A toolbox for managing anxiety in children with tips and strategies for mindfulness techniques.

Therapy doesn’t have to start and finish at the psychologist’s office; in fact, practising anxiety management techniques regularly and in a safe environment can result in better outcomes for your child.

Skilling up in calming strategies, breathing and grounding techniques will give you the confidence to teach your child and help them practice.

Strategies toolkit

The following strategies are a menu that you can choose from and, if necessary, adapt to your child’s needs and preferences.

Breathing techniques

• Hot chocolate breathing – “Pretend you are holding a hot chocolate. Breathe in through your nose, imagining you are smelling the delicious chocolatey smell. Then try to cool it down by slowly blowing the air gently out through your mouth. Smell the hot chocolate and blow it cool for three seconds each time. Keep doing this until you start to feel relaxed.”

• Dandelion breathing – “ Imagine you are holding a dandelion. Can you see hundreds of little white soft feathery bits? Use your breath to slowly blow them off. Can you see the floating in the wind?  You’ll need to do it 3 times”

• Balloon belly – “Imagine you have a balloon in your belly. Rest your hands on it and then let’s try and fill it with air. Breathe in while counting to 4 and feel your balloon belly growing. Hold it, and then release the air really slowly”

Throw away worries

• Worry dolls – There’s a Guatemalan tradition of creating colourful little dolls that help to take away worries. You can buy them but it is much more fun to make your own. Ask your child to tell the colourful dolls their fears and at bedtime put the dolls under their pillow. According to legend, by morning the dolls have gifted them with the knowledge to eliminate their worries.

• Worry boxes – Find a container (you can use an empty tissue box) where your child can put little notes with their anxious thoughts. Explain that they can put any worry inside the box and then you can work through each one together. Putting the worries in the box will make sure they don’t have to carry them around all the time. Your child might like to spend time decorating the box and naming it.

• Worry time – Agree with your child to schedule at the same time every day, 30 minutes for your child to talk to you about their worries. Having a dedicated “worry time” can help them push away the need to play out their fears in their minds until the scheduled time.

Grounding techniques

• 5,4,3,2,1 awareness – ask your child to do the following “Name five things you can see, 4 things you can touch, 3 things you can hear, two things you can smell, and one thing you can taste.” Focusing on the environment around them using their senses is a good way to short-circuit the worry loop that is part of anxiety.

• 3-3-3 rule – this mindfulness technique is easy enough for young children to learn. Teach your child to name 3 things they can see, identify 3 sounds they can hear, and move 3 different parts of their bodies. This activity distracts children from their worries and refocuses them on the present moment.

• Progressive muscle relaxation – involves tensing different muscles in your body and then releasing the tension. Help your child start with the muscles on their forehead and work their way down to their feet. You can use a script similar to this.

1. Scrunch up your forehead, count to 3, and let go.
2. Make a smile so big that your cheeks and nose are all wrinkled, count to 3, and let go.
3. Now imagine you have a very big grape in your mouth. Imagine it’s between your teeth and you bite down on it and hold down until it all mush. Count to 3 and let go.
4. Can you touch your ears with your shoulders? Have a go to see how far you get. Count to 3 and let go.
5. Good job! You need to loosen up a little more. Push your chest out and your shoulders back. Count to 3 and let go. Are you starting to feel more relaxed?
6. It’s time to show me how big your arm muscles have grown. Flex the left arm and hold for 3 then do the right arm and hold for 3.
7. Imagine you’re a cat about to pounce. Stretch your hands right back and hold then bring them forward like you’re a cat pouncing on a ball and hold. 
8. All your muscles are starting to relax. Pretend you have eaten more grapes but they are now in your stomach and you need to use it to squash them. Can you squeeze your tummy really hard to squash the grapes inside?
9. You’re now at the beach. You go on your tippy toes so you can see beyond the rocks. Count to 3 and relax.
10. It’s nice to feel the sand between your toes. Dig your feet and toes deeper into the sand, count to 3, and relax.

Programs for children and carers

• BRAVE – a free online program to help kids cope with worries and anxiety. There’s a tailored version for younger kids (eight-12), one for teens (12-17), and an accompanying program for parents.

• Cool kids – Cool Kids Online is an online program that is designed to help children who have fears and worries that bother them or get in the way of having fun. The program teaches children new skills to help them face their fears and worries, feel more confident, and have more fun. It is designed for parents to work through with their child at home.

• SPACE – Supportive Parenting for Anxious Childhood Emotions is a parent-based treatment program for children and adolescents with anxiety, OCD, and related problems. SPACE aims to treat children and adolescents with anxiety disorders and obsessive-compulsive disorder. Although children do not have to attend SPACE sessions – they are the patients!