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Parent and Child Psychological Services PLLC 
941.357.4090 (Office)/ 727.304.3619 (Fax)
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What to do with Worry by Kirsten Ellingsen, PhD, PMH-C

1/13/2023

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Worry is the thought component of anxiety.  An important part of effectively managing anxiety is recognizing, challenging, and changing unhelpful thoughts and thinking patterns. 

Worry can be productive and facilitate planning and problem solving for an upcoming event or figuring out how to prepare for an upcoming challenge.  It can be beneficial for academic achievement. It can enhance focus and motivation.  For example, if your child is worried about an upcoming test worry can encourage productive studying and enhance performance. It can also motivate action to prepare for potential risk or challenges, such as gathering supplies and an evaluation plan if a predicted hurricane nears. Worry might also help a child think through consequences and be more cautious to moderate risk-taking behavior.  

When worry is addressed or facilitates productive action it is a manageable and helpful part of normal life. Everyone worries. Just like we do not want to get rid of all anxiety, we do not want to get rid of all worry. The goal is to recognize and use worry to make safe choices and prepare or plan for necessary responses to challenges.

However, worry is an ineffective method to solve problems if thoughts begin to focus on extremes (e.g., the “what if…” or highly unlikely 1% possible negative outcomes) and become out of balance to real danger or circumstances. When worry is excessive, frequent and/or interferes with enjoying and full functioning in life it can become a significant problem.  It is a problem when worry is unrealistic with an exaggerated risk or probability that results in a child not wanting to participate in expected or otherwise enjoyable activities.

What anxiety might look like for children and teens
  • Frequent reassurance-seeking.
  • Afraid to separate from parents; fear of being alone.
  • Complaints about physical symptoms (headaches, stomachaches). 
  • Anger or Oppositional behavior. Increased moodiness or irritability.
  • More tantrums or meltdowns (particularly toddlers and preschool age children). 
  • Changes in appetite or eating behavior. Trouble falling asleep or regression in sleep.
  • Trouble falling asleep or regression in sleep.

Steps to Managing Worry
THOUGHTS: Teaching children that they can reduce worry and that worry thoughts are connected to how they feel is the first step to helping them effectively manage worry. Helping children identify worry as thoughts and choose more helpful and realistic thoughts is the goal.

Different types of thoughts can make a person feel more or less anxious. Encourage the Maybe for unknown. Help children become comfortable tolerating uncertainty (and that we cannot know 100% what will happen in any given situation). Learning strategies to increase calming thoughts and relaxation strategies to calm our body can help reduce worry and better manage anxiety. 

Challenge Worry: Break it down to understand concerns. Guide child/teen to more balanced or helpful thoughts. Ask “What is the evidence for this/against this”? Question “Are you sure?” “Is that a fact or feeling?” “Am I jumping to conclusions?”.

Help children identify and choose more helpful and realistic second thoughts, so that children realize that they are able to handle worry and feel better by noticing and transforming self-talk, perspective, and the thoughts.

Model healthy coping and express how you manage worries.

Facilitate problem solving and work together to come up with a plan rather than offering a solution or fixing the problem so your child is empowered to address the problem.

ACTIONS: While worry is the thought component of anxiety, there are actions that can help decrease and manage worry. 
Physical sensations (our fight or flight response) and emotional reactions are also part of anxiety.  Relaxation strategies (diaphragmatic “belly” breathing, progressive muscle relaxation, and guided imagery) can help reduce the physiological symptoms of anxiety.  Some suggestions for helping children manage anxious thoughts and worry (particularly when it is problematic) are presented below.
Finally, show compassion and help your child identify and express his or her feelings. Keep the worry in perspective. Validate feelings first. Don’t minimize feelings or dismiss worry Listen. Model calm. Acknowledge concerns and then help them come up with more useful thoughts. Make sure your child gets adequate sleep and re-sets with physical activity every day. 

Additional Resources:
Coping Skills for Anxiety www.therapistaid.com/worksheets/coping-skills-anxiety
Worry Less in 3 Steps: kidshealth.org/Nemours/en/kids/worry-less.html



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    Parent and Child Psychological Services is a private practice serving children and families in the Sarasota, Florida area. The practice is owned and operated by Dr. Gibson, a Licensed Psychologist who is Board Certified in Clinical Child and Adolescent Psychology. ​

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Parent and Child Psychological Services PLLC 
info@childtherapysrq.com
941.357.4090 (Office)
727.304.3619 (Fax)                                                                                                                                                               
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