How to Help an Anxious Child: A Clinical Psychologist’s Guide
To help an anxious child, start by validating their feelings without dismissing them, teach simple calming techniques like slow breathing, gradually expose them to feared situations rather than allowing complete avoidance, and model calm responses yourself. Anxiety is the single most common reason parents bring their children to see us at Anna Cohen & Co. The good news is that childhood anxiety responds extremely well to treatment. Most children show meaningful improvement within 6 to 8 sessions of evidence-based therapy, and the coping skills they learn stay with them for life.
If you are reading this, chances are you have watched your child struggle with worry, fear, or avoidance and felt helpless about how to respond. You may have tried telling them “there is nothing to worry about” (which does not work) or removing them from situations that trigger anxiety (which actually makes anxiety worse over time). Neither of these responses is wrong. They are completely natural parenting instincts. But anxiety responds best to a specific set of strategies, and once you learn them, your ability to support your child will change dramatically.
Understanding Childhood Anxiety
Anxiety is not a character flaw or a sign of weakness. It is the brain’s threat-detection system working too hard. Every child has this system. It is what keeps them safe by making them cautious around heights, strangers, or dangerous animals. In an anxious child, this system has become oversensitive. It fires in situations that are not actually threatening: school, social events, being away from parents, the dark, or new experiences.
The feeling your child experiences during anxiety is very real. Their heart races, their stomach churns, their muscles tense. Their brain is telling them that something terrible is about to happen, and their body is preparing them to fight or run. When you tell an anxious child “there is nothing to worry about,” you are contradicting what their body and brain are telling them. That is why it does not help.
7 Strategies You Can Use at Home
1. Validate First, Problem-Solve Second
Before offering solutions or reassurance, acknowledge what your child is feeling. “I can see you are really worried about tomorrow” or “That sounds really scary for you.” Validation is not agreement. You are not saying their fear is justified. You are saying you see them and you take their feelings seriously. This single shift in language calms the child’s nervous system and opens them up to hearing what you say next.
2. Teach Slow Breathing
This is the simplest, most effective anxiety tool for children of any age. When we are anxious, we breathe fast and shallow, which amplifies the physical symptoms. Teaching your child to breathe slowly and deeply sends a signal to the brain that the threat has passed.
Try “square breathing” with your child: breathe in for 4 counts, hold for 4 counts, breathe out for 4 counts, hold for 4 counts. Practise this when they are calm so it becomes automatic when they are anxious. For younger children, use a concrete visual like “smell the flowers, blow out the candles.”
3. Externalise the Anxiety
Give the anxiety a name or a character. “That sounds like Worry Monster talking again” or let your child name it themselves. This creates psychological distance between your child and their anxious thoughts. Instead of “I am scared,” it becomes “Worry Monster is trying to scare me again.” This is a powerful technique from narrative therapy that works remarkably well with children aged 5 to 12.
4. Use Gradual Exposure, Not Avoidance
This is the most important principle and the one that goes against every parental instinct. When your child is terrified of something, your natural response is to protect them from it. But every time you allow your child to avoid something they are afraid of, you are confirming their brain’s message that the thing is dangerous. The anxiety gets stronger.
Instead, help your child face feared situations in small, manageable steps. If they are afraid of dogs, start by looking at pictures of dogs, then watching dogs from across a park, then standing near a calm dog, and gradually building up. Each step teaches their brain that they can cope and the feared outcome did not happen. This is called graded exposure, and it is the foundation of every effective anxiety treatment.
5. Limit Reassurance
This one is hard. When your child asks “will I be okay?” or “what if something bad happens?”, your instinct is to reassure them. The problem is that reassurance provides immediate relief but feeds the anxiety cycle. Your child feels better for a moment, but the next time they feel anxious, they need reassurance again. Over time, they need more and more reassurance to get the same relief.
Instead of answering the anxious question directly, try reflecting it back: “What do you think will happen?” or “How did it go last time you were worried about this?” This helps your child develop their own capacity to manage uncertainty rather than relying on you to provide it.
6. Model Calm Responses
This is where my Regulated Parenting Model™ comes in. Children learn how to manage emotions primarily by watching how their parents manage theirs. If you respond to your child’s anxiety with your own anxiety (rushing to fix it, becoming visibly distressed, catastrophising), your child’s brain registers: “Even my parent thinks this is dangerous.”
The most powerful thing you can do in an anxious moment is stay calm yourself. Not dismissive. Not minimising. Calm. Your regulated nervous system communicates safety to your child’s nervous system in a way that words cannot. A dysregulated adult cannot regulate a dysregulated child. When you are calm, you give your child’s brain permission to calm down too.
7. Create a Worry Time
For children who worry throughout the day, designate a specific 10 to 15 minute “worry time” each afternoon or early evening. Your child writes down or draws their worries, and you discuss them together during this window. Outside of worry time, if a worry comes up, they write it down and save it. This teaches children that worries can be contained and managed rather than consuming the whole day.
When Home Strategies Are Not Enough
The strategies above will help many anxious children. But there are situations where professional support is needed. Consider seeking help from a child psychologist if:
- Anxiety has been present most days for more than a month
- Your child is refusing to go to school
- Anxiety is causing significant family conflict or distress
- Your child is unable to sleep alone, attend social events, or participate in normal activities for their age
- Physical symptoms (stomach aches, headaches, nausea) are frequent and have no medical explanation
- Your child is expressing hopelessness or saying things like “I can’t do this” or “I want to disappear”
- You have tried the above strategies consistently for 4 to 6 weeks without improvement
How We Treat Childhood Anxiety at Anna Cohen & Co
Cognitive Behavioural Therapy (CBT)
CBT is the gold-standard treatment for childhood anxiety with the strongest evidence base. It teaches children to identify their anxious thoughts (“something terrible will happen at the party”), evaluate whether those thoughts are realistic (“what actually happened last time I went to a party?”), and develop alternative, more balanced thinking. Combined with graded exposure to feared situations, CBT produces lasting improvements in 60 to 80 percent of children with anxiety disorders.
Play Therapy (for Younger Children)
Children under 7 or 8 often cannot engage with the thought-challenging component of CBT. Play therapy allows them to process anxious feelings through play, art, and storytelling. The psychologist creates a safe environment where the child can express and work through their fears at their own pace.
Acceptance and Commitment Therapy (ACT)
ACT is particularly effective for older children and teenagers. Rather than trying to eliminate anxious thoughts (which can sometimes backfire), ACT teaches children to notice and accept anxious feelings without being controlled by them, and to take action towards the things that matter to them even when anxiety is present.
Parent Coaching
We work with parents alongside the child to break the accommodation cycle (the pattern where parents unintentionally maintain anxiety by allowing avoidance, providing excessive reassurance, or modifying family routines around the child’s fears). Changing these patterns at home accelerates the child’s progress in therapy significantly.
How to Get Started
Call Anna Cohen & Co on 02 9555 1168 to discuss your child’s needs or to book a first appointment. We see anxious children at our Balmain (397 Darling Street), Waverley (269 Bronte Road), and Katoomba (Suite 6, Level 1, 68-74 Katoomba Road) clinics. Telehealth sessions are also available Australia-wide for families who cannot attend in person.
To access Medicare rebates of $98.95 to $145.25 per session (up to 10 sessions per calendar year), ask your GP for a Mental Health Treatment Plan before your first appointment.
About the Author
Dr Anna Cohen is a Senior Clinical Psychologist (AHPRA PSY1176554) with over 30 years of experience working exclusively with children, adolescents and families. She is the founder of Anna Cohen & Co and co-founder of Kids & Co Clinical Psychology, which operates across six locations in Sydney and the Blue Mountains. Anna is the author of four parenting books including Skilful Parent Happy Child and Taming Teens, and the creator of the Regulated Parenting Model™.
Frequently Asked Questions
What are the signs of anxiety in children?
Common signs include excessive worry, avoidance of activities or places, physical complaints without a medical cause (stomach aches, headaches), difficulty sleeping, clinginess, irritability, perfectionism, frequent need for reassurance, and difficulty concentrating. In younger children, anxiety often shows up as physical symptoms or behaviour changes rather than verbal worry.
Is it normal for children to be anxious?
Some anxiety is a healthy part of development. Fear of the dark, separation anxiety in toddlers, and pre-test worry are all age-appropriate. Anxiety becomes a concern when it is persistent, disproportionate, and causing your child to avoid normal activities for more than a few weeks.
What type of therapy works best for childhood anxiety?
Cognitive Behavioural Therapy (CBT) has the strongest evidence base and is the gold-standard treatment. For younger children, play therapy and parent coaching are highly effective. Acceptance and Commitment Therapy (ACT) is also used for older children and teenagers.
Can anxiety in children go away on its own?
Mild, situational anxiety often resolves with time and parental support. However, clinical anxiety that has persisted for months and interferes with daily life is unlikely to resolve without intervention. Untreated childhood anxiety is a strong predictor of anxiety and depression in adolescence and adulthood.
How can I help my child with anxiety at bedtime?
Establish a consistent calming routine, teach a simple breathing exercise for bed, use a worry journal they can close before sleep, avoid screens for 30 minutes before bed, and try a dim night light if darkness is a trigger. If bedtime anxiety persists despite these strategies, a few therapy sessions can make a significant difference.
Does Medicare cover treatment for childhood anxiety?
Yes. With a Mental Health Treatment Plan from your GP, your child is entitled to up to 10 Medicare-rebated sessions per year. The rebate is $98.95 to $145.25 per session. Ask your GP about the plan before booking to reduce your out-of-pocket costs.