear not! This post will take a deep dive into panic disorder, so you can feel confident navigating your child through their next wave of panic. We’ll talk about how panic disorder works, review common signs and symptoms, and discuss what parents (and professionals) can do to help.

What is Panic Disorder?

Panic Disorder is a type of anxiety disorder that can affect both kids and adults. It’s much more common in teens than in younger kids, but can strike at any age. People who have panic disorder have experienced panic attacks (also called anxiety attacks), and struggle with the fear of having another one.

Panic attacks come on suddenly, and may or may not have a clear trigger. A child may have a panic attack because they’re extremely anxious about boarding an airplane: in this case, the trigger is clear! But a child could also have a panic attack come on seemingly out of the blue, while relaxing at home or hanging out with friends. Sometimes, panic attacks can even wake a child up in the night!

Panic attacks are frightening, and it’s common for kids (and even adults) to worry they mean something’s seriously wrong. The physical symptoms can feel like you’re losing control of your body and mind. Children may worry they’re having a problem with their heart or lungs, or might even fear that they’re dying or going crazy.

Understandably, kids who’ve had a few panic attacks can get really worried about having another one. Sometimes this leads to desperate attempts to avoid things they think might trigger a panic attack, or to stay away from places where they think nobody will be able to help them. When this starts getting in the way of life, we call it Panic Disorder.

How is Panic Disorder Different Than a Regular Panic Attack?

Many people have panic attacks: up to 35% of people will have one at some point in life. They can happen as a part of other anxiety disorders, like social anxiety, generalized anxiety, phobias, or even OCD. They can also happen by themselves, without any other mental health problems.

Panic disorder, on the other hand, is much less common. It affects about 4.7% of U.S. adults and about 1-3% of kids and teens. For kids with Panic Disorder, the panic attacks are the source of anxiety. Kids are worried about having more attacks, of something bad happening during an attack, or of having a panic attack in a place where they’re not able to get help.

If a child is worried about something else—dogs, germs, other kids judging them—and they’re having panic attacks as a result, that’s not Panic Disorder. If a child is worried about the panic attacks themselves, and is trying to avoid them in unhelpful ways, that’s Panic Disorder.

What Are the Symptoms of Panic Disorder?

The symptoms of Panic Disorder include multiple bouts of extreme anxiety, as well as worries about having more attacks in the future. Photo by Shvets via Pexels.

To get a diagnosis of panic disorder, kids need to have had more than one panic attack. A panic attack is a sudden, unexpected burst of extreme anxiety or fear that only lasts a short time, usually 10-30 minutes.

They don’t always have a clear cause and may seem totally out of the blue. During a panic attack, a child may notice 4 or more of the following symptoms:

• Sweating

• Shaking

• Rapid or pounding heartbeat, or feeling like the heart is skipping a beat

• Chest pain or pressure

• Upset stomach

• Feeling short of breath or like you can’t breathe

• Strange sensations, like heat, tingling, or numbness

• Feeling dizzy or lightheaded

• Feeling detached from reality

• Feeling as though something really bad is about to happen (impending doom)

Essentially, a panic attack sends your body into full on fight-or-flight mode with no warning, which causes these intense physical symptoms. Kids with panic disorder become so afraid of these attacks that they go to great lengths to try to prevent them from happening. This means you’ll also see the following:

• Worries about having another attack

• Concern about the meaning of the panic attacks or negative consequences they could cause

• Trying to avoid or prevent attacks in ways that lead to significant behavior changes

Once these symptoms have happened for at least a month, a child can be diagnosed with Panic Disorder.

Signs of Panic Disorder in Kids

Panic attacks might be easier to spot than some other forms of anxiety, but Panic Disorder can still look different for each individual kid. If you’re beginning to suspect panic may be to blame for your child’s difficulties, here are three examples to consider.

1. Maya has had a handful of panic attacks over the past few months: her hands start to sweat, then she starts hyperventilating and crying. She was sitting in Biology class one day when she noticed her palms getting sweaty, and asked her teacher if she could leave class. Her teacher asked her to wait for another student to return from the bathroom, and Maya had a panic attack. Maya’s teacher has apologized and reassured her that this won’t happen again. However, Maya doesn’t want to go back to class for fear that she’ll have another attack.

2. Mateo has heart palpitations with his panic attacks, and gets a terrible feeling like something bad is going to happen. He’s gone to the doctor for a checkup and has a clean bill of health, but he can’t shake the feeling that his panic attack could turn into a heart attack. He worries about this possibility all the time, and asks his mom for reassurance that there’s nothing wrong with his heart. Every time he feels the slightest twinge in his body, he worries it means another panic attack is coming.

3. Ash has only had a couple panic attacks, but they really left an impression on her. Each one felt like an emergency, and luckily her mom was close by to help. Even though she hasn’t had one in a little while, Ash is really nervous about going to summer camp or sleepovers with her friends, because she’s anxious about having a panic attack away from home. She worries what her friends would think, and who would help her to calm down. Ash friends have noticed she’s turning down their invitations, but Ash is too embarrassed to tell them why.

Even though their symptoms are different, all these kids are struggling with repeated, unexpected panic attacks. As if that wasn’t enough, their anxiety about the attacks is so big that it’s getting in the way of important parts of life.

What Do I Do If I Think My Child Has Panic Disorder?

It’s important to rule out any medical problems or lifestyle issues before settling on a diagnosis of Panic Disorder for a child or teen. Photo by Liza Summer via Pexels.

If you’re concerned your child is having repeated panic attacks, it’s a good idea to check in with their pediatrician first to make sure what you’re dealing with is really anxiety-related. There are some medical conditions that can mimic panic attacks, and you’d hate to brush something off as “just anxiety” that could be made better with medical care.

Conditions like tachycardia and POTS can affect your heart rate and blood pressure, causing palpitations and dizziness. A child complaining of shortness of breath should be checked out for asthma, just in case. The cause could even be as simple as having too much caffeine: it’s hiding in all kinds of sports drinks and energy bars these days, and it’s so effective at triggering panic attacks that scientists use it when they want to research panic.

Once you’ve ruled out any underlying medical stuff, you can rest assured that as scary as your child’s panic attacks may be, they’re totally safe. Many children worry that panic attacks will cause serious harm or lasting damage. Knowing this isn’t the case can be a relief.

Next, take a look at some of the strategies below to help your child cope with panic and get back to enjoying life.

Helping a Child with Panic Disorder

You've learned the symptoms, you’ve ruled out any medical causes…now that you’re sure this is Panic Disorder, how can you help your child cope? It’s painful to watch your child go through debilitating anxiety, and emotionally exhausting for everyone involved.

Fortunately, Panic Disorder is very treatable! We have ways to help kids and teens who are dealing with panic, and we know they work. Here’s how a parent or caregiver can help a child through panic:

1. Educate Your Child About Panic Attacks

   Part of what makes panic attacks so scary is how mysterious they are. They seem to come out of nowhere, with little to no warning. Even if they aren’t dangerous, they feel like they are. It’s important for kids to know that panic attacks are not dangerous, and that they’re the result of their body doing the right thing at the wrong time. The symptoms kids feel during a panic attack are the result of their fight-or-flight response kicking in, which exists to help us escape life-threatening situations. We want to be able to feel that adrenaline rush when we really need it—just not on the school bus.

2. Practice Regular Relaxation

   It never hurts to learn new ways to calm down your body and mind, especially when you’re dealing with any form of anxiety disorder. Coping skills like deep breathing, muscle relaxation, and guided visualization really can help a lot of kids—but they work better when you practice them regularly, instead of trying them only when you’re panicked. Just like with any exercise, regular practice helps your child’s nervous system get better at coming out of fight-or-flight mode and returning to calm. Download my free guide for more ideas!

3. Use Grounding Skills When Panic Strikes

   Many kids find that typical relaxation skills don’t work super well in the midst of a panic attack: it’s hard to get all noodly when there’s adrenaline coursing through your body. Your child may find they have better luck with grounding skills. These skills give your child something to focus on outside of themselves, so they’re not just fixating on their body sensations and anxiety. Any kind of strong sensory input, like holding an ice cube, tasting a sour candy, or splashing your face with cold water can be helpful for grounding.

4. Accept That Panic Happens

   You may be surprised to learn that our goal when treating Panic Disorder is not to eliminate panic attacks from a child’s life. That’s like trying to keep yourself from ever sneezing again: it’s a bodily function that’s mostly outside of your control. The more time we spend stressing about panic attacks, the more anxious we become. Interestingly, the more kids accept that panic sometimes happens, the fewer attacks they tend to have. You can remind your child that although panic attacks stink, they’re manageable, they’re not dangerous, and they always end.

5. Approach, Don’t Avoid

   Kids with Panic Disorder are so fearful of having another attack that they change their behavior and routines to try to protect themselves. This can look like avoiding places where they’ve previously had an attack, repeatedly checking in with parents about their worries, monitoring their body for signs of panic, or saying no to activities that feel too risky. The more kids avoid these places and activities, the worse their anxiety is likely to become. Over time, the list of “dangerous” places can get longer. We can help kids overcome their anxiety by gently helping them return to these off limits places, so they can prove to themselves that they’re not so dangerous after all.

Panic Disorder Therapy for Kids

Cognitive Behavioral Therapy gives kids and parents the tools they need to deal with panic when it strikes. Photo by Any Lane via Pexels.

You don’t have to keep living in fear of your child’s next panic attack. In addition to the tips above, meeting with an anxiety therapist can help your child recover from Panic Disorder and learn skills they can use to manage anxiety as they grow. Cognitive Behavioral Therapy is often called the “gold standard” for anxious kids because we have lots of research to show how effective it is. It’s my first recommendation for families looking for help with panic.

Many “find a therapist” directories allow you to search for therapists who use specific forms of therapy, so you can specifically seek out counselors who practice CBT. This kind of therapy is very focused on education and skills. You can expect to get “homework” to practice with your child between sessions, and to be involved in your child’s therapy process. Happily, kids who learn CBT skills often move through therapy a little more quickly than kids who do not.

I love using CBT to help kids with anxiety, both in my therapy office and online. This kind of skills based counseling works great over telehealth, especially with kids ages 8 and up. If you’re located in the Charlotte area, I’d be happy to meet at my Davidson office. If you’re somewhere else in North Carolina, New York, or Florida, I offer virtual sessions using a secure platform that works just like Zoom.

Ready to get started? Send me a message. You can also download my free anxiety guide to learn more coping skills you can start using right away.

What Triggers Anxiety in a Child?

Sometimes, a child’s anxiety seems to come out of nowhere. One day, everything seems okay, and the next day, boom! You’re begging them to leave the car to go to school. Other kids may have seemed anxiety-prone since toddlerhood: they were just always more sensitive than their peers. You may even have been told that their worries were just a phase. But here you are, years later, still dealing with the same fears.

When you’re trying to tackle anxiety, it can help to know the root cause. Whether you’re dealing with an all-of-a-sudden attack or an always-been-there anxious temperament, knowing what’s triggered your child’s anxiety lets you better help them to manage it.

Genetics + Life Experiences = Your Child’s Anxiety Risk

Stress affects all of us differently. It’s not always clear why one child may struggle with anxiety after a tough experience, when another gets through the same situation seemingly no worse for wear. It’s likely that our genes and life experiences combine to give each of us a unique way of coping with anxiety and stress.

We know that anxiety runs in families. Kids who have relatives with anxiety disorders are more likely to develop one themselves. This is true even if the types of anxiety are different within the family; for example, a chid who has many family members with generalized anxiety may have a slightly higher risk of developing OCD. Depending on the genes your child inherits, they may be more or less anxiety-prone from the start.

Even if your child has inherited some anxious traits, anxiety still needs an outside event to trigger symptoms. Big events, like moves and divorces, can do this. However, more day-to-day stress plays a part, too. In general, a child who has a strong family history won’t need as big of a stress to set off anxiety. On the other hand, a child with very little family history could still become anxious after a big enough trigger.

There are plenty of things parents and families can do to support a kid with anxiety—and sometimes best intentions can accidentally cause anxiety to grow. But there are so many factors that contribute to childhood anxiety that it’s never one person’s fault.

What’s a Trigger, Exactly?

“Trigger” has become a household word…and sometimes a word used to tease people who are deemed overly sensitive. So let’s clarify what exactly we mean when we talk about anxiety triggers.

A trigger is a catchall term for anything that sets off anxiety. Triggers can be physiological, like drinking too much caffeine if you’re sensitive to it. They may be sensory, like the sound of a fire alarm going off if your child has a sensitivity to loud noises. They can also be situational, like taking a test if you struggle with perfectionism. The pandemic has served as an anxiety trigger for many kids in recent years.

Triggers are unique to an individual. What triggers one person might not be an issue for another. Sometimes it can be hard to figure out what exactly is setting off anxiety for a child. It’s helpful to discover your child’s triggers so you can figure out how to prepare for potentially difficult situations in advance. The goal isn’t to avoid triggers forever, but to find ways to gradually learn to deal with them.

Sometimes, people talk about triggers as being the thing that set off a child’s anxiety in the first place. Other times, “trigger” is used to describe the day-to-day events that cause anxiety to flare up again. We’ll talk about both types in this post.

Any Big Life Change Can Trigger Worries

Predictabilty and routine help children feel safe. Knowing what’s about to happen next gives kids a sense of control in a world that often feels big and unpredictable. Anything—good or bad—that upends routines in a major way can lead to increased anxiety for kids.

This is one reason why so many kids are struggling with anxiety after covid, even if their loved ones haven’t been seriously affected. Even without major illness, the stress of household routines collapsing in on themselves during quarantine was a lot to cope with. It’s also why starting at a new school or moving to new town can set of anxiety, even if your child is excited about the change.

Here are some big changes that can set off anxiety for kids:

• Moving to a new place

• Divorce or remarriage of a parent

• The birth of a new baby

• The death or loss of a loved one

On a more day-to-day basis, these changes in routine can cause anxiety to flare up, too:

• Unexpected changes in plans

• Changes in a parent’s work schedule that affect their time spent at home

• Vacations or travel

• New babysitters or caregivers

Family Stress Increases Anxiety Risk

Kids are really good at picking up on family stress. Sometimes, a chlid’s anxiety is almost like a release valve for pressure that’s been building up at home. If a child starts showing new symptoms of anxiety, it’s never a bad idea to do a quick assessment of how you and the rest of the family are doing managing your own stress.

If children sense that things are a little tense at home, they may respond by clinging or getting more anxious when they have to be away from a parent. Kids instinctively want to be close to a parent during uncertain times, to make sure they stay safe.

Any major stress in a family will affect children too, such as:

• Intense, frequent fights between parents

• A family member’s chronic or serious illness

• Job loss or trouble with finances

• A parent or caregiver’s own mental health struggles

• Struggles with racism or other systemic oppression

If your child is sensitive to family stress, you may notice that their anxiety gets set off by everyday scenarios such as:

• Changes in family routines or plans

• Parents leaving the house for work or date nights

• Having to separate from the family, such as for school or a sleepover

• Seemingly minor arguments, disagreements, or discipline

Friend and School Drama Are Often Triggers

The older kids get, the more important friendships become in their lives. And these friendships can be pretty turbulent! On one hand, most kids are desperate to be accepted as part of a group. On the other, they’re still figuring out the social skills they need to manage conflict without escalating disagreements into full-on drama.

Kids have to juggle all this social stuff while also dealing with academic pressure that can feel overwhelming. Homework, college admissions, and even just getting to class on time can be stressors for kids.

School and peer issues like these can contribute to the development of anxiety troubles:

• Returning to in-person school after being online during Covid

• Bullying or social isolation

• Transitioning fo a new school building, such as the move from elementary to middle shcool

• Learning difficulties, low grades, or other academic problems

Kids may notice that smaller triggers like these set off everyday anxiety at school:

• Projects that require public speaking

• Testing, especially standardized testing

• Feeling judged for their appearance, clothes, or interests

• Having to navigate a large or complicated school building

• Not sharing many classes with familiar friends

Grief: A Surprisingly Common Source of Anxiety

Grief is often associated with sadness, anger, denial, and a whole host of other feelings. But when we think of grieving children, anxiety might not be top of mind. Losing a loved one often means a loss of stability for kids. Their routines are upended, a safe person is gone, and suddenly, they’re aware of the many unexpected dangers that can happen in life.

It’s normal for grieving children to experience separation anxiety while grieving, because keeping loved ones in sight feels more safe. Health anxiety is also common, since children may worry about whether or not they or a loved one could get sick or die, too. The stress of grief can also lead to more generalized worries, trouble sleeping, and body aches and pains due to anxiety, too.

Some types of grief that can trigger anxiety include:

• The death of a family member or close friend

• Losing a loved one due to estrangement, a move, or imprisonment

• The death of a pet

• The loss of a pregnancy in the family

Triggers related to grief, death, and loss can trigger kids on a more day-to-day basis, too. Grieving kids may notice their anxiety heighten when faced with situations such as:

• Scenes of violence, illness, or death on TV or in movies

• Mentions of suicide in health class

• Assigned school readings with themes of grief and loss

• Anniversaries and holidays that remind a child of their loved one

• Being away from caregivers

Illness, Accidents, and Trauma Can Lead to Anxiety

Highly stressful and traumatic events can also shake up a child’s sense of safety. Even if nobody gets seriously hurt, the experience of an accident or a dangerous situation can leave a child with lasting worries.

At the beginning, you may notice your child is only anxious in situations that are closely linked to their stressful event. Over time, however, that anxiety can generalize. This means the anxiety pops up more often in situations that are only loosely connected to the original event. As time passes it can be harder to connect anxiety symptoms to the underlying trauma or stress that triggered them in the first place.

Traumatic or stressful events that can lead to anxiety include:

• Car accidents

• Attacks or bites from dogs or other pets

• A loved one experiencing a major illness

• Natural disasters such as fires, floods, and tornadoes

• Repeatedly hearing about crime, disasters, or other emergencies affecting people on the news

Children dealing with trauma may notice they feel nervous or overly aware of their surroundings even when there isn’t a clear trigger. They might also notice anxiety caused by:

• Sudden noises

• Sensory experiences (like sounds and smells) that remind them of their trauma

• People, places or things that are associated with the stressful event

Help Your Child Learn and Cope With Their Anxiety Triggers

Learning what triggers anxiety is the first step toward helping your child cope with worries in a healthier way. Once children know what sets their anxiety off, they can learn strategies to help them in difficult situations. They can even practice noticing their thoughts, and questioning whether the worries that bother them so much are even accurate.

These skills may seem small, but over time they add up. Coping skills can change a child’s perspective on anxiety and other big feelings. They can empower children by giving them some control when things feel totally out of hand. We can’t always change a stressful situation, but giving kids coping skills can help them deal with hard moments, both now and as they grow up.

I teach coping skills so much in my therapy practice that I’ve created an entire coping skills course for tweens on the subject. Kids ages 8-13 can learn anxiety management tools they can use right away. There’s content for parents, too, so you can learn why the skills work and how to support your child in practicing them. You’ll also learn what isn’t as helpful for anxiety, so you don’t unintentionally make worries worse.

You can learn more about the course, preview the lessons, and enroll your child here.

Do Coping Skills Work, or Are They Just a Band-Aid?

At first glance, you wouldn’t think coping skills were a controversial subject. What’s not to like about deep belly breathing or guided relaxation? We’ve all been talking about these kinds of skills for ages. Maybe that’s why we’re seeing a bit of a coping skills backlash these days. Coping skills have become such a popular concept that it’s tempting to think they’re the answer to every mental health problem.

It’s true. When they’re used incorrectly, coping skills can be a little like putting a band-aid on a major wound. But most of us still use band-aids, right? They give us quick help and make our lives more comfortable. We’re not going to outlaw band-aids just because they’re not the right choice in every situation.

The truth is, many parents and kid clients come into my therapy office asking for coping skills to deal with anxiety, stress, and even trauma. I think they’re right to ask! Coping skills may not be The Answer to Everything, but they do work. Let’s talk about what makes coping skills effective for kids.

No, Deep Breathing Isn’t Going to Magically Solve All Your Problems.

If a child is dealing with anxiety so severe that they have stopped attending school, they’re going to need more than coping skills to get back to living their normal life. Similarly, a child can learn all the coping skills on earth and it won’t be sufficient if parents are constantly fighting at home. Big, long-term, or complicated problems need more than just a few coping skills to resolve. They need to be looked at holistically.

Sometimes we put a little too much responsibility on kids to solve issues that are much bigger than themselves. For kids dealing with mild anxiety or a sensitive, deeply feeling temperament, coping skills may be all they need to course correct. For bigger issues, coping skills may just be the first step in a longer therapy process that involves parents or caregivers, too.

But When Coping Skills Work, They Can Change a Child’s Life.

Yeah, this is kind of a big statement, but I stand by it! I believe coping skills can change a child’s life. I wish I’d had access to more coping skills back when I was an anxious kid.

When we give children coping skills, we give them a sense of control over their own lives. We provide the emotional first aid they need to get through the day, which buys us some time to address the root cause of theri anxiety. And often, coping skills open the door to deeper learning. By changing their behavior, children make new discoveries about their feelings and relationships.

Anxious Kids Need Help Right Away

Imagine you’re a kid who has been dealing with debilitating anxiety for a long time. You can’t sleep at night, and you spend the whole bus ride to school feeling sick to your stomach. You haven’t gone on a sleepover in ages because it’s too scary to be away from home, and you’re pretty sure you won’t be going on any of the big field trips coming up, either.

Your parents have been begging you to try therapy, and you finally work up the courage to give it a try. You sit in a strange lady’s office, who tells you that she can absolutely help you with your anxiety…in 3 to 6 months.

How would that feel? 3 to 6 months is eternity for a kid. But that’s often how long it takes for a child to complete therapy, and during that time they’ll probably need to put in some hard work and try some things that scare them.

Coping skills give kids some “quick wins” that help them feel better right away. It may not cure their anxiety, but it can make it a whole lot easier to tolerate. Experiencing this fast relief—and discovering the control they have over their emotional responses—can help motivate children to go the distance in therapy.

Coping Skills Help Kids Stabilize, So They Can Do the Deep Work

Not only do coping skills motivate kids to go deeper in therapy, they’re often a necessary first step. Kids dealing with severe anxiety or trauma spend a lot of their time in fight-or-flight mode. When you’ve got all that adrenaline coursing through your body, you’re focused on survival, not learning.

It’s really hard to effect big, lasting change when a child is too worked up to learn. Effective coping skills soothe the nervous system, so kids can calm themselves more easily and spend less time in fight-or-flight.

If your child is participating in trauma therapy, learning to self-soothe is critical. As children tell deeper and more difficult parts of their story, they may find their symptoms get worse before they get better. Revisiting their coping skills helps kids care for themselves and prevent overwhelm.

Effective Coping Skills Help Kids Discover Their Own Power

Many kids (and adults) enter therapy feeling powerless in the face of their anxiety. It’s bigger than them, it’s frightening, and it’s seemingly impossible to control. Anxiety feels like something that happens to them, and since they’re powerless to change it, they might as well just give in to its demands.

Coping skills show children that they have agency when it comes to their feelings. Sure, painful emotions are going to happen sometimes, that’s just life. But we get to decide how to respond to anxious thoughts, and there are ways to calm anxiety so it doesn’t take over your whole day. Returning that sense of control to children can change their whole outlook on how they handle anxiety and challenging situations in life.

Coping Skills Work by Healing From the Outside In

Before I went to therapy school, I went to theater school. I took a bunch of acting classes. There are two big schools of thought in acting: “inside out” and “outside in.”

If you imagine a stereotypical, old school actor asking “what’s my motivation?” you’ve got a basic sense of what inside out acting is all about. In this approach, actors create an inner emotional life for their character that helps them decide what to do onstage: how to talk, how to move, how to behave.

Outside in actors do things in reverse order. They might figure out their character’s walk, first. Maybe they figure out an interesting voice to use. Going through the physical motions helps them understand how the character might be feeling, and why.

Neither approach is wrong! Both actors are going to get to the same place in the end.

I promise there’s a reason I’ve devoted several paragraphs to this. Therapy is the same way. Coping skills may seem shallow at first, compared to “deep” work like understanding the origins of anxiety or changing family dynamics. But they work from the outside in. They help kids get to that deep work.

I’ve had many a kid client figure out solid coping skills and return to therapy in a couple weeks with important new insights about their lives. They come into session and make a connection between their worries and a specific family situation, or share something they’d like to change about how they relate to their friends. Changing your behavior disrupts old patterns and gives you space to discover something new.

When Are Coping Skills a Bad Idea?

Before you think I’m some shill who has been paid off by Big Coping Skills or whatever, let’s talk about some of the drawbacks. There’s no one size fits all in therapy. Coping skills aren’t going to work for everyone or serve kids well in every situation. Here are some examples of times that coping skills will not be effective:

• When coping skills are used to avoid anxious situations forever, rather than gradually facing your fear

• When a child uses coping skills to push down or deny “bad” feelings in an attempt to “stay positive”

• When coping skills are used as a substitute for support from parents, caregivers, or other adults

• When a child doesn’t see anyone else modeling how to cope with feelings effectively

Coping skills aren’t a substitute for feeling your feelings. They don’t work very well in isolation, either: kids still need support from the adults in their lives to overcome worries and change family patterns that might accidentally contribute to anxiety. If they’re not used thoughtfully, coping skills can easily morph into an unhelpful form of toxic positivity.

Effective Coping Skills for Tweens

Coping skills work for kids of all ages. However, in my therapy practice I mostly work with tween-aged kids, roughly ages 8-13. Since these are the kids I see day in and day out, they’re the ones I feel most equipped to help when it comes to coping skills.

You couldn’t pay me enough to go back to middle school. The tween years can be really rough. Studies show that when kids tranistion to 6th grade, their grades dip and don’t fully rebound until they begin high school. Friend drama, relationship woes, academic pressure, and puberty all start during middle school, but most of the privileges and freedoms that come with growing up don’t arrive until later. Tweens get all of the angst, and not much of the fun.

The good news is tweens are at the perfect age for coping skills. Cognitively, they’re leaps and bounds ahead of where they were in elementary school. They’re ready for challenging stuff. But socially, they’re right at the beginning of the “big kid” years. There’s still so much in front of them. Learning coping skills in middle school sets kids up for success as they manage stress and drama in the years to come.

If you have a tween who would like to learn coping skills, you’ve come to the right place! My course, Worry-Free Tweens, was created just for them. It’s available online and on demand, so your child can complete the lessons at their own pace. Since we know coping skills work best when parents are involved, you’ll find plenty of information for yourself, too.

You can check out the course here.

5 Coping Strategies for Grieving Children

Grief can touch every aspect of a child’s life, from their relationships with friends to their thoughts about the future. It’s normal for kids of all ages to struggle with strong emotions after a loved one dies, but they may express their feelings differently than grieving adults. Body aches and pains are common in grieving kids, and you may also notice struggles with separation anxiety, difficulty sleeping, and trouble concentrating at school.

We can’t stop a child from feeling grief, but we can help them work through their feelings and learn to live with their loss. These 5 coping strategies can help your child to process their feelings about the death of a loved one in healthy ways.

Coping Skill #1: Reading Books About Grief and Loss

Reading a story together is a great way to gently introduce the subject of grief and loss to your child. Often, kids don’t have a strong understanding of death before it personally affects them. As hard as it is for adults to cope with a loss, it can be even tougher for children who aren’t sure what exactly is happening. Books about grief provide age-appropriate information that isn’t too overwhelming.

Young children may worry about what has happened to their loved one who died: Are they in pain? Are they scared? Older kids may worry about the thoughts and feelings they’re having in response to grief, and whether or not they’re normal. Children of any age may feel intense guilt about how they treated their loved one, and may even wonder if they somehow did something to cause the death.

When children are better informed, they’re less likely to struggle with worries like these. Seeing how characters grieve in stories give children examples of the many ways grief can look and feel. This can reassure children that no matter how they respond to grief, there is no wrong way to feel. Take a look at my recommended grief books for preschoolers as well as books for elementary-aged kids for ideas to get started.

Coping Skill #2: Scheduling Positive Activities

Sometimes, grieving people need to take a break from their grief. While it’s important to work through the feelings and pain of loss, they can become overwhelming at times. This is especially true for kids, who don’t have the capacity that adults do to handle lots of emotional pain all at once.

When a loved one dies, children may feel like nothing is fun or worth doing anymore. It’s common for kids to retreat from hobbies, extracurriculars, or social events they used to enjoy. Over time, this can lead to feelings of depression, which makes it even harder for a child to get out and enjoy life. A vicious cycle can form where the longer a child self-isolates, the worse they feel.

We can support children in taking breaks from their grief by setting aside time each week for activities that are fun, social, or creative. Tasks that give you a sense of accomplishment when you finish them are great, too. Playdates with friends, a family board game or craft night, gardening, or committing to visiting a new place in your town each week are all ways to help your child stay socially connected even when it feels hard to do.

Once you’ve chosen an activity, make sure to put it on your calendar so you can look forward to it and hold yourselves accountable. Sometimes, kids may feel reluctant to participate when the time comes. That’s okay—you can remind your child that it’s hard to get back to doing fun things after loss. Once they’re immersed in the activity, they may find it’s much easier to enjoy it.

Coping Skill #3: Letting Out Anger

There are many good reasons to be angry when a loved one dies. As a kid, it can feel so unfair to see so many other children enjoying time with their grandparents or other family members when your own time was suddenly cut short. Kids may also be angry at parents, doctors, or emergency workers who had to make medical decisions on behalf of their loved one who died.

It can be hard to figure out how to comfort an angry child, but they need support for their feelings, too. We can provide kids with safe ways to vent anger that don’t hurt people or damage belongings. Drawing a picture and ripping it up can help children release emotion. Other children may enjoy stomping on egg cartons, tearing cardboard, popping bubble wrap, or finding other materials that are safe to destroy.

Anger gives kids a lot of energy, so physical activity can be a big help, too. Any activity that increases a child’s heart rate can help them to discharge angry feelings. Jumping rope, riding a bike, or running laps are quick and easy ways to burn off some extra adrenaline.

Coping Skill #4: Examining Worries

A loved one’s death can change the way a child sees the world. This is especially true when a loved one’s death was sudden or traumatic, such as a death from an accident. Suddenly, the world no longer seems as safe as it used to. Something terrible and unexpected has happened, which makes life feel less predictable.

This can lead to a lot of worries for bereaved kids. They may worry about the health and safety of other loved ones, or about their own risk of dying. Some children may even feel less hopeful about the future, or have a sense that things just won’t turn out well for them in life. In big and small ways, their experience with grief can color a child’s thoughts.

We can help a child to pay attention to their thoughts and not take them at face value. Kids can act like detectives, gently questioning their worries to see how accurate or true they really are. Oftentimes, worries are not based on very much good evidence—they’re just guesses about what might happen in the future.

You can help your child by asking questions like “Do you have any proof that is true?” and “Even if this scary thing did happen, would it be as bad as it seems?” Remind your child of their own strengths and ability to problem-solve, as well as the network of supportive people who could help them in a true emergency.

Books like Tiger, Tiger, Is It True? help younger children to grasp the abstract concept of thinking about thoughts. Tweens can learn about how to “talk back” to worries in my coping skills course, Worry-Free Tweens.

Coping Skill # 5: Letter-Writing

There’s often a lot left unsaid when a loved one dies, especially if there wasn’t a good chance to say goodbye. Children may wish they could apologize for a past argument, share an update about their lives, or simply thank their loved one for the lasting impact they’ve left behind.

Writing a letter gives children a chance to voice all these unexpressed thoughts and feelings. Even though they can’t be directly shared with the deceased loved one, a letter can be read aloud to another supportive adult, like a parent or caregiver.

Letter writing benefits young grievers in other ways, too. Bereaved children need opportunities to tell their story to others and be heard. Repeating their story, and putting feelings into words, helps kids to make sense of what happened to them. The more children talk about their grief, the easier it becomes to discuss. We want to help children feel comfortable sharing their grief, rather than pushing it down.

You can help your child get started writing a letter in whatever format feels best to them: email, a word processor, or old-fashioned stationary can all work well. Your child can address their letter directly to their loved one. If they need help getting started, consider having your child complete a sentence such as:

• Something that reminded me of you recently was…

• I wish I could tell you…

• I want to say sorry for…

• My favorite memory of us is…

Once your child has finished the letter, listen attentively as they share it with you. They can then choose a way to “send” their letter to their loved one, such as bringing it to the gravesite or burning the paper and watching the smoke travel upwards toward the sky.

Help Your Child Cope With Grief and Loss

I hope these 5 strategies have given you ideas you can use right away to help your child cope with grief. Working through grief and loss is a long, complicated process. If you and your child could use some more support, here are some more resources for you.

My book, A Parent’s Guide to Managing Childhood Grief, is available for presale now. It includes over 100 activities you can use with your child at home to help them cope with the many feelings and struggles that accompany death and loss. You can find it at any major bookseller, including Amazon and Barnes & Noble.

If your child’s grief is mostly showing up as anxiety, they might benefit from my online coping skills course, Worry-Free Tweens. It offers a more in-depth look at how kids can spot unhelpful thinking patterns, as well as relax the body and mind and gradually face fears. The course includes a section for parents, too, so you can help your child practice new coping skills and empower them to overcome worries.

Finally, if you’re interested in counseling for your child, I may be able to help. As a children’s counselor and play therapist, I can work with families in North Carolina, New York, and Florida, either in person or online. You can reach out to me here.

My Child is Afraid of Halloween! What Do I Do?

Maybe it’s just me, but I love a good baby Halloween costume. I started researching them long before I became a parent, and I’m excited to have at least a year or two of freedom to dress my baby up without objections from him about my style decisions. Eventually, though, all good things must come to an end.

As children grow up and begin to develop their own (strong) opinions about things, including Halloween. What if your child’s views are not so enthusiastic? What if they are downright scared of Halloween? You may be wondering if it’s okay to push them to face their fears so they don’t miss out on any fun—or keep their siblings from having a good time. On the other hand, you don’t want to overwhelm your poor kiddo by subjecting them to an evening of skeletons and eyeballs.

What’s a parent to do? Let’s take a look at a few strategies to help children who are afraid of Halloween feel secure enough to (gently) try out some spooky fun.

Is it Normal for Kids to Be Afraid of Halloween?

If everyone else’s children are eagerly jumping into their Pennywise costumes or laughing with glee at the scary chainsaw man on the haunted hayride, you may wonder if it’s normal for your child to feel so scared.

When you stop to think about it, many Halloween traditions are very weird and unlike our normal day-to-day life. It’s a day deliberately intended to scare people. On Halloween, kids get to do a lot of things they aren’t allowed to do any other night of the year, like walk around the neighborhood in the dark and take candy from strangers. No wonder some kids have a hard time adapting.

I wonder if the abundance of scary games, movies, and other content geared towards children has led to more kids fearing Halloween. I can’t tell you how many kids have come into my therapy office deathly afraid of characters like Pennywise, Annabelle, or the cast of Five Nights at Freddy’s. Even creepy memes can have a lasting effect on kids. Remember Momo? She was a major subject in my office for about 6 months in 2019.

I do think it’s worth mentioning that while mild anxiety is totally normal and understandable, extreme anxiety may be a different story. A child who is creeped out by Halloween decorations or who is hesitant to go trick or treating is experiencing pretty typical fears. On the other hand, if your child is so paralyzed by fear that they have nightmares the entire month of October, or refuse to go to public places because they might have decorations up, she may be dealing with a more severe phobia that could use some outside help.

How to Help a Child Who is Scared of Halloween

We all want to protect our children from harm and help them avoid upsetting experiences when we can. That said, please don’t wrap your child in psychological bubble wrap and avoid all things Halloween-themed. While this might help your child (and you) feel less anxious in the short term, it is likely to make your child’s fears stronger and more persistent over the long term.

Anxiety makes us want to avoid the things that scare us. We get the sense that something terrible will happen if we don’t. The problem is that every time we avoid something scary, we reinforce the idea that it is worth being afraid of. The longer a child avoids a scary situation, the harder it will be to return to it when the time comes. This is why it can be so hard to go back to school after summer vacation, and why so many kids developed separation anxiety after months of togetherness during quarantine.

To help an anxious child, we want to:

• Let them know their feelings are normal and okay

• Talk, read, and play about feelings and scary things

• Clear up any misunderstandings that might make anxiety worse

• Support them in gently and gradually facing their fears

Let’s see how we can apply those ideas to help a child who is afraid of Halloween.

Practice in Advance of the Big Day

The best time to start addressing Halloween anxiety is not October 30th. I say this knowing full well that this blog post will go up on October 30th, the night before Halloween. But, I am assuming that you are likely reading this blog post at some future time. Hopefully, Future You has decided to Google this issue in September or early October, which gives you plenty of time to prepare.

Kids learn and make sense of things around them through repetition and play. Ever seen your child act out the same game over and over for a week and then move on to something else? They’re learning! Children also thrive on routine, which helps the world feel more predictable and safe. Repeated conversations about Halloween traditions helps children learn what to expect, and takes away the element of surprise that can be so frightening.

Reading books about Halloween together is a great way to facilitate conversation. As an added bonus, books are a gentle form of exposure for anxiety. You are gently showing your child that he can handle talking and thinking about scary subjects, and you’ll be right there to support him.

Talk About the Difference Between Real and Pretend

Little kids have a hard time distinguishing between fantasy and reality. Their imaginations and ability to “make believe” can add a lot of magic to childhood. On the flip side, it can also add a lot of fear!

Older kids and adults can delight in scary movies because they know that there’s no chance of Godzilla lurking around the corner when they leave the theater. Pretend scary stories let us experience the adrenaline rush of a good scare at a time when we know that nothing bad can actually happen. Imagine how it must feel if you aren’t so sure the Godzilla won’t be there!

You can use TV shows and movies as an opportunity to show your child that the stories are pretend, and the actors are playing make-believe. Mister Rogers once invited the actress who played the Wicked Witch of the West onto his show to teach this exact concept. Onscreen, the actress showed how she put on her costume and makeup, and used a pretend scary voice to play the part. In reality, she was a really nice lady! You can talk with your child about how actors use makeup and costumes to look scary, when really they are normal people—there’s plenty of videos of actors in and out of costume to back up your point.

Use Exposure to Make Scary Items Feel Familiar

Exposure is a big part of the kind of therapy I practice for kids with anxiety, called Cognitive Behavioral Therapy. In exposure, we help a child face unhelpful fears, but we do it in a gradual way. This helps kids build up their confidence, and learn to tolerate anxious feelings without becoming totally overwhelmed.

You can practice exposure at home by giving kids a chance to look at and handle scary Halloween props in small doses. This could mean taking the scary mask from a sibling’s costume out for your younger child to handle and play with. It could also mean walking on the opposite side of the street from a Halloween display to view it from a safe distance before getting closer. It often helps to make these exposure situations funny: try talking with your child in a goofy witch voice, or encourage them to make fun of a monster that frightens them. It’s hard for things to be both funny and scary at the same time.

Involve Your Child in Halloween Prep

Helping your child participate in Halloween traditions in an age-appropriate way gives them another opportunity for exposure. It’s also another chance to highlight the difference between real and pretend by showing kids how things are made. A glowing jack-o-lantern seems a lot less intimidating when you saw the pumpkin that was scooped and carved to make it.

Giving your child a role in the Halloween festivities allows them to feel a sense of control over the situation. You can let your child pick out your decorations, play their choice of music, and decide what snacks to enjoy or what candy to give out to trick-or-treaters. Feeling in control can ease anxiety, and getting to pick out all the details might give children an added motivation to participate.

Fun is Most Important!

Okay, so I’ve gone on and on in this post about the importance of exposure and facing your fears. All of that is true! But also…Halloween is a holiday, and it’s one day a year. While I encourage you to gently help your child overcome Halloween anxieties, there’s no need to push them so far out of their comfort zone that the holiday stops being fun.

We’re looking for progress, not perfection. Maybe this isn’t the year that you go trick-or-treating in the neighborhood that goes all out for Halloween with super gory decorations. Maybe your young child would be more into a casual daytime party with friends rather than a nighttime trek with the big kids. Some aspects of Halloween may just be too intense for young or sensitive kids to handle, and that’s perfectly okay.

What’s most important is communicating to your child that having anxiety is okay, and that we don’t always have to do what it tells us to do. By staying calm and finding small opportunities for exposure, you are showing your child that you can handle their big feelings. They may be terrified of the ghost hanging on the neighbor’s house, but you aren’t!

Help for Anxious Kids in Davidson, NC

Do your child’s anxieties extend past Halloween? If you’ve got a sensitive kid who is prone to big feelings, it might feel like there’s a minefield of situations you have to tread carefully around to avoid triggering a meltdown. If anxiety is getting in the way of your child living their best life, counseling can help make things more manageable.

I am a former-anxious-kid-turned-therapist who loves working with children and tweens. I see kids in person for CBT and play therapy at my office in Davidson, North Carolina, just outside of Charlotte. If you aren’t close by, we may still be able to work together! I see kids throughout North Carolina, New York, and Florida for online therapy. If you’re not sure you’re ready to start therapy, or need some basic help right away, check out my coping skills course for anxious kids and tweens.

If you’re ready to start child anxiety therapy, drop me a line. I’m always happy to hear from you.

Explaining CBT to a Child: 4 Topics to Talk About

Cognitive Behavioral Therapy, also known as CBT, is one of the most effective forms of therapy for children with anxiety. There’s a mountain of research behind it to prove that it helps kids with a variety of anxiety-related problems, from tantrums and acting-out behavior to worrying and sleep difficulties. Although it’s helpful for all ages, studies show it’s especially effective for kids in the 11-13 age range. Maybe that’s why I’m such a big fan of using it in my tween therapy practice!

If you’re reading this post, maybe you are intrigued by CBT, too. It’s possible it’s been recommended to you by your pediatrician, or perhaps you’ve discovered it by Googling around for anxiety treatment for kids. However you learned about it, you might be wondering how to discuss it with your child. As helpful as CBT is, it’s also full of intimidating-sounding therapy jargon. In this post, I’ll break down some of the main concepts in a child friendly way, so your child will be ready to rock their first CBT therapy appointment!

What is Cognitive Behavioral Therapy?

Cognitive Behavioral Therapy is a skill-based therapy that’s used with both kids and adults. It’s a way of dealing with anxiety that’s focused on the present, rather than the past. You probably won’t spend a ton of time in CBT talking about family history and early childhood, because uncovering the root of where anxiety comes from isn’t the main goal of this style of therapy.

Regardless of where the anxiety came from, anxious kids need strategies to deal with it. That’s the main goal of CBT: learning tools to cope with anxiety when it arises, both now and in the future. Although it sounds simple, the effects of CBT can be really deep. Research shows that 70-80% of kids respond well to CBT, and they often see lasting results from short-term therapy. In my experience, learning the right coping skills often leads to an “aha” moment for kids. They start to understand how their own anxiety works, and that they have a say in how they think and feel, which is really empowering.

Common CBT Techniques

A child in CBT therapy might learn any or all of the following techniques:

• Relaxation techniques to calm the body

• Mindfulness or grounding skills to focus attention during times of stress

• Keeping a journal or written log to track worries at home

• Practicing “cognitive restructuring”, a way of transforming unhelpful worries

• Gradually exposing themselves to things that trigger anxiety

• Using roleplay to practice skills

• Doing “experiments” in real life to test if their fears really come true

Okay! Now that you’ve got an overview of what CBT is and how it works, let’s move on to talking about how to discuss it with your child. The next 4 sections cover what I think are the most helpful concepts for children to understand about CBT.

CBT Topic #1: The Cognitive Triangle

Most children view their emotions as something that come out of the blue. They come and go, sometimes without good reason, and they’re difficult or impossible to control. Heck, many adults feel this way about their feelings, too: how many times have you heard someone say that something “made them angry” or “made them anxious”? Many of us feel pretty powerless when faced with strong emotions like anxiety and anger.

However, it’s not really true that our feelings come out of nowhere. Any time something happens to us, all day long, we have a thought about it. It’s our thoughts that tell us how we should feel about what’s going on. Most of the time, this process works great and our thoughts let us make accurate judgment calls about situations. But for anxious kids, overly negative thoughts might lead them to feel anxious when they don’t really need to be.

The cognitive triangle is a map that shows how our thoughts, feelings, and behaviors are all connected to each other. Our thoughts tell us how to feel, our feelings influence how we act, and then our actions play a big role in how we see the world and future thoughts we might have. Teaching a child about the cognitive triangle is a great first step when introducing them to CBT.

You can use the cognitive triangle to show how different people can have the same experience, but end up feeling and acting different ways based on their thoughts. For example, a child who loves animals might see a dog sitting on the sidewalk and think “Cute, I love dogs!”. This would make her feel excited and happy. She might walk up to the dog and pet him. Another child who was bitten by a puppy in the past might see the same dog and think “Oh no, he could bite me!”. That would make him feel anxious and afraid. He’d probably cross to the other side of the street to avoid getting near the dog.

Learning and practicing the cognitive triangle helps kids understand that there’s no one “right” way to respond to a situation. It can also help them to notice the vicious cycles that sometimes form when a person is anxious. For example, if the boy in the story above keeps avoiding every dog he sees, he will never get the chance to learn about all the friendly dogs that exist in the world. He may just keep on fearing dogs forever.

CBT Topic #2: Thoughts or Actions Can Change Feelings

Once a child knows about the cognitive triangle, you can move on to the next step. Our thoughts, feelings, and actions are all connected, which means that changing one of those things changes the others. It’s pretty hard to change a feeling: just telling someone to stop being anxious probably isn’t going to work! It’s easier to change our thought or change our actions, and deal with the anxiety that way.

Your child can change her thoughts by learning how to spot worries and turn them into something more useful. She can change your actions by learning coping skills to relax her body and focus on something besides her worries. Either way, she’ll be helping herself to shrink her anxiety down, or turn it into a more helpful feeling to have.

CBT Topic #3: Talking Back to Worries

In CBT, kids learn a process to change their thoughts called “cognitive restructuring.” Because this is pretty much the least child-friendly term ever, I usually just refer to it as “talking back” to thoughts. To practice this technique, kids first need to get skilled at noticing when they’re having a worry. Next, they learn how to gauge whether or not their worry is realistic or not—usually, it isn’t! Finally, they come up with something that is more helpful and realistic they can say to themselves instead.

You can tell your child that in CBT, she’ll learn she doesn’t have to believe everything her worries tell her. Therapy will help her learn how to spot worries, and decide whether or not they’re worth listening to. She’ll learn how to “talk back” to the unhelpful ones, so that they won’t boss her around anymore. Tiger-Tiger, Is It True? is a great book for introducing this concept to preschoolers and early elementary-aged kids. Older kids might benefit from giving my coping skills course a try, where I cover this subject in detail and talk about how to try “talking back” to worries at home.

CBT Topic #4: The Feelings Remote Control

I often use this “remote control” analogy when I’m talking about coping and relaxation skills with kids. Activities like deep breathing, muscle relaxation, and guided visualization are one way that we can change our behavior in order to improve our mood. It can help kids understand the reason we’re always asking them to do things like “take deep breaths.”

When we’re hit with a really intense emotion, sometimes focusing on it just makes it get worse. Kids with anxiety are prone to doing something called ruminating: going over their worries again and again, which magnifies them. Coping skills work like a remote control that helps kids to “change the channel” on their feelings by shifting them into another emotional state. They can also work to “turn the volume down” on an intense emotion, to make it more manageable.

Most kids are familiar with remotes and how they work, which makes these terms helpful shorthand when you’re trying to help your anxious child. Relaxation skills like breathing and muscle relaxing can help turn down the volume, while music, exercise, and guided visualization can help to change the channel.

OK, You’ve Explained CBT to Your Child. What’s Next?

You’ve walked your child through the basics of Cognitive Behavioral Therapy. What’s the next step? If you know this is the approach for you, you can look for a therapist that specializes in CBT on therapist directories like Psychology Today.

If you live in New York, North Carolina, or Florida, I might be able to help you at my tween therapy practice. I love helping kids learn CBT, because these skills don’t have an expiration date: they can help kids manage anxiety and worries for the rest of their lives. That is pretty cool! If you’re not located in a state where I’m licensed, you might like my CBT-inspired coping skills course. It’s a self-guided class (not therapy) for parents and children that teaches my favorite techniques for managing anxiety at home.

I could chat about CBT all day, so if you are curious, feel free to reach out! You can ask a question or request an appointment here.

Is Your Child a Highly Sensitive Person?

Have you noticed that your child is deeply affected by things that don’t seem to faze other kids? Maybe your son is ultra-sensitive to the way clothing fits, and absolutely can’t stand seams in his socks. Or, your daughter always seems to melt down after spending a day in a loud or crowded place. Many of the children I work with in my child counseling practice fit this description: they’re very perceptive, emotional, and respond strongly to changes or sensory input. They might be Highly Sensitive People, a term used by some therapists and parenting experts to describe kids who have big responses and strong feelings.

What Is a Highly Sensitive Person?

“Highly Sensitive Person” is a term coined by the psychologist Dr. Elaine Aron in the 1990s. According to Dr. Aron, Highly Sensitive People (or HSPs) are neurologically wired in a way that makes them more sensitive to the world around them. This means they respond more strongly to sensory stimuli, like loud sounds, strong smells, and bright lights. They also react with bigger, stronger emotions as a result. HSPs tend to feel things very deeply, and may need a longer time to emotionally recover when upset.

Being “Highly Sensitive” Is Not a Diagnosis

Being highly sensitive isn’t a disorder or mental health problem, it’s just a personality trait. It’s also more common than you might think! Dr. Aron estimates that around 15-20% of people qualify as highly sensitive. In fact, she considers herself to be a Highly Sensitive Person. Just like a person might be introverted or extroverted, they can also be more or less sensitive.

A therapist can diagnose a child with anxiety or depression, but they can’t diagnose a child as being an HSP. There is no in-depth test that can “prove” how sensitive a person is. What’s more, being highly sensitive isn’t a problem to be solved. Just like any personality style, it has its pros and cons. On one hand, the strong reactions and emotions HSPs experience can be hard to manage. On the other, they tend to be incredibly empathetic, creative, and perceptive.

Ultimately, calling someone (or yourself) a “Highly Sensitive Person” can help put a name to experiences that otherwise might feel lonely or “weird”. It can be helpful shorthand to describe your child, and might help you find coping strategies to help with strong feelings. On the other hand, it’s just a label. You only have to use it if it’s helpful to you.

Signs Your Child May Be Highly Sensitive

Wondering if your child might be a Highly Sensitive Person? Here are a few of the most common signs of high sensitivity that I see in my child therapy office:

• Difficulty With Change: Pretty much every child struggles with transitions sometimes, but HSPs are really affected when their routines are thrown off. This can look like an inconsolable tantrum if a playdate is canceled, anxiety about going on an unexpected errand, or discomfort with their room being rearranged at home.

• Empathy and Intuition: Because highly sensitive kids are so attuned to subtle changes, they’re great at spotting other people’s emotions. These kids are often the ones who can read their parents like a book and pick up on everyone’s nonverbal cues. They can easily feel what others are feeling, which often makes them compassionate young people.

• Easily Overwhelmed: Sensory input that wouldn’t bother other people can overwhelm a sensitive kid. They may not be able to tolerate loud parties or music as well as other children. Certain textures or foods might bother them. Busy places can be visually overstimulating and lead to fatigue or a grouchy mood. I also often hear about HSP kids being particular about their clothing having the right fit or texture.

• Strong Emotions: These kids might get labeled as “dramatic” or “fussy” by others. They feel things deeply, and their emotions tend to be bigger and last longer than you might expect. Being highly emotional often means HSPs are creative and funny. However, without adequate coping skills they can be overwhelmed by their feelings.

No formal test exists that can “diagnose” someone as being a Highly Sensitive Person. However, if you’re curious, you can take this self-test on Dr. Aron’s website to see if your child fits many of the HSP traits.

How to Help a Highly Sensitive Child

It can be tough growing up as a highly sensitive kid. Adults may not always understand why a child feels things so deeply. Meanwhile, a child may have a hard time putting her big feelings into words. If your child is struggling with sensory overload or emotional overwhelm, there are things you can do to help.

• Remember the Positives: If you’ve been dealing with the harder parts of this personality style, it can be easy to forget that being highly sensitive is a gift. I’d be willing to bet that many artists and people in creative professions are HSPs. You can’t have all that empathy and intuition without also having the sensitivity and anxiety—they’re two sides of the same coin. You can help your child to reframe her way of seeing the world as a strength, rather than a weakness.

• Practice Coping Skills: A highly sensitive child’s powerful emotions can easily lead to overwhelm. These kids need to learn healthy ways to channel their strong feelings, so they don’t turn into panic or tantrums. You can support your child by practicing mindfulness or relaxation skills at home to soothe anxiety. Physical activity, art, and journaling are other helpful outlets for strong emotions.

• Provide Structure: Many sensitive kids fare better when they have a predictable schedule. Children feel safe when they know what’s coming next, so a set routine can calm your sensitive child’s nerves. Consistent boundaries can also help children with strong feelings to better regulate their feelings. This doesn’t mean you have to be harsh or strict—just that you generally stick to your word. Just like a predictable routine, predictable rules help children feel more secure.

Considering Child Counseling in North Carolina?

Sometimes, despite everyone’s best efforts, kids need a little extra help. I tell families that a child doesn’t need to have a serious problem in order to benefit from counseling. There’s probably a time in every person’s life when having somebody to talk to can make a difficult phase pass by a little more easily.

If your sensitive kiddo could use some strategies for dealing with strong emotions, check out my online coping skills courses for kids. They’re available at-home, on demand, wherever you live. Worry-Free Tweens, my course for kids ages 8-12, could be a good bet if your child’s sensitivity leads to anxiety.

A child counselor can help your child better understand her strong feelings. In therapy, highly sensitive kids can learn how to cope with the day-to-day situations that lead to stress. They can also learn ways to self-soothe and deal with overpowering feelings when they happen. My hope is that kids and parents leave my office recognizing how cool it is to have strong feelings.

I love working with highly sensitive kids and preteens in my Lake Norman counseling office. If you aren’t nearby, I also see children for online therapy throughout North Carolina, New York, and Florida. Ready to get started? You can get more information or request an appointment here.

Online Trauma Therapy: How TF-CBT Helps Kids Heal At Home

2020 has been a weird year. The pandemic has been a trauma event for the whole world: we are all going through it together. As Covid continues on and case counts rise and fall, regular life carries on, too. Kids are experiencing traumas like accidents, illnesses, and violence just like they were before the pandemic began. How do you get your child the trauma therapy they need while staying at home? In this post, I want to talk about online TF-CBT, and why it’s a great option for kids’ trauma therapy both now and in the future.

Why Consider Online Trauma Therapy?

Families may consider online trauma therapy for a variety of reasons, some of which are not unique to 2020. Depending on where you live, it might be hard to find a counselor who knows how to treat childhood PTSD. Other life circumstances can make it hard to find time to drive to a counselor’s office in the middle of a 9-5 work day. Health conditions might also prevent a child or parent from easily being able to travel. Here are a few situations where online trauma therapy can help:

• You really connect with a therapist who lives in your state, but not your town

• You live in a rural area where it’s hard to find a trauma specialist

• You or your child is living with a chronic illness or disability

• You and your ex-spouse have joint custody, so your child travels between two far-apart homes

• Your child’s schedule is extremely busy, and it’s hard to squeeze in another appointment

Doing therapy online means you can see therapists all over your state. You have way more options! If you’re looking for someone who specializes with a specific age group or a particular problem, online therapy broadens your horizons.

What is TF-CBT?

TF-CBT stands for Trauma-Focused Cognitive Behavioral Therapy. It’s a form of therapy that was created to help kids with PTSD symptoms following a trauma. If you imagine a stereotypical therapy session, what comes to mind? Do you picture going into a room and talking about your earliest childhood memories while a therapist nods and says “How does that make you feel?” If so, that’s not what happens in online TF-CBT.

This style of therapy is skill-based, meaning kids learn coping tools they can use in the here-and-now to get some relief quickly. It is also fairly short-term, meaning that children will usually attend therapy for a matter of months. TF-CBT is designed for children from age 3 to age 18. Any child who can put their trauma experience into words is likely to be a good fit for this therapy approach.

How Does TF-CBT Work Online?

TF-CBT is divided into three parts. Here’s how each of them works online:

In the first phase of TF-CBT, kids learn about trauma symptoms and practice coping skills to manage them. Children learn that many other kids have gone through similar experiences, and felt the same way they do now. They rediscover how to soothe their body and mind when trauma symptoms send them into high alert. A TF-CBT counselor can model how to practice relaxation skills on video chat, email handouts to families to practice at home, and share educational books and videos online.

In the second phase of TF-CBT, children gradually begin to face their fears. Many children are bothered by upsetting memories or flashbacks after a trauma. They may also be fearful of situations or people that remind them in some way of what happened. In this middle part of the therapy process, the therapist helps the child gradually expose themselves to scary situations or memories in a careful way. Children can use their new coping skills to manage strong feelings as they arise.

An important way children face their fears is by creating a trauma narrative: a story about their trauma experience from their own point of view. This can be done online using a shared Google Doc for older kids, or by using online comic strip or art programs for younger children. Either way, the therapist is there at all times to make sure the child isn’t overwhelmed.

Finally, children and parents meet together. Kids have an opportunity to share their story with their parents. Meanwhile, parents have the change to show children that nothing they think or feel is too scary to be mentioned. This helps children and parents strengthen their bond after trauma, and paves the way for the child to graduate from therapy. I really enjoy seeing families curled up together on the couch to read their child’s story: it’s much more comfortable than being in my office!

The Benefits Of At-Home Therapy for Trauma

While I love seeing children for face-to-face therapy, online counseling has a few distinct benefits to offer. Until I started practicing online, I’d never considered its hidden perks! Here are a few advantages to consider if you’re considering at-home trauma therapy for your child:

• Online therapy can feel less overwhelming than being face-to-face. This can be especially helpful for shy children who are nervous about talking to a strange adult. When kids are in my office, they’re very aware that I’m close by and looking at them. Online, though, I seem a bit more removed. This makes it easier for some children to open up.

• Being at home means being close to comfort objects. If a child gets overwhelmed during a home session, they are already in a place that likely feels safe and comfortable to them. Pets, stuffed animals, siblings, and photos of loved ones can all be brought into sessions for emotional support.

• As a therapist, I’m able to watch children write and create their stories in real-time. A shared Google Document allows me to observe a child’s thought process as they’re writing, without having to awkwardly peek over anyone’s shoulder. This can be really helpful when children are sharing memories of trauma, because I can spot important details quickly.

Looking for an Online Child Trauma Therapist in North Carolina, New York, or Florida?

I’m a Davidson-based children’s counselor who specializes in childhood trauma and anxiety treatment. I’m also a big proponent of online therapy for kids! I love online counseling because it gets rid of many barriers that make it hard for kids to get good quality therapy. If you’re not local to the Charlotte area, I offer online TF-CBT throughout North Carolina, New York, and Florida.

If you’re looking for an online trauma counselor for your child, you can learn more about me or reach out to schedule an appointment. I’m always happy to chat and answer questions before scheduling.

You can also learn more about TF-CBT and trauma here or by checking out my blog posts on the subject.

What Are Coping Skills?

Skills, strategies, tools for your emotional toolbox…coping skills go by a lot of names, and as a children’s therapist I talk about them all day, every day. But you know how sometimes if you say a word over and over, it starts to sound weird? That’s kind of how I’m starting to feel about the term “coping skill.” What even is a coping skill, exactly? I love coping skills and I sing their praises often: I have covered how to use them to manage all sorts of feelings. Today I’m going to do something a little different and talk about what coping skills are, why kids need them, and why they aren’t always healthy.

The Definition of a Coping Skill

“Coping skill” is a broad term that gets used to describe pretty much any activity that is good for a person’s mental health. Let’s take a look at a dictionary definition for “coping mechanism” to see if we can get a little more specific:

an adaptation to environmental stress that is based on conscious or unconscious choice and that enhances control over behavior or gives psychological comfort.

Technically, any healthy habit that reduces stress is a coping skill: stuff like getting good sleep, proper nutrition, and exercising regularly. But usually, when we talk about coping skills we mean something that provides more instant gratification. Coping skills are things that we can do in-the-moment, when we are feeling lousy, to help us turn down the volume of our emotions and avoid getting overwhelmed. They help us to get through stressful situations with a little more ease, and without doing something we’d regret later on.

Coping Skills Are NOT Just a Band-Aid

I sometimes hear people criticizing coping skills, claiming that they are a band-aid solution for a deeper problem. I get where they are coming from: coping skills deal with symptoms without trying to figure out where they come from. If a child uses a deep breathing technique to manage anxiety, she is soothing herself but probably isn’t going to discover that caused the anxiety to happen in the first place. Because of this, coping skills are sometimes seen as being too “surface-y” or superficial to create lasting change.

In my experience, this just isn’t the case! Coping skills provide an entry point for kids to dig deeper into the issues that are really bothering them. When a child learns and practices coping skills, she learns that her feelings don’t just “happen” to her: she has some control over them, and how she chooses to deal with them. That’s a pretty huge discovery! Once children discover they can create positive change with coping skills, it often empowers them to create change in other places in their lives. The same is true with families: trying new coping skills disrupts old patterns of behavior between parents and kids, and clears the way for something new.

…But They Probably Won’t Solve All Your Problems, Either

For kids with mild anxiety or life stress, learning a few effective coping skills may be all they need to feel better. However, most kids with a diagnoseable mental health struggle like anxiety or depression will need therapy beyond coping skills in order to heal. Finding coping skills that work well can lay a strong foundation for future therapy.

For example, children with anxiety might find relief from cognitive behavioral therapy, which can help them to face their fears without getting overwhelmed. Kids who are acting out at home can work together with their parents to break old cycles of behavior, find discipline that works, and enjoy a more positive relationship. Children who have survived a trauma will likely need a specialized therapy like TF-CBT to help them work through their feelings and memories in a safe way. For all these kids, coping skills are a great first step—they’re just not the end of the road.

Types of Coping Strategies

There are a million coping skills out there, but most of them fall into one of a few main categories. Not all coping skills work for all people, and you’ll probably need a few different options to help you navigate different situations. Here are the main types of coping skills that I help kids to learn in my therapy practice:

Relaxation: These skills help kids to soothe and relax the body, which can in turn help the mind feel more calm. Because anxiety symptoms are often felt strongly in the body, relaxation is especially helpful for anxious kids. A few common relaxation coping skills are:

• Soothing activities, like a warm bath or a cup of herbal tea

• Deep breathing exercises

• Progressive muscle relaxation

• Guided visualization

Mindfulness: Mindfulness skills help a child to stay in the here-and-now, rather than worrying about the future or thinking about the past. Mindfulness helps children to focus their attention on the present, be more aware of their feelings and surroundings, and feel more grounded during times of intense stress. These skills include:

• Meditation

• Observing and describing your surroundings

• Panic attack coping skills like the 5-4-3-2-1 technique

• Sensory play, for younger children

Safe Ways to Express Feelings: Sometimes, strong feelings just need to be let out. These skills help kids vent their feelings in a safe way that isn’t destructive or hurtful to themselves or other people. This is especially helpful for kids who experience strong anger, since uncontrolled anger might lead to hitting, breaking toys, or yelling at others. Here are some healthier ways to express emotions:

• Journaling

• Non-aggressive physical activity

• Creating art

• Assertive communication skills

Positive, Rewarding Activities: Fun is good for our mental health. Doing things that give us a sense of satisfaction and enjoyment are key to giving meaning to life and preventing depression. Kids need to be around other kids in order to grow and develop emotionally, so social opportunities are important coping skills for them, too. Here are a few examples of activities that fit the bill:

• Sports and recreational activities

• Hobbies that encourage a sense of accomplishment

• Spending time with supportive friends

• Volunteering

Can Coping Skills Ever Be Unhealthy?

The short answer: yes. Many of the things kids do that adults call “bad behavior” are actually attempts to cope with stress or strong feelings. Kids do these things to try to help themselves feel better—after all, if there was no benefit to the behavior, why bother at all? Adults don’t use perfect coping skills 100% of the time, either: who among us hasn’t turned to a bowl of ice cream or online shopping to deal with a bad day?

Coping skills can be adaptive, meaning they are healthy and helpful, or maladaptive, meaning they might help someone momentarily feel better, but they’ll do more harm than good in the long run. Some of these unhealthy coping skills are only mildly unhelpful, such as:

• Procrastination

• Numbing or ignoring feelings

• Tantrums or meltdowns

• Yelling, swearing, or name-calling

Other maladaptive coping skills are more serious, and can be dangerous or harmful. Seriously unhealthy coping skills include:

• Drug and alcohol abuse

• Self-harm

• Violence toward others

• Risky behavior, like shoplifting or dangerous driving

We all use some of these unhealthy coping skills occasionally, but it’s not good for kids—or adults—to rely on them as the main way they handle stress. Obviously, the more dangerous maladaptive coping skills are not good for anybody and need to be taken very seriously. Children using drugs, alcohol, or self-harm as a means to cope need the help of a therapist or other crisis resources.

Need Some Coping Skills Ideas for Kids?

Coping skills are a great form of self-help to try while you’re looking for a counselor, or before considering mental health treatment. My online coping skills courses teach kid-friendly strategies for dealing with strong emotions in a self-help format you can access any time. Worry-Free Tweens, designed for kids 8-12, is a great intro course for managing anxiety at home.

I have a bunch of articles on coping skills that kids and parents can use at home to deal with a variety of issues. Check out the resources below:

Coping Skills for the Pandemic
Anger Management Coping Skills
Coping Skills for Anxiety
Depression Coping Skills
Coping Skills for Panic Attacks

If you are looking for a counselor to help your child work on coping skills and you’re in North Carolina, New York, or Florida, I may be able to help. You can contact me here.

Online Social Groups for Kids Can Help Beat the Pandemic Blues

2020 is a weird year for pretty much everyone, but it might be especially tough for kids. Children need to be around other children in order to grow and learn, and the pandemic has made this hard to do. Preteens and teens, who are in a developmental stage where friendships become central to life, might be hit especially hard by social distancing. If your child is struggling with depression or loneliness, online social groups can be a great way to reconnect with old friends or meet new people. Here are a few things to consider if your child is considering joining a group!

The Benefits of Online Groups for Kids

If you’ve noticed signs of depression or anxiety in your child, your first thought might be to seek out a counselor. One-on-one therapy can be a great option for many kids, giving them new coping skills and a chance to work through their feelings with an adult who isn’t a friend or family member. However, if a child is feeling lonely or struggling socially, there are some things that individual therapy just can’t provide as well as a group.

Any time a child has the opportunity to socialize with peers, it benefits her emotional wellbeing. Here are a few ways that extracurriculars, clubs, and online group classes of any kind can benefit kids’ social and emotional growth:

• Group activities give kids a real-life opportunity to practice social skills like turn-taking, compromise, and starting and maintaining conversations.

• Learning and mastering a new activity helps kids feel more confident and boosts self-esteem.

• Group activities provide a chance to meet like-minded kids who might become good friends.

• Socializing with others can help treat and prevent depression.

The Benefits of Therapy Groups for Kids

In addition to the benefits listed above, therapy groups have a few extra perks that can make them particularly effective for kids struggling with anxiety, depression, or social skills difficulties:

• Being in a therapy group helps kids realize they are not alone with their feelings: they’re in a room with other kids who share their experience and get what it’s like.

• Children in therapy groups have the opportunity to help and support each other, which is empowering.

• Being in a group more closely mimics the “real world” experiences kids are likely to have once they leave the therapy office: if they can use their coping skills in group, they can use them outside of group, too!

Small Online Classes Encourage Kids’ Interests

No matter what your child’s interest, there’s probably a group out there to learn about it. Outschool offers small group online classes for kids on pretty much every subject under the sun, from video game design to cupcake baking to how to draw Baby Yoda. I find that smaller groups tend to feel less awkward for kids (and adults!) than big ones, which might make it easier to socialize in classes like Outschool’s. Class lengths vary, too, from multi-week courses to one-off classes, so it’s not a big commitment to give it a try.

Online Communities Connect Tweens and Teens (Without Roblox or TikTok)

While not exactly a group activity, kid-friendly online communities can be valuable for preteens and teens because they’re budget-friendly and available 24/7. If you’re looking for an alternative to social media or the typical Minecraft and Roblox fare, check out this awesome list of age-appropriate online communities from Commonsense.org. I’m particularly intrigued by the Harry Potter Alliance, an online club for kids that uses the Harry Potter series to encourage social activism. Am I too old to join?!

Online Gaming Groups Help Children Practice Social Skills

Often, kids who are struggling to make or keep friendships could benefit from brushing up on their social skills: things like how to keep conversations going, deal with conflict, and speak up for themselves assertively. But what kid really wants to go to a place where they feel like their social awkwardness is under a microscope? Not only is learning social skills through play less uncomfortable for kids, it’s also likely to be more effective: role playing conversations with an adult is never going to be exactly the same as talking to another kid.

Game-based groups offer kids an opportunity to socialize and practice skills in a low-pressure environment, and these types of groups often translate easily into online sessions. I am currently running Dungeons & Dragons-based therapy groups for kids in my own practice, and I’ve found that the game gives kids some structure that makes getting to know each other online feel less awkward, while still giving plenty of opportunities to be creative.

Need More Help Finding an Online Social Group?

The resources I’ve listed here are available to kids throughout the US, but ongoing social distancing means local opportunities are likely popping up in your community, as well. Many dance, art, and music studios are offering distant group learning options for kids, and your local library may be able to give you information about other nearby programs. Older kids might be interested in online foreign language classes offered by local chapters of language and culture societies like the Alliance Française, which are often available online and reasonably priced.

If you’re local to North Carolina, New York, or Florida, my D&D therapy groups might be a good option. Not local to one of these states? Consider my sister site, Young Dragonslayers, where we run non-therapeutic D&D groups for kids focused on friendship-building and fun. I also offer an online coping skills class for tweens, which can help your child learn to manage worries from home.

If you’d like more information on these online social groups or other counseling services, you are always welcome to contact me.

5 Coping Skills for Kids and Teens with Panic Attacks

They seem to come out of nowhere. One minute, your child seems just fine, and the next, it’s like a switch has flipped without a clear reason why. Kids and teens who suffer from panic attacks experience intense anxiety that seemingly pops up out of the blue, along with physical symptoms like a racing pulse, sweating, hyperventilating, shakiness, and a general sense that something terrible is about to happen.

For some kids, relaxation skills and other coping skills for anxiety aren’t super helpful when it comes to managing panic attacks. In this post I’ll be sharing a few techniques kids and teens can use to deal with panic attacks when they happen, to hopefully make them less intense and less frequent.

What Happens to the Body During a Panic Attack?

When adults have a panic attack for the first time, it’s not uncommon for them to head to an ER because the symptoms feel so intense and scary. The pounding heartbeat and other physical symptoms of panic can make people suspect a heart attack or another medical emergency is to blame, rather than anxiety. As freaky as panic attacks can feel, the good news is that they are harmless and go away on their own. Most panic attacks peak around the 10 minute mark, and fade away within 20 to 30 minutes. Almost all panic attacks are over within an hour.

We don’t really know why panic attacks happen, but we do know how they happen. When a person has a panic attack, their brain is doing exactly the right thing at exactly the wrong time. When we are in a life-threatening situation, our brains send our bodies into fight-or-flight mode, which triggers a big dump of adrenaline into the bloodstream.

This adrenaline surge gets us super amped up: suddenly, we are really energetic, our senses are heightened, and our hearts are beating quickly to empower us to make a quick escape or fight off a threat. This is helpful, but uncomfortable: we can also end up with chest pain, lightheadedness, excessive sweating, and other body sensations.

The Faulty Fire Alarm

When a child has a panic attack, it’s as if someone pulled a fire alarm in the hallway at school. Their fight-or-flight response is sounding the alarm bell for no apparent reason, giving the child a surge of adrenaline they don’t need. When a person experiences fight-or-flight symptoms out of context, they can feel extra scary: it’s as if you’re losing control of your body! This can lead people to get extremely focused on their physical sensations, and become fearful of future panic attacks. Ultimately, both of these behaviors make panic attacks worse.

Adrenaline doesn’t stay in the body for very long, which is why even the scariest panic attack will eventually get better on it’s own. Keep reading for ways your child can help make these attacks dissipate more quickly, and maybe even prevent them from happening in the first place.

Panic Coping Skill #1: Use an App to Get Grounded

Kids who are anxious often learn how to calm their symptoms by relaxing: imagining a peaceful place, taking deep belly breaths, and trying to clear the mind of worry. These techniques can work for panic attacks as well, but I often hear from kids that they are so distracted by the feeling of panic in the body that they can’t focus on anything else. They end up just sitting with their anxious feelings, which makes the anxiety spiral further and further out of control.

For these kids, grounding techniques can pull focus away from the anxiety and physical symptoms and direct it towards a focal point outside of the body. Grounding techniques help kids to stay focused on the present moment, rather than getting lost in their emotions or worried about the past or future. They usually work by helping a child to connect with their 5 senses, or by encouraging the child to observe details around them.

What’s Up? is a free app designed to help kids who are in the middle of intense anxiety or a panic attack soothe themselves. The app has all sorts of options for managing anxiety, from positive affirmations to breathing techniques. One section, titled “Get Grounded”, guides kids through simple grounding activities that can be done anywhere. Kids are prompted to name 5 items in a given category: for example, 5 things in the room that are red, or 5 foods you eat during the holidays. When the mind is engaged in this way, it’s hard to stay panicked at the same time.

Panic Coping Skill #2: Squeeze an Ice Cube or Take a Hot Shower

Engaging with any of the 5 senses can help kids feel more grounded and break the cycle of a panic attack. Many experts recommend using heat or cold sensations as a way to help kids feel more “in the moment” and to pull focus away from overwhelming emotions. I’ve personally seen many kids have success with squeezing an ice cube, jumping into a hot shower, or even stepping out into the front yard for a few minutes on a cold night.

This technique is especially helpful if your child’s panic attacks tend to happen at home. It can be a bit harder to use when you’re out and about, but a cool drink from a fountain or splashing water on your face in the restroom might be feasible when panic attacks happen in a public place. If you find that grounding skills are helpful, my online coping skills courses might benefit your child, too.

Panic Coping Skill #3: Sniff Some Lavender

Yep, this really is a thing! Lots of us have powerful emotional reactions to scent, which makes our sense of smell an especially helpful tool for grounding. There is some research to suggest that lavender is effective in soothing anxiety, and a lot of us probably associate it with relaxation, anyway. If your child isn’t a lavender fan, I think any other soothing scent, like vanilla or chamomile, would work just fine. The most important thing is to shift the brain’s focus away from the panic response onto something more pleasant.

You or your child can keep a bottle of essential oil or a rollerball container of fragrance on hand to use at the first sign of a panic attack. If a child can’t carry those objects to school, maybe a scented hand lotion could work as an alternative. I’ve even heard of children keeping a cotton ball on hand that’s been infused with a favorite scent, so that they always have a coping tool at their disposal.

Panic Coping Skill #4: Cut Caffeine

Okay, this is not really a coping skill, it’s just a thing not to do. However, it is really important, especially for preteens and teens who may have discovered the joys of Starbucks. I don’t want to forbid anyone from ever enjoying a pumpkin spice latte for the rest of time—most of us can get away with drinking coffee in moderation—but it’s important for teens and adults to understand the link between caffeinated drinks and anxiety symptoms.

Think about what happens when you drink coffee or soda: you feel more energized and alert, and if you drink too much, you might notice your heart pounding. It’s not too far off from what happens during a panic attack. Drinking caffeine isn’t likely to cause anxiety on it’s own, but it can worsen symptoms in people who are already struggling with it. In fact, high doses of caffeine have been shown to trigger panic attacks in studies.

Swearing off coffee and soda for the rest of time probably won’t cure anxiety, but it’s a smart idea to be careful about how many caffeinated drinks your child consumes. It’s also important for your child to be aware that it’s normal and okay to feel a little jittery after having a lot of caffeine. Sometimes, people who are prone to panic get so alarmed by that over-caffeinated feeling that they focus on their heartbeat or other body sensations, eventually triggering a panic attack.

Coping Skill #5: Remember This Will Pass

Sometimes, changing your mindset about panic attacks is the most effective way to make them better. Children and teens with panic need to understand what happens during a panic attack in order to feel reassured that they are safe, and that the attack will be temporary. This can cut down on the anxiety children feel anticipating future attacks, and when kids feel less anxious, they’re less likely to have panic attacks. It may seem weird, but accepting that panic attacks will happen sometimes can reduce the likelihood that the panic attacks happen at all!

When a child first starts noticing signs of a panic attack, it can help to simply put a name to it: “I’m having a panic attack.” Sometimes, even just doing this helps create some distance from the overwhelming feelings and make the panic attack less severe. Children can also remind themselves these feelings won’t last forever, or even set a timer or keep an eye on the clock to predict how long it will take for the adrenaline surge to fade away.

More Help for Children and Teens with Panic Attacks

I’ve written a few other coping skills articles on this blog, and kids and teens with panic might benefit from the 5-4-3-2-1 technique in this post on anxiety coping skills, as well as the skills listed for kids with coronavirus anxiety.

If you’re looking for more in-depth help mastering coping skills, check out Worry-Free Tweens. I designed this online course specifically for kids and young teens struggling with anxiety and panic attacks. It’s a self-guided course that includes videos for both you and your child, so you both have a road map for what to do the next time panic strikes.

Begin Child Therapy for Panic Attacks in Davidson, North Carolina

If your child or teen has been dealing with panic for a while, and coping skills like these haven’t been effective, it may be time to get extra help. Some kids with severe anxiety and panic benefit from medication which can make their panic response less intense. You can talk to your child’s pediatrician to see if this is an option for you, and they can refer you to a psychiatrist who specializes in treating children.

Counseling can also help kids with panic learn how to use coping skills more effectively, spot overly negative thinking that leads to anxiety, and gradually face their fears in a safe, supported way. I use CBT to help children with anxiety. If you’d like to learn more about the counseling services I provide, contact me here.

Coping Skills for Kids to Manage Coronavirus Anxiety

Imagine what it must feel like to be a kid during this pandemic. You’re dealing with a dangerous event that you don’t have any frame of reference for. The adults in your life can’t tell you how long it’s going to last, or how bad it’s going to get. And to make matters worse, most of your favorite things to help yourself feel better—seeing friends, playing sports, even going to school—are now off-limits. It’s no wonder we’re seeing so many kids struggling with anxiety due to the coronavirus.

As communities begin to reopen, we may actually see kids’ anxiety increase, since they’ve been out of their routines for so long. For kids with anxiety, having to face potentially stressful situations like school or crowded grocery stores after having a long break from them can be really hard. Here are a few coping skills to help your child deal with uncertainty now, and self-soothe when it’s time to get back to daily routines.

Coronavirus Coping Skill #1: Imagine a Peaceful Place

Right now, kids’ day-to-day surroundings may not be changing very much, but they can draw on their memories and imagination to give themselves a relaxing change of scenery. I find I’ve been using this skill much more often with children during quarantine.

The idea is that by focusing all our attention on making a memory feel as real as possible, our mind and body will start to respond as if we’re actually there. If you’ve ever heard a song from your childhood and immediately felt nostalgic, or smelled perfume that reminded you of a person or place, you know how this works.

To practice this skill, have your child select a place that feels safe and relaxing to her. Ask her to close her eyes, and guide her through questions focusing on the 5 senses to help her make her image of this place as real as possible:

• What do you see around you in this place? What colors are there? Are you inside or outside?

• What do you hear in this place? Is there music? Are people talking?

• Can you reach out and touch something around you? Wiggle your toes—what are you standing on?

• Breathe in. What does this place smell like? Flowers, the ocean, food?

• Is there anything that you would eat or drink in this place? What does it taste like?

After your child has spent a couple minutes focusing on her peaceful place, you can instruct her to slowly open her eyes. You might want to ask about what place she chose, and how this exercise felt for her. Imaginative kids often really enjoy this activity, and can do it alone with some practice.

Coronavirus Coping Skill #2: Worry Breaks

Kids who are prone to anxiety are often also prone to catastrophizing: imagining the absolute worst-case scenario possible for a given situation. Catastrophizing thoughts can be like a snowball rolling down a hill: a problem starts small, but as a child continues to think about it the problem seems bigger and bigger, until suddenly it’s out of control.

There are so many unknowns about the coronavirus, and media coverage is constant and often scary. Children who are worried about the virus or its effects have a lot of fuel for their anxiety, and few distractions to pull their focus. This can get those snowballs rolling downhill pretty quickly! Worry breaks are a way to help children break the cycle of worrying over and over (called ruminating) and have a healthy outlet for their fears.

To practice this technique, pick a short amount of time—10 to 15 minutes—each day that you can be available for your child. This is a special time set aside for your child to share his worries with you, where you will be able to listen and give your undivided attention. Some children prefer to journal or write their worries down alone, and that’s okay, too! What’s most important is that the time is limited in order to prevent too much ruminating from happening. You can set a timer on your phone to help with this.

After the time is up, it’s time to stop worrying for the day. If your child starts noticing worries at other times, he can remind himself that there will be plenty of time to worry about this at his next break. He should then shift his attention to something else, like a pet, game, or TV show. By the time the next worry break comes around, your child may discover that his worry has gotten smaller, or disappeared entirely. Over time, practicing this technique helps kids learn to better control their worries and keep the snowballing from happening.

Coronavirus Coping Skill #3: Outdoor Movement

The steps we’ve been taking to protect our physical health—staying indoors and avoiding contact with other people—can also take a toll on kids’ mental health. During quarantine, many families are relying more on screen time and indoor activities to help keep kids occupied during the day. No judgment here: especially if you’re working from home, you’ve got to do whatever you need to do in order to help keep kids calm and entertained.

However, kids who are spending all their time doing sedentary activities probably aren’t getting their movement needs met, which can increase anxiety, depression, and acting-out behavior. All that energy needs to go somewhere, and if it’s not given an outlet we might see it start to show up in unhealthy ways.

If your child is starting to feel a little wobbly emotionally, it’s a smart idea to prioritize some time each day to play outdoors. Getting out in the sun and fresh air is a welcome change from sitting in the bedroom all day, and some studies suggest that sunlight activates serotonin production in the body, which could boost a child’s mood. Being more physically active during the day can help kids cope with sad and anxious feelings, and might also lead to a better (and maybe earlier) night’s sleep.

Coronavirus Coping Skill #4: Mindful Sensory Play

Okay, so what if you’re stuck in the house and you can’t go outside? Maybe it’s raining, or you’re not able to directly supervise your child’s play for the next hour. What can your child do to self-soothe indoors that doesn’t require a screen?

Sensory play is any kind of playful activity that engages kids’ 5 senses. I sing the praises of this kind of play a lot, because it has an almost magical appeal for kids: it calms super active children, helps keep easily distracted kids grounded and focused, and it’s very soothing for children with anxiety. During quarantine, I’m hearing from families that play with a sensory component can be really helpful for children who are starting to bounce off the walls due to pent-up anxious energy.

Many mindfulness techniques encourage us to put our focus on our senses, because this naturally gets us to pay attention to the present moment, rather than thinking about the past or worrying about the future. Sensory play gives kids this same mindful opportunity: they’re noticing what their body is feeling right now, which means they’re not worrying about past or future events.

Pretty much every kid I know is obsessed with slime, but it might not be the most realistic option for unsupervised play at home, especially if your child is younger. Luckily, there are plenty of sensory play alternatives that don’t require as much cleanup. Here are a few to consider:

• Coloring with scented markers, crayons, or pencils

• Rocking on a rocking horse, or bouncing on a trampoline

• Mixing washable paint colors in a sealed ziploc bag

• Playing with play-doh (bonus points for scented) or Orbeez

• Taking a bubble bath or giving toys a bath in the sink

• Putting dried rice, pasta, or beans in a container to create a sensory bin

More Resources for Kids Coping with Coronavirus Anxiety

Sometimes, adding a few more coping tools to your toolbox is all that you need to help a child with anxiety. If that’s the case, you can check out my coping skills for anger, coping skills for anxiety, and coping skills for depression posts to get more ideas.

Does your child respond better to video? If you’re looking for a more engaging, in-depth way to learn coping skills, check out Worry-Free Tweens, my video course that teaches anxiety coping skills to kids and parents. These self-help videos lead you through a sequence of kid-friendly coping skills to help kids manage anxiety, panic attacks, and excessive worrying.

If your child’s struggles are getting more intense, getting in the way of daily activities, or worsening as your area begins to reopen, short-term counseling might help your child to bounce back from this stressful experience. You can search for children’s therapists in your area on Psychology Today, or if you’re in New York or North Carolina, you can reach out to me here.

4 Coping Skills to Help Children with Depression

If your child is experiencing severe depression symptoms or is feeling suicidal, please contact 911, the National Suicide Hotline, or the Crisis Text Line.

As anyone who has experienced anxiety symptoms knows, anxiety and depression often go hand-in-hand. People who have survived a trauma also often have symptoms of depression, including hopelessness, numbness, or lack of interest in activities. Because of this, I often see children struggling with depression in my therapy office, even though I specialize in PTSD and anxiety disorders.

There are lots of coping skills for anxiety that can offer some quick relief, either by distracting a child from worries or by helping the body to relax. I think it’s a little trickier to find skills that provide “quick wins” for kids with depression. Maybe this is because anxiety often has a more sudden, intense onset, and depression tends to be a consistent feeling for a longer period of time. In this post, I’ve compiled a few simple ways to help a child cope with depression that are supported by research. While some of these may not be as simple or quick as a breathing exercise, building these habits over time can help boost a child’s mood and encourage positive thinking.

Depression Coping Skill #1: Schedule Positive Activities (Even if They Don’t Sound Fun)

Many people assume that depression is caused by a negative event in life: for kids, maybe this is a move, a divorce, or an experience being bullied. While it’s true that tough life situations can trigger depression, researchers who studied depression found that a lack of positive experiences can also lead to low mood. Kids struggling from depression often withdraw: an elementary schooler might prefer staying home to going on play dates, or a preteen might drop out of her extracurriculars. This can create a vicious cycle where the lack of positive, rewarding activities in a child’s life make the depression worse, which in turn makes it harder to get out of the house.

You can help your child by encouraging activities that are social, fun, or provide a sense of accomplishment. Therapists call this technique behavioral activation, and it’s a treatment for depression in adults, as well as kids. Even if a child is reluctant, scheduling these kinds of activities and sticking to them can have a positive snowball effect. Think of it like going to the gym: you might really dread going the first time, but once you try it, you’ll realize it wasn’t so bad. In fact, you might feel so energized that you get motivated to go back the next day. The same thing can happen for children: the first outing might be really hard, but they may surprise themselves, and have more fun than they expected, which can make the next activity easier and more fun.

Here are a few positive, rewarding activities to consider:

• Making a meal or a snack together

• Trying an art class, or another class related to a child’s interests

• Taking the dog for a walk

• Re-arranging a child’s bedroom

• A movie night with a friend
  

Depression Coping Skill #2: Talk Back to Negative Thoughts

Kids with depression are prone to ruminating: mulling over their negative thoughts over and over again, which makes their sad feelings more intense. Depression often exaggerates and distorts our thinking, making our thoughts too negative to be true. Kids can stop the cycle of ruminating by spotting these overly-negative thoughts, questioning them, and coming up with a more helpful and realistic alternative. This is called cognitive restructuring and it’s an important part of cognitive-behavioral therapy, an approach that helps people learn how their thoughts and behavior influence their feelings.

This skill is best for kids who are elementary-aged or older. Sometimes it is hard for kids to learn this skill on their own, because it requires them to think about thinking, which is an abstract concept. A child counselor can teach children how to master this idea and practice “talking back” to negative thoughts. I often use the picture book Tiger Tiger, Is It True? to help kids understand how changing their thoughts can change their feelings.

You can help your child catch himself when he’s thinking something too negative to be true, and encourage him to ask himself questions like:

• Do I have any proof this is true?

• What would I tell a friend who had this thought?

• Is there another way of looking at this?

• OK, it if really is true, would it be the end of the world?

If your child benefits from this form of thinking, CBT might be a great option to help them cope with feelings of depression, and learn to change the thinking patterns that can trigger sadness and low mood.

Depression Coping Skill #3: Add More Sunshine

Many people notice that their depression is worse in the winter, when there is less access to sunlight. Seasonal Affective Disorder, a form of depression that often starts in the fall and ends in the spring, can occur in kids as well as adults. There is a theory that sunlight might encourage the body to produce serotonin, a chemical that influences many processes in the body including our sleep, digestion, and mood.

For kids, outdoor play is a great way to improve mood and cope with depression. Children who play outdoors get more sunlight, but this kind of play offers all kinds of other benefits, too. A study by the American Medical Association found that “children will be smarter, better able to get along with others, healthier and happier, when they have regular opportunities for free and unstructured play in the outdoors.” Being more connected to nature can also be a mood booster for both children and adults. Interestingly, spending more time in nature has been shown to help kids with ADHD feel more relaxed and focused, as well.

You don’t have to go on a big camping trip or expensive vacation to get the benefits of playing outdoors: a trip to the park, playing catch in the backyard, or a walk on a local nature trail can be just as helpful.

Depression Coping Skill #4: Practice Good Sleep Hygiene

Therapists like to say that sleep, exercise, and nutrition are all important for treating and preventing depression. If your child is feeling down, it’s worth looking into all 3. I have personally noticed that many of the children I meet who are feeling depressed are also really struggling with their sleeping patterns. Often, these children are staying up late, having a hard time falling asleep, and as a result have really shifted their sleep cycle to start and end later than is typical. These kids often have to operate at school on very few hours of sleep, or end up sleeping all day and missing out on the daylight hours they could be spending with friends.

Insomnia is a common symptom of depression, so it’s totally understandable that depressed children often have such a hard time falling asleep. What makes this situation so tricky is that sleep deprivation can also make people more vulnerable to anxiety an depression, so disturbed sleep can create a vicious cycle that ultimately makes depressed feelings more intense. In addition, if a child is losing a lot of their daytime hours to sleep, it cuts back on their opportunities to socialize or get involved in other positive activities that can reduce and prevent depression.

Sleep hygiene is a term to describe many habits that can encourage people to fall asleep and stay asleep, leading to a better night of rest. These habits on their own may not be enough to completely resolve sleep problems for a child, especially if she is also struggling with bedtime anxiety, but they’re a great place to start. Here are a few things to consider if you think your child’s sleep patterns might contribute to depression:

• Stop using any electronics (phones, computers, TV) for at least 30 minutes to an hour before bedtime.

• Finish any soda or other caffeinated drinks 4-6 hours before it’s time to sleep.

• If your child is struggling to fall asleep, encourage him to read a book or try another quiet activity for a few minutes. This can help kids feel tired faster, whereas tossing and turning in bed can make children more angry or anxious, and less likely to sleep.

• Create a routine for your child that is consistent each night and can help her unwind, such as reading a book together and practicing a relaxation technique.

• Checking the time repeatedly at night can lead to more worry and less sleep. If this is the case for your child, put the clock or phone in a position in the bedroom where she can hear the alarm but can’t see the face or screen.

• Make sure your child gets enough physical activity during the day, so that they are ready to relax by bedtime.

Begin Therapy for Kids with Depression in Davidson, North Carolina

Depression is tough, but kids can and do bounce back from their low moods. Trying these coping skills at home can be a great first step in fighting back against depressive symptoms. Looking for a way to go deeper with coping skills? Check out my online courses, which teach coping skills to kids and tweens in a self-study format. You and your child will learn specific skills you can start using right away, and get tips on how to practice them effectively.

If your child is dealing with depression after a loss, my activity book for bereaved children helps caregivers support children as they work through their grieving process. It’s available on Amazon, Barnes & Noble, and at local bookshops near you.

If you try these techniques and find your child is still struggling, a counselor can provide in-depth help and support. If you live in the Davidson, NC area and would like to learn more about how therapy can benefit children with depression, anxiety, and trauma, contact me here.

Anger Management: 3 Coping Skills for Kids

There’s a trick question that I love to ask kids who visit my office struggling with anger: Do you think anger is good or bad? If someone is looking for coping skills to help with anger management, it must be a bad thing to have, right?

I really believe that anger is a good thing for a person to have. It may not be comfortable to feel, but it serves an important purpose. Anger lets us know when something is unfair or unjust. It gives us the energy to persevere at something, even when the task is challenging. It can help us defend ourselves during an emergency. If someone never experienced anger, they’d probably be in trouble.

On the other hand, anger can come out in all kinds of unhelpful ways. When children express anger through destructive behavior or by hurting others, it can damage their relationships as well as their self-esteem. In this post, I’ll share 3 coping skills for anger management that children can use to channel their angry powers for good, instead of getting in trouble.

Anger Management Coping Skill #1: Non-Angry Physical Activity

It’s not a big surprise that exercise can help get angry feelings out. Sometimes, kids are encouraged to do something like punch a pillow or rip up paper when they’re mad. While this works just fine for some kids, it’s not the best option for others. Some kids with really intense anger find that these kinds of activities actually fuel their anger. Because punching and ripping are angry gestures, it can create a kind of feedback loop that keeps the anger going.

For these kids, physical activity that has nothing to do with anger is a better bet. Simple physical movement like jumping jacks, running in place, or hopping onto a bike can all be good options for burning off anger. It can also be helpful to encourage kids to be mindful while they are moving: if a child is running in place while thinking about how angry she is at her sister, it’s less likely to help. If the child really focuses on the task of running, her anger might burn off more quickly.

Anger management Coping Skill #2: Journaling

Writing down feelings instead of saying them aloud can be a great option for kids who tend to blurt things when angry that they’ll regret later. Writing these angry thoughts down helps “get them out” without necessarily having to share them with someone else. I think this type of journaling is best done by hand, because handwriting helps connect the person to what they are writing and slows down a person’s thought process.

Once a child has cooled off, he can reread his thoughts and decide if there’s anything in them worth bringing up in a conversation. Recording angry thoughts can also be a great way to spot the exaggerations and distorted thinking that leads to intense anger in the first place. Children can use journaling both to cope with angry feelings, and to learn more about the way the brain can play tricks on us when we’re angry.

Anger Management Coping Skill #3: Positive Self-Talk

A short, simple phrase can put a more realistic spin on situations that trigger anger. Often, when a child is angry, her thoughts exaggerate how bad a situation really is. Kids may find themselves thinking things like “I never get what I want”, “I hate this”, or “This is no fair.” Thoughts like this are usually too negative to be entirely true, and they can intensify anger.

Kids can come up with a statement to say to themselves to help them cope with these angry thoughts. Something like “I can handle this”, “It’s not a big deal”, or “This isn’t worth getting in trouble for” can help a child to self-soothe, and remind her that she doesn’t have to believe everything she thinks.

This is a technique that is borrowed (and slightly tweaked) from the book What to Do When Your Temper Flares, a self-help book to help children deal with anger. I love this book, and if this technique works well for your child, it’s worth checking out.

More Coping Skills Help for Anger Management

If you are looking for more anger management coping skills for kids, you may want to also check out my previous blog post on coping skills for anxiety. Most coping skills are versatile, and can help kids manage pretty much any strong emotion.

Looking for more tools for your child’s toolbox? My online coping skills self-help courses help kids learn strategies they can use to self-soothe when anger or strong feelings strike. These skills grow with your child, equipping them with skills to handle difficult situations both now and in the future.

If you’re looking for help for a child with anger in Davidson, NC, feel free to reach out to me here. I love meeting with kids in my counseling office, and also see kids throughout North Carolina, New York, and Florida for online therapy.

3 Quick and Easy Coping Skills for Kids with Anxiety

In therapy as in life, there’s no such thing as a quick fix. Helping a child work through anxiety or trauma is a gradual process, and a child often needs lots of time to grow, learn new ways of thinking about things, and make sense of experiences. When working with kids, it helps to be patient.

But what about the times when patience isn’t going to cut it? What if your child is in the middle of a panic attack, and you need help right now? Or you’ve only recently started therapy, nut there’s an event looming in the near future that you know is likely to trigger anxiety? These situations are what coping skills are made for. Read on to learn 3 easy coping skills for kids with anxiety that can be used any time, anywhere.

What’s a Coping Skill, Exactly?

“Coping skill” is a broad term for any healthy habit or activity a person uses to manage strong feelings. They turn down the volume on anxious thoughts, so a child can carry on with her day. They are used deliberately when a person is feeling anxious, stressed, or angry as a way to cool off their feelings, so the person can think more clearly or get through a difficult situation. Coping skills can also be an alternative to unhealthy or even harmful behavior that some people resort to when feeling overwhelmed.

Meditation, mindfulness, physical activity, and creative arts activities all fall under the umbrella of coping skills kids with anxiety or other mental health concerns might use to manage their emotions. Lots of coping strategies help kids to focus on their breath or objects around them to help them take their attention off their anxious feelings, and focus them on something else.

Teaching a child coping skills won’t address the underlying cause of anxiety or trauma symptoms. However, helping a child learn to relax, self-soothe, and focus their attention elsewhere is a critical skill. . Over time, coping skills can build resilience and keep kids from having strong reactions when they feel stressed.

Why Do Kids with Anxiety Need Coping Skills?

When a child is very anxious, her brain and body are in fight-or-flight mode. Fight-or-flight is a natural response that is hardwired in all of us to help keep us safe from danger, giving us a big surge of adrenaline and other hormones that quickly get us ready to fight off an attacker or run for our lives. Fight-or-flight affects many systems in the body, including heart rate, sweating, breath, and digestion.

An anxious kid’s fight-or-flight response isn’t working quite the way it should. It’s going off at the wrong times, putting him in this physically uncomfortable state when he doesn’t need to be there. While coping skills can’t change the circumstances making a child anxious, they can help to change the fight-or-flight response.

Coping skills help anxious children to relax in both the short- and long-term. They help the child to calm down right away, lessening the anxiety and panic so that the child can decide how to handle a situation. They can also help in the long run: the more a child practices a coping skill, the more effective it becomes. Some children with anxiety find that when they practice coping skills regularly, their fight-or-flight response becomes less sensitive.

How Coping Skills Work for Anxious Children

Coping skills can work in a few ways:

• They can help kids to relax: coping skills are a great way for kids with anxiety to calm their fight-or-flight response.

• They buy kids time: they give children an opportunity to pause and consider all their options before making a decision.

• They shift a child’s focus: coping skills often help a child put his attention on something outside of himself, which can help to reduce worries.

Coping Skill for Anxiety #1: Breathing in a Box

Breathing in a box is a simple way to teach children how to breathe slowly and mindfully. Draw a square on a piece of paper, and have your child trace their finger around the shape.

As your child moves his finger up one side of the square, he can breathe in on a count of 4. Next, hold the breath for a count of four as his finger moves along the top of the square. As his finger moves down the side, breathe out on a count of 4. Finally, rest for a count of 4 as his finger moves along the bottom of the box, before starting the breath cycle again.

The full cycle would look like this: Breathe in 1-2-3-4, Hold 1-2-3-4, Breathe out 1-2-3-4, Rest 1-2-3-4.

Coping Skill for Anxiety #2: Squeeze and Relax

Progressive Muscle Relaxation, or “squeeze and relax”, is a popular coping skill used to help kids struggling with anxiety, trauma, and insomnia. When a child is anxious or afraid, the muscles of the body tense up, which can lead to headaches, stomach aches, and other bodily symptoms of stress. Squeezing and releasing each muscle group in a sequence sends a message to the brain and body that it’s safe to relax right now.

To practice this, your child can start by squeezing the hands tightly (but not painfully) for a few seconds, and then relaxing. With just one squeeze there should be a noticeable difference in how the hands feel. Try the squeeze again, and then move to other muscle groups, like the arms, shoulders, stomach, and legs. Start at the top of the body and move down to the feet, before ending with one big, full-body squeeze.

Coping Skill for Anxiety #3: 5-4-3-2-1

This simple tool is particularly good for combating panic attacks as well as trauma symptoms like flashbacks. Grounding skills like this one pull a child’s focus away from the worries in her head and back to the world around her. Here’s how to try this coping skill:

Name 5 things you can see in the room or place around you
Name 4 things you can touch around you
Name 3 things you can hear (you may need to really pay attention)
Name 2 things you can smell: if you can’t smell anything after really trying, name your favorite smells
Name 1 thing you can taste: if you can’t taste anything, imagine what the last thing you ate tasted like

This quick skill can be used almost anywhere, since all it requires is use of the 5 senses.

More Coping Skills Resources for Anxious Kids in North Carolina

If these coping skills seem like a step in the right direction for your child, there are many more options to try. My educational course for anxious kids, Worry Free Tweens, covers these coping skills and other tools for managing anxiety in more depth. You’ll also find tips for parents so you can help your child to practice at home, and manage your own stress, too.

If you feel like your child needs more support, or other issues insomnia or back-to-school anxiety are making life complicated, therapy can help. I love helping anxious kids learn strategies to handle their worries. If you’re in the Lake Norman area of North Carolina, I’d love to help at my child therapy office. You’re always welcome to reach out to me, or to inquire about online counseling, which is available to kids in North Carolina, New York, and Florida.