Preteen Girl Attitude? How to Get Along With Your Preteen Daughter

While most of us know to expect moodiness from teenagers, some parents may be surprised when the angst starts earlier than they expected with their preteen girls. Seemingly overnight, the sweet, well-behaved little girl you’ve raised has turned into a sassy, eye-rolling machine. What happened?! Is this normal? The short answer is yes, absolutely, and it’s nothing to take too personally. For the long answer, you can keep reading this post on how to manage preteen girl attitude, and keep your relationship with your daughter going strong.

Why Is My Preteen Girl Suddenly So Disrespectful?

It can be a little shocking for parents to witness a sudden transformation in their child’s behavior during the preteen years. After all, 10, 11, and 12 year old girls are still pretty young! Many girls this age still have an interest in playing with dolls and toys, and at the same time they’re starting to have decidedly grown-up reactions like sarcasm and heavy sighs.

We can thank hormones and puberty for a lot of these behavior changes. While preteen boys can certainly be moody as well, I notice that girls often start noticing this irritability sooner. This is likely because girls tend to start puberty a little bit earlier than boys, typically around age 11. Preteen girls are grappling with big changes physically, emotionally, and socially during this time.

What Causes Tween Girl Attitude? (Hint: It’s Not All Your Fault)

On one hand, girls’ bodies are maturing and their brains are going through a major restructuring. Estrogen and progesterone, the hormones responsible for puberty in girls, can also cause mood swings. Meanwhile, the brain is going through its biggest growth spurt since toddlerhood…which might be why there are some similarities between toddler and teen meltdowns.

During the preteen and teen years, the brain is adding new neural connections and eliminating ones that it no longer needs. While other parts of the brain are “under construction,” preteens and teens might be relying more on their amygdala to make decisions. This part of the brain is associated with the fight-or-flight response, aggression, and impulsive reactions.

On the other hand, increasingly complicated friendships and more demanding homework make the middle school years the most stressful years of school for many kids. In fourth grade, most girls probably weren’t worried about being kicked out of their friend group or voted off the lunch table, but by sixth grade this can be a real worry.

When you think about all these changes occurring in a short period of time, it’s no wonder we see fairly sudden changes in how many preteen girls are feeling. You didn’t suddenly become mean or uncool. This is just par for the course with growing up.

It’s Not Just You! This Is Actually Pretty Normal.

Most, if not all, of the less-than-pleasant behaviors you’re likely to seen in your tween daughter are totally normal. As difficult as they are to live with, they are also a sign that your daughter is developmentally on track. Please don’t beat yourself up worrying that you might have done something to cause this! No matter what, most preteen and teen girls are going to struggle with intense emotions and attitude at some point.

Preteen girls are beginning the difficult process of separating from their parents, and figuring out who they are as individuals. It’s a necessary step in their path to adulthood, but it can also be a bumpy ride. Here are a few behaviors that are totally normal and expected for preteen girls:

• Eye rolling

• Sarcastic tone of voice

• Overly harsh responses to criticism or being told to do something

• Crossed arms or other defiant body language

• Criticizing or nitpicking you

• Heavy sighs or other nonverbal expressions of being annoyed

When Should I Step In to Help My Tween?

Although very annoying, the behaviors listed above are not likely to be harmful, and will usually go away on their own with a little patience and understanding. On the other hand, there are some behaviors to look out for that are not as typical for the tween years, and are a sign your child needs extra help. If you notice your child struggling with one or more of the behaviors on this list, bring it up to your pediatrician or a therapist:

• Breaking or damaging things when angry

• Getting into trouble for disrespect at school

• Withdrawing from friends or losing interest in activities

• Difficulty getting along with other children

• Thinking or talking about self-harm

• Any very sudden or dramatic changes in mood or personality

How Should I Discipline A Tween for Attitude Problems?

Preteen girls often tell me that they are just as bothered by their moodiness as their parents are. The sarcastic comments fly out of their mouths before they even fully realize what they’re saying. It feels out of their control, and it’s no fun for anybody.

Because most tween attitude issues aren’t dangerous or deliberately harmful, and they are a part of normal development, the best response might be to ignore the behavior. I realize this a tall order for parents! Often, children repeat behaviors that get a lot of attention from parents. By ignoring the attitude, you may help your preteen get over this stage faster, while also saving yourself an argument. Here are a few more tips to consider:

• Watch your own tone. Think about how you tend to talk when you’re angry or stressed. If you’re using sarcasm or yelling, it’s more likely your child will copy your behavior. You can model the behavior you want to see in your child by making sure to speak respectfully around the house.

• Use natural consequences. Is your tween child refusing to do her chores? This might mean you have to do them yourself later, and won’t be free to drive her to her friend’s house this afternoon. This type of discipline is often more effective than just taking away a privilege, because it helps kids connect cause and effect.

• Offer a chance for a “do-over.” Sometimes, preteens don’t even realize that they’re not using a great tone of voice. You can help your child develop more self-awareness and practice speaking calmly by letting them “rewind” a conversation and try saying something again, minus the attitude.

• Pick your battles. It’s exhausting being a parent, and it’s doubly exhausting trying to deal with hard behaviors. Conserve your own energy by focusing on the conflicts that really matter to you, and let the rest slide. It’s okay to ignore an occasional sassy comment without making it a teaching moment every time.

How to Get Along Better With Your Tween Daughter

There is some truth to the stereotype that teen (and preteen) girls tend to butt heads more often with their moms than anyone else. If you are a mom who has enjoyed a close relationship with your daughter up until this point, it must be so disheartening to suddenly feel like everything you do drives your kid up the wall. Even though it’s a normal phase and not your fault, there are things you can do to keep your relationship with your daughter strong while you weather these preteen years together.

• Build in more positive, one-on-one time. If your daughter seems to be snapping at you every time you open your mouth, you probably aren’t feeling so thrilled about being around her right now. In fact, you might find yourself avoiding her or bracing yourself for another fight whenever you’re in her presence. Over time, this can make parent-child relationships more strained when, deep down, your daughter still wants your time and attention. Finding activities you both enjoy doing together can make arguments less likely, and give your daughter the focused attention she is craving.

• Connect with what interests her. Lots of tween girls I know are superfans of a particular TV show, anime series, or book series. They’d love nothing more than to be able to gush over their interests with an adult who is willing to listen! When you take the time to learn about the subjects your tween is geeking out about, you are showing her that you take her interests and opinions seriously.

• Teach her about her brain and emotions. Preteens are able to think more abstractly than younger kids, which means they can understand how the changes in their brains and bodies might be affecting their moods. It can be a relief for a tween to know that there is a valid reason she’s feeling so moody and vulnerable. Talking about moodiness as a brain change can also help both parents and kids to take the behavior less personally the next time it happens. If you need help with this, check out my coping skills courses which provide lots of education about how our feelings work.

More Help for Preteen Girls

If you’ve got a preteen girl who is struggling with anxiety or other big feelings, check out my coping skills course, Worry Free Tweens. This is an online, educational class (not therapy) that includes videos for both you and your child to watch at your own pace. You’ll come out of it with a set of specific tools you can use right away to deal with worries, panic, and anxiety.

I write about preteens a lot on this blog, because they’re one of my favorite age groups to work with in therapy! You can check out some of my other blog posts here:

How Preteens Are Stressed About Covid-19 (And How You Can Help)
Internet Safety for Preteens and Teens
What Causes Anxiety in Tweens?

If you’re thinking about enrolling your preteen child in counseling, my virtual door is always open. At the moment, I can work with families in New York, North Carolina, and Florida through online therapy.

Anxiety About Returning to School After Covid? Here's How to Help.

Even kids who are usually eager to attend class may be feeling nervous this back-to-school season. The pandemic threw a wrench in many children’s daily routines, leaving them with tons of unstructured time and few opportunities to hang out with other kids. Combine that with the uncertainty in many school districts about what the new school year will look like, and you’ve got a recipe for school anxiety. Today, I’m sharing some advice about back-to-school anxiety, and how to help your child feel confident and prepared for an unusual school year.

My Child Loves School. Why Is This Year So Much Harder?

We are going to be seeing the after-effects of the coronavirus pandemic on children for a while. As daycares, schools, and extracurricular activities reopen for business, many kids find themselves feeling more anxious, rather than less. Back-to-school jitters are common for all kids, but there are a few good reasons why this year’s return to school may be especially challenging:

• Kids have been out of school much longer than a normal summer vacation, which makes returning harder

• It’s tough to transition back into the strict routines of school after lots of unstructured time at home

• Not having chances to socialize with other kids can increase social anxiety

• Some children are very worried about the coronavirus, and how they’ll stay safe at school

• New safety measures, like masks and social distancing, might trigger anxiety for kids

• Uncertainty about the school’s reopening plans can make anxiety worse

What Are The Signs and Symptoms of School Anxiety?

Chances are, if your child is nervous or reluctant to go back to school, you are hearing a lot about it already! However, sometimes it’s hard to distinguish between run-of-the-mill worries about the first day of school and stronger anxiety that might need some extra help to overcome. In addition, some kids are not as vocal about their anxiety, and their symptoms may be more body-based. Here are a few clues to look out for if you think your child might be struggling with school anxiety:

• Headaches, upset stomach, or complaints of other physical problems on school mornings

• Frequent trips to the school nurse during the school day, without a clear illness

• Repeated worries about bad things that could happen while at school, such as getting sick

• Tantrums, anger, or outright refusal to go to school

• Panic attacks, which may seem to come out of the blue

• Anxiety that seems to be more intense or long-lasting than what is usual for the child’s age

One or more of these symptoms might indicate that your child’s worries about school are stronger than they need to be, and they could use some help to move past them.

How Can I Help My Child Get Ready to Go Back to School After Coronavirus?

Right now is a great time to help your child combat anxiety and prepare to go back to school. There is no getting around it—this school year is likely to be a weird one, and it’s understandable that kids are feeling nervous! Even so, there are steps that parents can take to help kids soothe their worries and feel more ready to deal with the changes this year might bring.

If your child has been spending tons of time isolated at home, now is a great time to (safely) help them get used to being back in public. You don’t want your child’s first venture back out into the “real world” to be on the first day of school! If you are safely able to do so where you live, let your child accompany you on grocery store runs or other errands. Try some outdoor activities that allow for social distancing while still letting your child be around other people.

This can help your child re-build their tolerance for transitions between activities and get used to socializing again. It’s also a great opportunity to practice wearing masks and using good hygiene, which might be needed for in-person school.

School Hasn’t Started Yet. What Can I Do Now to Reduce My Child’s Coronavirus Anxiety?

The summer weeks leading up to the start of school are also a great time to prepare your child for what changes to expect when school reopens. Are they likely to be online, in-person, or a mix of the two? Will children be expected to wear masks? Will their desks be spaced further apart, or will children be attending school in smaller groups? Younger children can benefit from acting out these changes through play, while older kids can handle a simple conversation.

Even if you’ve done it before, this is also a great time to review facts about coronavirus with your child and check for any misinformation that is causing anxiety. Make sure your child knows how coronavirus is and isn’t spread, and emphasize what measures their school will be taking to keep students and teachers safe. Many children I work with are very fearful about catching coronavirus through food, or simply by being outside of the house. Accurate knowledge about how the germs spread can reduce anxiety.

School Has Started For My Child, And The Anxiety Hasn’t Gone Away. How Can I Help?

For some kids, anxiety about school might subside once they’re settled into their new routine. For others, anxiety symptoms may stick around and continue to cause problems. This year, parents may be put in the difficult position of having to make decisions about whether or not to allow their child to return to in-person classes. Parents might also find themselves worried about or not in agreement with school policies, but needing to send their child to school, anyway.

Whatever choice you make, it’s a good idea to avoid speaking negatively about the school’s decisions in front of your child. Kids will take your opinions to heart, and they’re looking to you to help form their own beliefs about school. You can help to set a tone in your household that is both optimistic and realistic. If you need to vent about the impossible situation you’re being put in as a parent, find a friend to talk to away from your child’s listening ears.

My Child Won’t Be With Friends This Year. How Can I Make It Easier?

Some children may struggle from being separated from their friends at school this year. Whether it’s due to social distancing in the classroom, attending school on alternate days, or friends changing schools or switching to homeschooling, this can have a big impact on a child’s attitude about school. Help your child find ways to keep in touch with friends, whether through group zoom chats, after-school activities, or an old fashioned phone call. Games or structured activities might make staying connected with friends feel easier and less awkward.

The usual, non-pandemic advice for how to help kids with school anxiety still applies, too. Practicing relaxation skills at home, encouraging consistent attendance, and reading books to children about school stress can help ease the transition back to the classroom. You can check out my earlier post on back-to-school anxiety for more detailed advice.

More Help for Returning to School After Covid

Unicef has a great mental health guide for helping kids re-adjust to school this year. I also really like healthychildren.org’s practical advice about how students can stay safe at school, as well as how to address bullying and other issues that might be more intense as this school year begins.

My favorite tools for helping children practice relaxation skills are Headspace and Insight Timer for guided visualizations, and the app What’s Up? to help kids struggling with panic attacks feel more grounded.

If you’re looking for counseling for your child with school anxiety, my virtual door is open, and I’d love to hear from you. I can see clients in New York, North Carolina, and Florida for online therapy.

Online Therapy for Minors: What You Need to Know

Telehealth is more popular than ever before. By now, many of us are probably used to consulting with doctors, physical therapists, and counselors online. Given the current stresses in the world, there are many children and teens who could really benefit from having an understanding person to talk to.

However, many of the “big name” companies for online therapy primarily cater to adults. In this post I’ll go over what you need to know about online therapy for minors. This information should be helpful whether you’re a parent looking for therapy on behalf of a child, or a young person seeking therapy for yourself.

What’s Online Therapy, and Who Uses It?

Online therapy goes by a lot of names: teletherapy, telehealth, virtual therapy, video therapy…ultimately, all these terms describe the same idea. Online therapy is mental health treatment that is done over the internet, using a video conferencing platform. Sometimes when people hear “telehealth”, they think of “telephone”, but online therapy almost always includes both sound and video. Most therapy sessions take place using programs that are very similar to Zoom or Google Meet, but with more security in place to make sure the conversation stays private.

Some reasons a young person might choose online therapy are:

• They have chronic health or mobility problems that make it hard to meet in person

• Their family is taking precautions because of the coronavirus

• They live in a rural area where it’s hard to find a local therapist

• They or their parents have busy schedules that make it hard to drive to an office

• They just feel more comfortable doing therapy from home

How Do I Find an Online Therapist Who Works With Kids Under 18?

Some of the large, national companies who provide online and text therapy only serve adults. The ones that do see minors typically only see teenagers ages 13 and up. In general, I think your best bet is to find a therapist who is licensed in your state and specializes in kids or teens. This is especially true if you are looking for therapy for a younger child. When you’re selecting a therapist this way, you are able to learn more about them and their approach, and ultimately have more control in choosing a therapist whom seems like a good fit for you and your family.

You can use therapist directories like Psychology Today to search for counselors in your area who work with minor clients in your city or state. TherapyDen is another great option for searches: it’s a smaller directory, but gives you lots more information about each individual therapist, including their commitment to social justice and inclusivity. If your finances are limited, Open Path Collective is an awesome resource that may be able to help you connect with a private practice therapist who can offer you a reduced fee for appointments.

Will a Minor Child’s Therapist Talk to Their Parents, Too?

Most people under the age of 18 don’t have the legal right to keep their therapy sessions 100% private, because they have a parent or guardian who is legally in charge of their care. A parent or legal guardian can access a child’s medical records at any time. On the other hand, can you imagine going to a therapist knowing that everything you say is going to be shared with your Mom or Dad? It makes it very hard to open up, and almost guarantees that therapy won’t be effective.

It can be a little bit of a balancing act to respect a minor’s need for privacy while also making sure parents feel included and have the information they need to help their child. Even though parents have a legal right to know everything, most therapists who work with minor children will ask that a parent allow treatment to remain mostly private.

When I work with young people, I usually share what I am doing with parents—for example, what coping skills I’m teaching or what our therapy goals are—but I don’t share personal things that a child has told me without permission from that child. That way, kids can feel secure in knowing that I’m not going to tattle on them to their parents, but parents can also feel secure in knowing what is happening in treatment.

How Does Confidentiality Work Online for Kids Under Age 18?

Even for therapists who keep sessions with minor children private, there are a few situations in which a parent must be told what is going on. All therapists have to follow a code of ethics which includes a promise to always inform a parent or caregiver if a child is in a very dangerous situation. This is called mandated reporting. The three major reasons that a therapist might need to break confidentiality with a minor client are:

• The therapist suspects that a child is being physically or sexually abused

• A child is at risk of self-harm, or of hurting someone else

• The therapist hears about an elderly person or a person with a disability being abused

If a therapist has to report one of these events, only the information needed in order to keep everyone safe will be shared. For example, if a child is feeling suicidal, a therapist will share this with parents and, if needed, other professionals who can help. The therapist wouldn’t share unrelated information with those people, like how a child feels about family or friends.

Therapists can share this kind of information with parents in emergency situations, but in general, therapists can’t share information about a minor client with anyone else unless they have specific permission to do so. Teachers, employers, extended family, or other people in a child’s life won’t be told anything about therapy without written permission.

Can a Minor Seek Out Therapy Without a Parent’s Consent?

The short answer is: it depends on where you live. I wish young people never found themselves in this position, but I know that sometimes teens feel unsafe telling their parents about their need for therapy. Each state has its own rules about whether or not minors can be in therapy without a parent knowing, and in most states, the rule is that anyone under 18 needs written permission from their parent or guardian.

This article from Teen Vogue has some helpful information and advice if you are a minor looking for therapy and find yourself in this difficult situation. Another good suggestion I’ve heard is to reach out to your school’s counselor: they can help you right away, it’s confidential, and they will know about your state’s rules and resources you might have in your neighborhood.

If you are in an urgent situation and you need help right now, here are some crisis hotlines that are open to teens:

Crisis Text Line
Suicide Prevention Lifeline & Chat
The Trevor Project (LGBTQ Friendly)

Online Therapy for Minors in North Carolina, New York, and Florida

If you are looking for therapy for your minor child, or if you’re a young person doing your own research, I offer online therapy for children and preteens. Most of my clients are between the ages of 9 and 13. I’m licensed in New York, North Carolina, and Florida, so I can see kids for online therapy in any of these states. If you’d like to learn more about online counseling or make an appointment, you are welcome to contact me.

If you’re the parent of a child or tween looking for online help, my coping skills course might be a good support as you consider your therapy options. Worry-Free Tweens is an educational class for kids and parents, and teaches some of my favorite anxiety management skills for this age group.

Dungeons and Dragons as Therapy? How This Popular Game Helps Mental Health

During quarantine, many of us have been looking for activities to fill our stay-at-home time that feel more rewarding and productive than endless Netflix streaming. Many people are craving an escape from real-life stress and looking for ways to connect with friends that feel more personal than texting. Maybe it’s not surprising, then, that Dungeons and Dragons experienced a revival during the pandemic.

Although it may seem surprising at first, it makes sense that people are turning to D&D during stressful times. Dungeons and Dragons and other roleplaying games are increasingly popular tools in group therapy can help players improve their emotional and social well-being. In this post I’ll unpack how D&D is used in group therapy, and why it can be a benefit for mental health.

What Is Dungeons and Dragons?

Dungeons and Dragons, also known as D&D, is the most popular tabletop roleplaying game on the planet. It was invented by Gary Gygax and Dave Arneson in 1974, so it’s been around for a while and has built up a large following of devoted players. Players in D&D take on the role of a character in a fantasy world, and they collaborate with other players to pursue a goal, collect treasure, or defeat bad guys. Unlike most other games, there is no set path to take, and characters don’t just progress along spaces on a board. What makes D&D and other roleplaying games unique is that the players improvise to create a story together, and their choices affect what happens next.

The game is facilitated by a lead player, called the Dungeon Master, who describes situations for the players and asks them how they’d like to proceed. Then, it’s up to the players to decide how their character would act in a given situation. To add an element of chance to the game, players then have to roll a die to see how well their plan works. It’s not competitive, and there are no winners or losers: everyone works together toward a common goal. This can lead to surprising, funny, and even touching moments during game play that could never have been planed in advance.

Why is D&D Having a Moment Right Now?

Although D&D has always been popular in geek culture, it’s enjoying a moment right now due to the popularity of Netflix’s hit show, Stranger Things. Although the show is set in the 80s, the teen characters’ obsession with D&D has piqued the interest of 2020’s kids. Although it isn’t D&D specific, TV shows like Game of Thrones have also made fantasy stories cool, and helped to bring previously “nerdy” interests into the mainstream. Finally, podcasts like The Adventure Zone and Critical Role are bringing younger, more diverse people into a game that might have formerly been associated with older guys playing in a basement. Thanks to pop culture, D&D is cool again, and being played by more young people than ever.

What Are the Mental Health Benefits of D&D?

Play of all kinds has mental health benefits—it’s why play therapy has been used to help kids since the days of Freud, back when psychology was a new and emerging field. Play helps us to assimilate information we’ve learned, test new ways of behaving before using them in real life, hone our social skills, and boost our creative problem-solving abilities.

Although we might think of play as something reserved for little kids, the truth is that older children, teens, and even adults benefit from having playful experiences in life. Unfortunately, the older we get, the harder it is to find socially acceptable ways to play. D&D is an awesome, age-appropriate way for older kids and adults to recapture that playful childhood feeling and reap some of the same benefits that play has for younger kids.

Some of the possible mental health benefits of D&D are:

• Improved social skills with peers

• Increased self-esteem and self-confidence

• Ability to express yourself and your needs assertively

• Improved impulse control and practice with turn-taking

• Stronger creative thinking and problem-solving skills

What Makes D&D Work So Well in Therapy?

Although there are plenty of games in the world that aren’t just designed for little kids, D&D has a few unique characteristics that sets it apart from the rest when it comes to improving mental well-being. Here are a few reasons why D&D is so great when used in therapy:

• D&D is collaborative. Rather than competing against each other, players must find a way to get along and work together.

• Playing as a character who is different from yourself allows you to literally see the world through someone else’s eyes, which can build empathy.

• Because the game is based in role-playing, it’s a great way to try out new ways of interacting with other people in a low-stakes, fun environment.

• Playing the game tends to help people bond and build friendships. D&D provides a structured way to get to know new people that might feel less awkward than making small talk with a stranger.

• D&D players have almost unlimited creative freedom, which can be liberating. Do you want to be a 1,000 year old elf sorcerer with purple hair and a pet mongoose? You can do it in D&D.

How Does a D&D Therapy Session Work?

Usually, D&D therapy is group therapy: you need a team of at least 3 or 4 people to get the game going. Unlike other forms of group therapy, D&D groups tend to be pretty intimate, which makes it easier for players to get to know each other. It’s most common for therapy groups to meet on a weekly basis, but this can vary.

Typically, groups begin with a check-in for participants to talk out of character and connect with each other. This is a great time to share about how the week has gone, and share anything that has happened that might be relevant to the group’s goals. Once everyone is settled in, the actual game-play portion of the session begins, facilitated by at least one therapist who can keep an eye on everyone’s progress and make sure that everyone is having fun. After playing, the group ends with a wrap-up conversation, which can be a great time to connect what is happening in the game to the particular goals of the therapy group.

The actual time spent playing D&D can vary a lot: based on the age and attention span of the players, a session could be as short as 1 hour or as long as several hours! It’s safe to assume that most therapy groups will be on the shorter side.

More Info On D&D As Therapy

For more info on the mental health benefits of D&D, check out one of the following resources. Geek and Sundry has an awesome, in-depth look at how D&D can help kids with social anxiety get excited about going to group therapy. If you’re more of a video person, check out this interview with a D&D therapist to hear more about her work.

If you’re local to North Carolina, New York, or Florida, I may be able to help you get started with D&D Therapy! I co-facilitate a few groups for middle and high school students, and they’re a highlight of my week.

If you’re not looking for therapy, but interested in the social-emotional benefits of roleplaying, check out Young Dragonslayers, where my geeky colleagues offer online friendship-building D&D games for kids all over the U.S.

6 LGBTQ Kids Books I Love

Amidst everything else going on right now, June is Pride Month, when we celebrate the impact LGBTQ people have made on our country and the world. Recently, I have been on the hunt for children’s books that address social issues while also being a genuinely good, fun read for kids. I’ve been looking forward to sharing a handful of books about LGBTQ topics that I’ve found over the past year that I think fit the bill. Whether you have a family member who is part of the LGBTQ community or you’re simply wanting to expand your child’s worldview, the books below can help open up a conversation and give kids positive examples of all kinds of families.

Benefits of LGBTQ Books for Kids

Reading a book together can be a great way to introduce complicated subjects to kids in a nonthreatening way that allows children to learn at their own pace. All kids benefit from having toys and stories around them that reflect their own identity, as well as give them a peek into someone else’s worldview. Books about the LGBT community can be extremely affirming for kids growing up in families with 2 moms or 2 dads, but they can also help all children to better understand their classmates, neighbors, and friends.

When a child reads a story, they’re putting themselves in someone else’s shoes. It’s an exercise in building empathy that can have long-lasting benefits. By reading stories about different types of families, kids learn to celebrate diversity and look past superficial differences to see that all families are really the same, and connected by love.

Why I Picked These Books

I love reading books with children that talk about social issues or help them to understand mental health concepts like anxiety, depression, and trauma. Reading a book together can let children know that their feelings are normal and they’re not alone. What I don’t love so much is that, a lot of the time, these books provide great information to kids but are not particularly engaging reads. It’s easy for these types of books to start to feel overly teach-y or preach-y, which I think can lead kids to check out of the story.

I love these books because, aside from representing diverse families and explaining LGBTQ issues to kids, they’re just genuinely good books. The illustrations are beautiful, the characters are likable and believable, and the plots help pull kids into the story and give them a different perspective on the world. I also looked for books that touch on multiple aspects of the LGBTQ experience (same sex parents, gender nonconformity, feeling accepted and celebrated) and books that go into more or less depth on the subjects depending on a child’s age. Finally, I tried to find books that had other kinds of diversity, too, including families from different races and cultures.

6 Picture Books to Check Out During Pride Month

Click on the titles to read a full review of each book!

Julián is a Mermaid by Jessica Love

I found this in a local bookstore earlier this year, and was drawn to it because of its beautiful watercolor illustrations. Julián is an Afro-Latinx kid living with his grandmother in a New York City neighborhood, where he becomes fascinated with the annual mermaid parade. Julián imagines himself as a mermaid, and dresses up in secret in the family’s home… until his grandmother catches him in costume. The story has a happy ending, and gently explores what life might be like for gender-nonconforming kids without directly talking about it. I think any child would enjoy this book, and would find a message to take away from it about being seen and accepted for who you really are. Recommended for ages 3-8.

It Feels Good to Be Yourself by Theresa Thorn

Unlike the other books on my list, this one is very direct in discussing sex and gender, and definitely a little bit “teach-y”. However, if you need to talk about gender identity with a child, this book is for you. It Feels Good to Be Yourself gives parents and kids simple, straightforward, and child-friendly language to talk about sex and gender, gender nonconformity, and people who are cis, trans, and non-binary. I appreciate that this book is positive and hopeful, and uses vocabulary that any child can understand. The illustrations, drawn by a nonbinary artist, are beautiful and feature diverse kids and families. Recommended for ages 3-9.

Love Makes a Family by Sophie Beer

This is a board book with a sweet, simple story geared for younger children who may not be ready for the other books on this list. Love Makes A Family emphasizes and celebrates how families of all shapes and sizes show their love for each other. Although not mentioned in the text, the bright, modern illustrations show families with 2 moms and 2 dads, multiracial families, children raised by grandparents, and single-parent families. Recommended for toddlers and preschoolers.

Stella Brings the Family by Miriam B. Schiffer, Illustrated by Holly Clifton-Brown

For older kids who have outgrown board books, Stella Brings the Family offers a more direct, thoughtful look at one child’s experience of being in a family with two dads. Stella has to decide who to bring with her to school for her class’s Mother’s Day celebration, since there is no mom in her family. When other children ask her who performs all the motherly tasks in her life, like reading bedtime stories and packing her lunch, Stella is able to name all the important family members who fill the “mom role” for her. This is an inclusive book that gets great reviews, and is recommended for ages 4-8.

Not Quite Narwhal by Jessie Sima

Okay, so this one isn’t exactly an LGBTQ-specific book, but I had to include it anyway because it is such a helpful story to have around. Kelp, the story’s hero, grows up believing he’s a narwhal and living with a family of narwhals, even though he sometimes feels out of place and struggles to do typical narwhal things. When a strong current sweeps him onto land, Kelp learns that his identity isn’t quite what he thought, and he’s been a unicorn all along. Kelp learns that he doesn’t have to belong to any particular group, because all his friends accept him for who he is. The art style makes this book really popular with little kids in my office, and the story is open-ended enough that pretty much all children can find meaning in it. Recommended for ages 4-7, but even preteens sometimes enjoy this one.

Mommy, Mama, and Me by Leslea Newman, Illustrated by Carol Thompson

Another board book for younger kids, this is a sweet and simple story in rhyming verse that describes the loving, daily activities of a family and their toddler, who just happens to have two moms. The illustrations are sweet and look like real people, and the toddler’s gender isn’t made clear, so all children can see themselves in this book. Reviews I’ve read from parents say that their children want this read over and over. A second book in the series, Daddy, Papa, and Me, covers a toddler with two dads. Recommended for ages 1-3.

More Resources for LGBTQ Books

If you’re looking for more LGBTQ books for kids, check out this big list of books featuring LGBT characters or this list of LGBT books for young readers.

If you’re looking for LGBTQ-affirming counseling, databases like Psychology Today and TherapyDen allow you to search for therapists who are allies or who have specialized experience helping LGBTQ families.

Signs and Symptoms of Germaphobia in Children

After months of hearing about the dangers of catching COVID-19 and the need to sanitize everything, who among us hasn’t become a little germaphobic? Being extra wary of germs during a pandemic is a normal and healthy response. For children, however, fears about germs, catching illnesses, and needing things to stay clean might stick around long after our country reopens. Fear of germs is really common among kids with anxiety and OCD, and I suspect we’ll be seeing more kids than ever experiencing it after the pandemic. In this post, I’ll be sharing how to tell when your child’s fear of germs has become overwhelming, and how to spot common signs and symptoms of germaphobia in kids.

What’s Germaphobia, Exactly?

Simply put, germaphobia is a fear of germs: viruses, bacteria, parasites, you name it. An extreme fear of any of the creepy-crawlies that can make people sick is considered germaphobia. Although most people worry about spreading germs and catching diseases (especially right now), kids with germaphobia have fears that go above and beyond what is considered typical for most people.

Like other types of phobias, germaphobia is a response that is out of proportion to the actual threat. Even though germs can be dangerous, the lengths that germaphobic kids go to avoid contamination are extreme. In severe cases, the cleaning, avoiding, and rituals of germaphobia can start to feel like they’re taking over a child’s life.

As an example, a child with a healthy concern about germs might be diligent about washing their hands whenever they come in from outside, after they go to the bathroom, and before they eat. A child suffering from germaphobia may feel compelled to wash their hands constantly throughout the day, possibly to the point that their skin becomes chapped and dry. Most people might avoid eating meat at a restaurant that looks undercooked, but germaphobic kids might refuse to eat in restaurants at all, because they can’t control how the food is prepared.

What Makes An Intense Fear of Germs More Likely?

Phobias are more common among people who already have an anxiety disorder. Kids who are already prone to anxiety may be more likely to develop germaphobia symptoms than those who are not. In particular, many people with germaphobia are diagnosed with obsessive compulsive disorder, a form of anxiety that makes people feel like they have to perform certain actions over and over again to reduce anxiety or keep something bad from happening.

Obsessive worries about getting sick, throwing up, and contamination from germs are extremely common among kids and adults with OCD. Oftentimes, people with these types of obsessive worries feel compelled to wash their hands excessively, avoid places or objects they fear have been contaminated, or to overly clean their homes or belongings, sometimes in a ritualized way. Because these symptoms are so common in people with OCD, some experts believe that people who are truly phobic about germs can be diagnosed with OCD, as well.

Common Symptoms of Germaphobia In Children

Excessive hand washing, cleaning, and avoiding dirty places are all symptoms of germaphobia.

If you recognize your child’s behavior in one or more of the bullets below, it could mean that your child’s worries about germs and illness have gotten bigger than they need to be, and could be interfering with everyday life. Of course, mental health problems like germaphobia can’t be diagnosed over the internet, so you’ll need to follow up with your pediatrician or a children’s therapist. Here are some of the most common symptoms of germaphobia in children:

• Repeated, uncontrollable worries about getting sick or being exposed to germs

• Intense fear or terror about contamination

• Physical symptoms of anxiety, such as rapid heartbeat, stomach upset, and sweating when confronted with something that triggers the fear of germs

• Excessive cleaning or hand washing, that sometimes develops into a ritual that must be done the same way each time

• Avoiding people, places, or things that are “contaminated” with germs

Signs Your Child Has Germaphobia

Anxiety symptoms can be hard to spot: they’re felt very intensely by the child who’s experiencing them, but may not always be visible to parents or other people. Signs, on the other hand, are behaviors that are more apparent to outside observers. If you notice any of these possible signs of germaphobia in your child, it could indicate they are struggling with invisible fears about germs or disease:

• Avoiding places that your child perceives are “germy”, such as grocery stores, shopping malls, public transit, or airports

• Refusing to touch things that have been touched by other people, or requiring that things be cleaned or covered in plastic before touching

• Tantrums, crying, screaming, or clinging to a parent when in a public place that might contain germs

• Repeatedly asking for reassurance about not having germs or not getting sick

• Frequent handwashing, showering, or cleaning that seems to be more frequent than needed, especially if the cleaning has to be done in the same way each time

• Your child’s cleaning, avoiding, or worries are exaggerated and getting in the way of daily life

Cognitive Behavioral Therapy for Kids With Fears of Germs

Germaphobia can quickly become overwhelming, both for kids and families. Fortunately, therapy can help kids to feel more in control of their worries and develop a healthier level of concern about hygiene and germs. Cognitive behavioral therapy, a specialized form of therapy that helps kids to change unhelpful thoughts and behaviors, is often recommended for children with germaphobia or OCD.

Kids who participate in cognitive behavioral therapy learn to become more aware of when their worries are unrealistic, learn relaxation skills, and gradually face their fears of germs and contamination so that they can get back to their normal lifestyles. Because CBT is based on learning skills, it is a great fit for both in-person and online therapy.

If you’re located in New York or North Carolina and interested in counseling, I may be ale to help! I work with kids and tweens at my child therapy office in Davidson, North Carolina, as well as online in New York and Florida. You can send me an email to learn more. Not ready for therapy, but looking for more general help with worries? My online self-help course helps kids learn coping skills to manage anxiety at home.

How to Talk to White Children About Racism and Protests (and Why You Should)

In the week since my last blog post, round-the-clock media coverage of the coronavirus pandemic has given way to round-the-clock coverage of nationwide protests following the death of George Floyd due to police brutality. The footage of the protests can be scary: just a few nights ago, protesters in Charlotte, North Carolina (where I live) had a frightening conflict with police. I can’t imagine how overwhelming it must be for parents and families to be thrust directly from one crisis into another: how can we possibly begin to explain this to children who have been through so much already?

I have been looking for resources to help my White families discuss the protests and racism with their children, and have been coming up short. There are plenty of articles on how to have “the talk” with Black children to help them understand how to stay safe around police as they grow up, but not as many on how to help White kids become better allies. If you’re living in a mostly White community, like I am, it’s easy to avoid having uncomfortable discussions like this because we don’t see or feel the impacts of racism on a daily basis.

Even if you’re living in an area where there aren’t protesters nearby, I think it will benefit your child’s mental health to make them aware, in an age-appropriate way, of what is going on in our country. Let’s talk about how to talk about race.

Why Is It Important to Talk to White Children About Race?

I grew up a in a White family, living in a mostly White neighborhood, attending a mostly White school. It was a friendly community where nobody made overtly racist comments, and the school system encouraged tolerance and kindness. Each February, for Black History Month, we read books about Martin Luther King, Jr. and Rosa Parks and talked about how we used to discriminate against Black people in our country.

Since we only ever talked about racism as something that happened during slavery or in the protests of the 1960s, I assumed racism was a thing of the past. Looking around my classroom of kids who all looked like me, there was nobody to help me think otherwise. If I had never left my small town, would I have learned this wasn’t true?

We all want our children to grow up to be empathetic, moral, and accepting of others. In order to achieve this goal, White kids need to understand the real struggles that others go through on a daily basis. While it’s important for children to learn that everyone is equal, it’s just as important for them to learn that some people aren’t treated equally by our society. It can feel really uncomfortable to talk about racism as a here-and-now event. However, if kids grow up believing that racism is a solved problem, they may have a hard time believing their Black friends when they encounter discrimination.

At What Age Can We Start Talking About Race?

Children are able to notice differences in skin tone and hair color at an early age: one study found that babies as young as 3 months old already show a preference for looking at faces of their own race. Toddlers are often quick to point out differences in people around them (whether it’s polite to do so or not) and this is a great time to help give them the vocabulary to talk about race in a respectful way.

By openly talking about race with children as they grow, we’re showing them that it’s okay to do it. Race is an uncomfortable subject for many adults, and children pick up on this and avoid bringing up the topic as they get older. For kids who are too young to have a conversation about race, you can teach your child through your own actions. Here are a few suggestions for how to introduce the subject of race to young kids:

• Do your best to let your child see you interacting with people who don’t look like your family

• Give your child dolls and toys that represent other races, and use playtime to discuss differences in people’s skin, hair, and language

• Read picture books together that have non-White main characters

What Should I Say to Kids About the Protests?

Just like we have tried to shield children from alarmist coverage about the coronavirus pandemic, it’s also a good idea to protect young kids from media about the George Floyd protests that is not appropriate for them. Repeatedly seeing violence on TV can be scary, anxiety-provoking, and even traumatic for both children and adults. Kids do not need to see the George Floyd video or other violent acts firsthand in order to understand the injustice that caused them to happen.

Elementary school-aged kids are usually very interested in rules, right and wrong, and the idea of things being fair or unfair. This can be a great way to frame conversations about racism that uses language children already understand. You can ask your child to think of a time when they were treated unfairly, and discuss what they did to make things right. Author Jennifer Harvey told NPR she is using this technique to help her White children understand why the protests are happening now:

I [talked with my children about] how they might respond when they have been harmed or an injustice or an unfairness has happened to them and they aren't heard. Because we've been having these conversations, my kids understand that peaceful protest has not yielded justice for black and brown people in this country.

We're wrestling with it as a family and acknowledging that it's really unsettling, but also appreciating that people are really hurt and really angry. 

Kids know how it feels to be really angry, and helping them to understand the protests as an expression of pain and anger can help them connect with what is happening in an age-appropriate way.

Should I Wait for My Child to Bring up the Subject?

Talking about race feels so taboo for many children that they may not bring up this subject on their own. By initiating a conversation about racism and the protests with your child, you’re communicating that it’s an okay, safe thing to talk about. This might make it more likely that they bring up the subject on their own next time.

You can always let your child lead the discussion after you bring up the topic, and use their questions as a gauge for how deep the talk needs to go. It might be helpful to ask your child what they have already heard about the protests: given the constant media coverage, it’s possible your child has already heard a lot about what is going on. Learning what your child has already heard in their own words can also help you to correct any rumors or misinformation, and to identify worries your child might be having about the protests and other current events.

Resources for Talking About Racism and Protests with Kids

If you’re ready to start having this conversation but you’re looking for a guide, here are a few resources that I have found and liked:

Beyond the Golden Rule is a free downloadable ebook from Teaching Tolerance that has tips, child development information, and interviews with experts to help parents talk about prejudice with kids from preschool through the teen years.

Parents also has an age-by-age guide for talking to kids about race that is a shorter read and has concrete action items for kids up to age 8. This one might be especially helpful if you’ve ever heard your child say something judgmental or unkind about someone else’s race or appearance.

I found this article about how to discuss the current protests with White children very helpful. The author interviewed for the article also has a book, Raising White Kids, to help parents talk about race and teach anti-racism to their children.

If you can’t make it to a bookstore right away, you can find read-alouds of many children’s books that discuss race and diversity on YouTube. Check out Sankofa Read Aloud’s channel for a few options, including this reading of The Day You Begin.

If you are more of a podcast person, check out the 20-minute podcast “Talking Race with Young Children” to get advice from experts on how to have helpful conversations that are age-appropriate for little kids.

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.

What Causes Anxiety in Tweens?

I see tons of preteens with anxiety in my practice. While anxiety is common at any age, there seem to be some unique challenges to preteen life that can make worries more intense. We tend to think of the teen years as a time of major physical, emotional, and social upheaval, but those changes are already beginning for lots of tweens. This may be especially true for girls, for whom puberty often starts between the ages of 10 and 14. There can be many reasons for anxiety, including genetics, but in this post I’ll be sharing 3 of the top issues I hear about from my preteen clients that trigger their anxiety.

Tween Anxiety Cause #1: The Middle School Transition Is Rough

Do you ever feel nostalgic or daydream about going back to middle school? I don’t. I don’t know anyone who does. Middle school is really rough! The academics get a lot harder, but without any of the fun freedoms that high school students enjoy to reward them for their efforts. Students may be switching classrooms throughout the day for the first time, all while trying to navigate a new school building, without the opportunity to blow off steam at recess like they were able to a few years ago. Add the shifting social world of preteens and the awkwardness of puberty into the mix, and it’s pretty much a recipe for anxiety.

I hear from tweens that 4th and 5th grade feel like a big step up in terms of what kind of work their teachers expect, maybe in preparation for this shift to middle school. Bright kids who find learning comes easy to them may be able to sail through the lower grades without great study skills, but things start to get more real around this time. This can result in disorganization, trouble finishing homework in a reasonable amount of time, and missing work.

Research backs up the idea that the shift to middle school is really hard on kids. A study of middle schoolers compared the grades of kids who had to switch to a new school for 6th-8th grade to kids who stayed in a K-8 school. The study found that kids who had to change schools experienced a drop in academic performance that didn’t let up until 10th grade! The researchers think that staying in the K-8 school allows kids to be the “top dogs” in school for longer, which tends to make kids more relaxed and reduces bullying. By comparison, moving to middle school suddenly puts kids in the “underdog” position again as the youngest kids in school, leading to more anxiety and social troubles. Speaking of social issues…

Tween Anxiety Cause #2: Preteen Bullying Is The Worst

While the high school bully who pushes kids into their lockers is a familiar cliche, the truth is that bullying is at its peak during the tween years. Research on bullying has shown that it’s most common between ages 10 and 13, and that kids who are bullied during this age range may feel the effects more strongly than an older teen. That’s because preteen kids are starting to form the identities and friend groups that will carry them through to the end of high school. Being ostracized or feeling like an outcast in middle school can set the stage for a tougher social experience in the teen years.

Interestingly, the research also showed that preteen bullying doesn’t usually look like that shoved-into-a-locker cliche. Tween bullying is often more subtle and focused on relationships: for example, spreading gossip, making passive-aggressive “jokes”, or excluding someone from the lunch table. This kind of bullying can be harder for adults to recognize and punish, which makes it harder to stop. Even though “drama” like this is common among preteens, it can be really agonizing for kids, especially those who are being excluded on a regular basis. When the bullying is more than occasional, it can become a source of anxiety and low self-esteem.

Tween Anxiety Cause #3: Body Image Awkwardness

Many kids start puberty in the tween years: for girls, this usually happens between ages 10 and 14, and for boys, between ages 12 and 16. Preteens find themselves suddenly looking more like adults, and having to manage their hygiene like an adult, too. This is a big adjustment! Even when kids have gotten good education about what to expect in puberty, they may wonder about whether their experience is “normal” or feel really embarrassed about body odor, body hair, and other signs that they’re growing up.

I often hear from tween girls in particular that they feel super self-conscious about their bodies. We all know that girls are under a lot of pressure from pop culture to look a certain way, which can lead even young tweens to question whether their body type is measuring up to the ideal. This can create unrealistic expectations, lower self-esteem, and prompt anxiety about looking “good enough” in front of peers.

I also hear, though, that this body anxiety can come out in more subtle ways. Sometimes, well-meaning remarks from family members or friends about how a preteen is “growing up” can spark anxiety and make young people feel like they’re under a microscope. After all, nobody was commenting on their body shape at family functions a few years ago! These offhanded compliments heighten a preteen’s sense that their looks are being evaluated by everyone around them—the last thing most tweens want.

Therapy Can Help Preteens Manage Their Anxiety

Do you see your preteen kid struggling with any of these issues? Tween-aged kids are often at a great stage in life to benefit from counseling: they have the cognitive skills to learn more advanced ways to manage worries, but still have a playful attitude that can make the therapy process creative and fun. Not every tween who struggles with anxiety will need therapy to feel better. However, having someone to talk to who isn’t a friend, parent, or teacher can be really valuable to a preteen who feels alone with anxiety, and can make this phase of life move by a little more smoothly.

If you’re looking for some extra support for a preteen in North Carolina or New York, you can contact me here.

Will We See More Agoraphobia Symptoms in Children After Coronavirus?

Have you started imagining life after coronavirus? What’s our “new normal” going to look like once we’re all allowed to be together again? Even though my dreams of long-distance travel or seeing a Broadway play may still be far off, I’ve started to wonder what the near future will hold for children’s mental health. Many families that I work with are already observing big changes in their children’s behavior from being cooped up in quarantine. Oftentimes, though, we don’t really see all of the effects of a trauma experience emerge until after the stressful experience is over. As more cities start to open up, I think it’s possible we’ll be seeing more symptoms of agoraphobia in children. Here’s why.

First Of All—What Is Agoraphobia?

Agoraphobia is a type of anxiety disorder. People with agoraphobia are afraid of being in situations or places where it would be difficult to get away or get help in a crisis situation. Agoraphobia gets its name from the Greek word agora, which is a type of crowded, outdoor market often held in a town square. Many people with agoraphobia are fearful of being in this type of crowded, open space, but plenty of other situations can trigger agoraphobia fears, too. For example:

• Leaving the house

• Riding on public transportation, like a city bus

• Enclosed spaces like elevators, movie theaters, or bathroom stalls

• Anywhere with a large crowd, or where you have to wait in a line

• Big, open places, like shopping malls or parking lots.

For people with agoraphobia, these kinds of situations can set off worries such as “I won’t be able to get out of here if there’s an emergency” and “What if I get sick and nobody can come to help me?” This can lead to intense anxiety, panic attacks, and even cause people to start avoiding triggering places altogether. Agoraphobia is more common in adults, but kids can have it, too.

During Quarantine, Everyone Is a Little Agoraphobic

Big shopping malls, public transit, large crowds, movie theaters…when was the last time you were in any of these places? If you’ve been practicing social distancing, it’s probably been a while, and you might not even be leaving home as much as you used to.

Just like the new rules about handwashing have made us all a little OCD, social distancing protocols that help us keep each other safe have temporarily made us all a bit agoraphobic. We’re staying home more, and we’re naturally avoiding big crowds and public spaces that might put us in contact with others. If you have found that you start to feel nervous around crowds these days due to fears about transmitting or catching coronavirus, you’re not alone.

Many of us will gradually overcome these worries as the threat of coronavirus subsides…and it will, eventually! However, the longer we stay away from something that triggers our anxiety, the more intense our anxiety response is likely to be the next time we encounter it. For kids who may already be prone to anxiety, returning to public places and crowds might be very frightening for a while.

Returning To Our “New Normal” Could Trigger Agoraphobia Anxiety for Kids

If anxious kids have been avoiding public places for a while during quarantine, they may naturally feel some nervousness about returning to business as usual. This may be especially true if your child is fearful of catching coronavirus, or is not sure how the virus is transmitted. Worries about catching coronavirus could easily morph into worries about getting sick or being unable to get help in certain places.

It’s natural for us to want to avoid scenarios that trigger anxiety, which can set off a vicious cycle for anxious kids: they avoid a feared situation, which provides temporary relief but ensures that they will feel even more anxious the next time the scenario presents itself. This can make anxiety even worse in the long run, until some places or activities feel completely off-limits.

What’s more, it seems likely that our “new normal” may not look quite the same as our old normal. Gloves, masks, and other PPE may become more commonplace. We may have to get used to spacing ourselves further apart in lines, or acclimate to having our temperature taken before boarding an airplane. This different look and feel could be really scary for kids: even if masks keep us safe, they will take some getting used to! I can imagine that this will be an additional hurdle to overcome in helping anxious kids resume life in public places.

Is Agoraphobia Common in Children?

It’s not too common. Most often, people develop agoraphobia in their teenage or young adult years. More rarely, the symptoms can start earlier in childhood. Less than 1% of U.S. kids meet all the criteria for an agoraphobia diagnosis, but it can also be a tricky form of anxiety to diagnose. Because it can be hard for kids to put their worries into words, it might be hard to tell whether a child is reluctant to leave home due to social anxiety, separation anxiety, agoraphobia, or another type of worry.

Kids are more likely to develop agoraphobia if they have already had panic attacks in the past. They may also be at increased risk of developing agoraphobia symptoms if they’ve experienced a previous trauma, or had a loved one get hurt or ill outside of the house, for example, at a movie theater or amusement park. Past experiences and a history of anxiety can both contribute to kids developing agoraphobia.

Signs and Symptoms of Agoraphobia in Children

Children may not be totally aware of what is triggering their intense anxiety, or why. For parents, this can make spotting agoraphobia a little challenging. A child’s behavior might be confusing: for example, complaining of stomach aches before a family outing, or insisting on always taking the stairs rather than riding in an elevator. Here are a few common signs and symptoms of agoraphobia in kids to keep an eye out for if you suspect this may be an issue for your child:

• Reluctance or refusal to go out of the house, not just for school but for more “fun” activities as well.

• Panic attacks, which might include sweating, rapid breathing, a racing heartbeat, a flushed face, or stomach upset.

• A child might voice worries about getting lost and not being able to find a parent in public, getting sick or having a panic attack in a public place, or fear about something dangerous happening and not being able to escape it.

• The fears happen in multiple settings, for example, in elevators, crowded stores, and the movie theater.

Experiencing some or all of these symptoms isn’t enough to diagnose your child with agoraphobia, but it can help point you in the right direction. Knowing what the likely culprit is for your child’s anxiety is a good first step in finding the right help.

How to Help a Child With Agoraphobia

Agoraphobia is a form of anxiety, so treatment involves many of the same tools that we use for kids with other forms of worry. In particular, cognitive-behavioral therapy is commonly used to help kids with all forms of anxiety, and it can be really helpful for agoraphobia, too. A big part of therapy for many kids with agoraphobia is practicing gradual exposure. When kids avoid something that scares them, it provides a temporary relief but allows their fear to grow and worsen over time. Gradual exposure helps kids slowly work up to facing their fears, so that they can break the avoidance cycle and start to shrink their anxiety back down to a manageable level.

Working with a CBT therapist, your child might come up with a list of scary places or situations and rank them from easiest to hardest to complete. With the support of a counselor (and maybe a parent as well), your child can start making small steps towards doing scary things, starting at the bottom of the list and moving up to more and more challenging situations. Most kids find that once they start exposure, their fear drops away pretty quickly. Pretty soon, even the really frightening places or situations don’t seem so overwhelming anymore.

Kids might also learn coping skills to help with anxiety, so they can help their bodies relax more effectively when their panic gets triggered. Sometimes, just learning about how anxiety works in the body can help kids feel more in control of their panic, as well.

Does Your Child Need More Help?

If you think your child could benefit from some more personalized help, I would recommend finding a counselor who specializes in treating kids with anxiety disorders. If you’re in North Carolina or New York, I use cognitive-behavioral therapy to help kids manage anxiety through video sessions. You can contact me here.

If you aren’t local to one of those states, I’d recommend getting started with Child Mind Institute’s excellent intro to agoraphobia. You can also search for child therapists in your area on Psychology Today.

How Preteens Are Stressed About Covid-19 (And How You Can Help)

Preteens are often left out of discussions about mental health. Not quite little kids and not quite teenagers, it can be harder to find resources that are meant just for them. I was interviewed recently for an article on Healthline about how kids of different ages are dealing with coronavirus stress, and it inspired me to dig a little deeper into how tweens, in particular, are being impacted by the pandemic. I’ll be sharing some of the worries I’ve noticed are on preteens kids’ minds, and how parents can support their tweenage kids through this time.

What’s Considered “Preteen”?

For the purposes of this post, I’ll be considering ages 10-12 as preteen kids. Typically, kids in this age group are getting ready for or just starting middle school. Many children this age—especially girls—are dealing with the physical and emotional changes of the beginning of puberty. Lots of preteen kids are still playful and imaginative, but they’re also developing more of an interest and awareness of teen culture. It’s an interesting in-between time in a kid’s life, and it’s one of my favorite ages to work with in therapy.

Preteens Worry About Family Due to Covid-19

Preadolescent kids have more strongly developed empathy than kids in the younger age ranges. Whereas younger kids may be most worried about their personal safety during the pandemic, preteens have more awareness of how the coronavirus might also impact people around them. Since preteens have more access to the internet and media, they’re more likely to know basic facts about the pandemic, and understand that kids are not usually seriously affected by the virus. However, they’ve also heard that older people are more susceptible, which can lead to worries.

Many of the preteens I work with are voicing concerns about the well-being of their adult family members, both physically and financially. Lots of kids in this age group are aware of the impact the pandemic is having on employment and businesses, but they usually don’t have an in-depth understanding of their family’s own financial situation, which can lead to worries. Here are a few common worries I’m hearing from preteens about family:

• Worries that grandparents, great-grandparents, or other elderly family members or friends may contract the coronavirus and get seriously ill.

• Worries about their parents’ health if the family is affected by COVID-19, particularly if parents have pre-existing medical conditions.

• Worries about whether their parents can afford to be out of work, fears about having enough money to support the family, and concerns about how these financial changes could impact daily life.

How to Help Preteens With Family Worries

While children don’t need to know all the details of a family’s finances, it can be really helpful for preteens to hear reassurance from parents right now about how the family is planning to deal with financial setbacks. It’s often enough for kids to learn that there are no worries about continuing to put food on the table, or to hear about the family’s plans to get financial assistance to help support the family business.

On a similar note, discussing how the family is planning to care for older family members, and the steps that family members are proactively taking to stay safe, can alleviate some anxiety for preteens about the family’s health. Encouraging preteens to FaceTime or text family members who are living alone or have health concerns can empower them to feel involved in helping their relatives, and keep family connections going while social distancing.

Preteens Are Susceptible to Coronavirus Rumors

Many preteen kids have similar access to the internet and smartphones as their teenage siblings, but their critical thinking skills aren’t as developed as an older teen’s. Since the coronavirus is still dominating the news cycle, kids on the internet are likely getting all sorts of information about it when they go online, and this information may or may not be reputable. Even if your tween child doesn’t have this kind of access, her friends likely do, which allows rumors to quickly spread and become exaggerated as they pass through a social group.

Getting age-appropriate information about the coronavirus tends to reduce anxiety, but on the flip side, reading sensationalized news stories or information from questionable sources can make preteens’ anxiety worse. Many preteens view influencers on social media and YouTube as being trustworthy and relatable. They may not be as skeptical about information that’s presented as fact from what they perceive to be a trusted source.

How to Help Your Preteen Sort Out Coronavirus Facts From Fiction

Here are 3 common misconceptions I’m hearing from many preteen clients, and how you can help your child to make sense of all the information they may be getting from friends, the internet, and social media:

Where the virus came from: Conspiracy theories abound about the “real” source of the cornavirus, which can lead to increased confusion, anger, and fear for tweens. You can help your preteen by presenting the facts that we know for certain, as well as acknowledging that there are things we still don’t know for sure. It might be helpful to point out that when we don’t know something, people are tempted to fill in the blanks with information that might not be true.

Newly discovered symptoms of COVID-19: Doctors are making new discoveries all the time about how the coronavirus impacts people. However, there is also a lot of misinformation online about what problems can be symptoms of coronavirus. Tween kids need help making sense of what they’re reading, and understanding that many of these complications are very rare.

Racist content online: Sadly, some kids are telling me that they are reading or hearing things from others that express racism towards Chinese people for “giving” us the coronavirus. This can be really confusing for preteens who aren’t sure what they’re supposed to believe. You can help your child by making clear in no uncertain terms that we can’t blame any ethnic group for this illness.

More Support for Preteens Dealing with Coronavirus Stress

Many preteens are going to be able to muddle through this pandemic with some extra support and patience from the adults around them. However, if you’re noticing that your preteen’s anxiety seems to be getting worse over time, is much more intense than other kids his age, or is getting in the way of daily life, it could be a sign your child needs extra help to cope with this stress.

After seeing so many preteens struggling, I created a class called Worry-Free Tweens to help kids learn coping skills for anxiety and stress management. It’s a self-paced course that’s available wherever you are.

Online therapy can be a great option for preteens, who are usually tech-savvy enough to manage sessions without a lot of help from parents. Sometimes, just having an adult to vent feelings to who isn’t a parent can help preteens unload some of their stress. A licensed counselor can also arm your child with coping skills to help them deal with intense feelings and get through stressful times more effectively.

If you’re in North Carolina or New York, I’m able to provide telehealth to kids in these states. You can reach out to me here. If you are located elsewhere, check out Psychology Today for options near you.

Online CBT Therapy for Kids With Anxiety

Kids weren’t meant to sit inside all day, isolated from friends while overhearing scary things on the news. Our “new normal” in quarantine may be especially tough for kids, who are so reliant on their daily routines to help them feel safe in the world. If you have noticed a spike in your child’s anxiety symptoms since the coronavirus, you’re not alone. It’s an understandable response to a very strange, stressful time in our history. Fortunately, one of the most effective treatments we have to help anxious kids—cognitive behavioral therapy—translates easily into online work with a therapist. In this post I’ll be sharing the basics of how CBT can help kids with anxiety disorders, and how it works to get CBT therapy online.

What Is CBT, and How Is It Different Than Other Forms of Therapy?

What do you imagine when you think of therapy? Maybe that stereotypical image comes to mind of a patient lying on a couch, free associating about their childhood experiences while a therapist quietly nods. While some therapists still practice this more “old school” form of therapy (and it really works for some people!) therapy doesn’t always have this look and feel. CBT is a very popular approach to therapy that offers another way to deal with stress, anxiety, and mental health struggles.

CBT stands for Cognitive Behavioral Therapy, and it’s a style of therapy that focuses on helping people learn new ways to deal with problems in the present, rather than gaining insight into the past. While you might discuss past experiences with a CBT therapist, in general the goal is finding solutions in the here-and-now. To do this, clients in CBT therapy learn how to spot the negative thinking patterns and self-talk that can lead to exaggerated worries and depression.

In CBT therapy, your child might…

• Learn coping skills to manage stress more effectively

• Gradually practice facing her fears in order to overcome them

• Learn how to identify overly-negative thinking

• Practice replacing negative self-talk with more positive, realistic self-talk

• Learn social skills to express herself confidently and assertively

What Makes CBT So Popular for Kids with Anxiety?

One big reason CBT has become so popular for treating childhood anxiety is that it can help kids feel better faster. The coping skills children learn in CBT can be used right away to start managing anxiety, panic, and stress, so many children notice some improvement in their moods early on in treatment. CBT is often a shorter form of treatment, and in general, people in CBT need fewer sessions of therapy than people who aren’t. Kids who get CBT therapy for anxiety symptoms may be able to progress through therapy more quickly, and return to their lives with skills to handle future problems.

Another reason for CBT’s popularity is that there is a ton of research to show it’s effective. As a therapist, I like knowing that the skills I’m teaching kids to manage their anxiety have been studied over and over, and have been shown to be the most helpful tools for the job. I like feeling confident that the therapy techniques I’m using are the most likely to help a particular child, and have been shown to be safe.

How Does CBT for Children Work With Telehealth?

While some forms of therapy may look and feel a little different when conducted online, in my experience CBT sessions via telehealth feel pretty similar to my in-office sessions! Because CBT is more task-oriented and involves more learning and teaching, it’s a natural fit for online therapy. While I often incorporate games, art, and play into my child therapy sessions, CBT puts an emphasis on helping kids put their thoughts and feelings into words, too. I think the fact that it’s a more verbal form of therapy helps make online sessions flow smoothly.

If your child is enrolled in online CBT therapy, she might participate in activities like these:

• Role-play difficult situations with a therapist to figure out healthier ways to respond

• Learn relaxation skills in session, like deep breathing and mindfulness techniques

• Practice turning negative self-talk into more positive or realistic self-talk

• Set goals to practice at home during the week, such as practicing a relaxation skill or raising her hand more often in class

• Learn more about how anxiety works, which can help kids feel less alone with their feelings

Online CBT therapy might use books, worksheets, and other teaching aids to help children get the most benefit from learning new skills. I sometimes email simple worksheets to parents that kids can use to track negative thoughts during the week. I sometimes assign other “homework” assignments as well, such as practicing a new skill during the week or trying to reach out to friends more during quarantine. Usually, CBT homework requires no more than 5 minutes a day of work—I know kids are overloaded with school assignments right now, and I don’t want to add to that stress!

Online CBT Therapy for Kids in North Carolina, New York, and Florida

If your child is having a hard time dealing with anxiety during quarantine, CBT can help her manage this stressful situation and equip her with tools that she can use to deal with anxiety even after quarantine ends. As a first step, you may want to consider my online course, Worry-Free Tweens, which teaches CBT-inspired coping skills to anxious kids ages 8-12.

If you’re in North Carolina, New York, or Florida and looking for online therapy for your child, my (virtual) door is always open. I love using CBT to help kids and tweens overcome anxiety and worry. You can reach out to me here to learn more.

Pros and Cons of Online Therapy for Kids

While many people may not have considered online therapy as an option until quarantine forced us to take a lot of our lives online, it’s been around for years. Large companies like Talkspace and BetterHelp have mostly appealed to millennials who are comfortable with technology and may not have much time during a 9-5 day to make it to a brick-and-mortar therapy office. In addition, plenty of private practice therapists have used online therapy to help reach people who may not otherwise be able to access therapy, such as those in rural areas or people living with chronic illness. Until recently, though, most online therapy services were for adults, not kids.

Because I didn’t see many online children’s therapists out in the world, I was skeptical about whether kids could benefit from this kind of help. Since I want to help my community flatten the curve, when quarantine hit I decided it was time to find out for myself! While I am looking forward to the day when I can go back to my playroom, I have made so many exciting discoveries about online therapy that I would never have realized if quarantine hadn’t pushed me to give it a try. In this post I’ll be sharing some of the most surprising “pros” I have discovered about online therapy for kids, as well as the “cons” to be aware of, since no form of therapy is the perfect fit for every child.

What Kids Are a Good Fit for Online Therapy?

Online therapy, or teletherapy, may not be the best fit for everyone. However, in the past few weeks I have seen some children and families benefit more from online sessions than they have from in-person therapy. Here are a two scenarios where I’ve found online therapy has an edge over face-to-face counseling:

Children whose behavior problems only occur at home. I can’t tell you how many times I’ve had parents tell me that their child’s behavior at home and in my office is a night and day difference. Some parents have even asked if they should film their child’s behavior, because they’re afraid I won’t believe how tough things can really get behind closed doors.

While I don’t recommend filming your child, online therapy gives me a better chance at seeing behavior problems firsthand. Since kids are participating in therapy from home, in a familiar place, they often behave more naturally than they would in my office. Since I’m present on the screen but not physically in the room, it’s more likely that kids will fall back into familiar patterns with the parent as if I’m not there. This gives us the opportunity to work through the problem together, as it’s happening, in real time.

Kids who have a hard time opening up about tough subjects. While many kids enjoy and appreciate individual time spent with a counselor, I have found that some kids feel too exposed or overwhelmed in face-to-face sessions to get vulnerable about painful experiences. Play therapy and art therapy techniques can help give kids the feeling of “safe remove” from an issue that they need to open up, but so can online therapy.

Some kids may feel a little bit less “under the microscope” when they’re talking through a screen or typing, which can make it easier for them to speak their mind. I’m finding that many of my clients who are recovering from grief or trauma are able to speak more directly about their experiences than they were in my office.

The Pros of Online Therapy for Kids

Online counseling isn’t better or worse than face-to-face therapy—just different. Here are a few of the potential benefits that online therapy can offer for kids with anxiety, trauma symptoms, or behavior problems.

• Online therapy can feel more confidential, which can make it easier to open up about difficult subjects.

• Video and text chatting mimics the way that children are most comfortable communicating with friends.

• Kids can design their own “safe space” for therapy sessions that includes all their favorite comfort items: loveys, dogs, and favorite snacks allowed!

• For parents with demanding work schedules or non-traditional hours, online sessions can be easier to manage than in-person therapy, because there is no commute required.

• Home-based sessions can help kids and therapists work through tough behaviors at “the scene of the crime,” which can make it easier to practice new skills. Some kids enjoy doing roleplays of difficult situations using their own toys as props to find better ways to resolve conflicts with siblings or friends.
  
  
  

The Cons of Online Therapy for Kids

For some kids, individual virtual counseling may not be the best option. While some of these issues can be problem-solved in session, other kids might benefit more from another form of therapy, such as family counseling, parenting skills coaching, or face-to-face sessions, when available. Here are a few factors that I have observed can make individual online therapy more difficult for kids:

• Preschool children have a harder time paying attention to a screen for a full therapy hour, and seeing a familiar face onscreen instead of in real life can be a little confusing. For very young kids, shorter “check-ins” with a therapist paired with parenting support sessions might be a better bet.

• Some kids with ADHD may have a tough time with online therapy, since it might require them to sit still for longer. This is especially true for younger children. Adding in extra movement to sessions can help, but individual online therapy may not be the best fit.

• It’s a little harder to pick up on nonverbal information in online therapy, like subtle facial expressions, body language, and small changes in tone of voice. This is true for both the therapist and the client. If a child already has a hard time picking up on these social cues, online therapy can make it more challenging.

• Online therapy sessions rely mainly on sight and sound, and so the sensory experience is not as rich as in-person play therapy for kids with sensory processing needs. Adding sensory play materials like play-doh and scented markers at home can help to address this.

Learning about the pros and cons of online therapy for kids has inspired me to keep offering it as a service even in our post-quarantine world. I have a feeling that for many kids, combining face-to-face visits with occasional online sessions could give them the best of both worlds and make therapy more accessible for many families. If you’d like to chat more about online therapy, or set up an appointment for your child, I’m located in the Davidson, NC area and happy to help. You can contact me here.

How to Help a Child Cope with Anxiety

4 ways to take care of your child (and yourself) when stress is high

If you are the parent of an anxious child, you know how draining anxiety can be. Worries, rituals, and meltdowns can consume tons of time and energy, not just for your child but for the whole family. When a child’s anxiety is too strong to manage, the effects can ripple outward to impact siblings and parents. This is even more true during quarantine, when everyone is cooped up together and it’s harder to take time away to blow off steam. Even in unusually stressful times, kids can learn to feel more in control of their worries, and there is a lot you can do to help as a parent. Here are 4 ways to help your child learn to cope better with anxiety.

Help Your Child Understand That Anxiety Isn’t Bad

I often ask kids who are coming to my office for anxiety a trick question: is anxiety a good thing, or a bad thing? Many children assume that the goal of therapy is to totally eliminate their anxious feelings. As a parent, you can help your child understand that anxiety is an important feeling because it helps them know when something is not safe. Can you imagine what would happen if we didn’t feel at least a little anxious before crossing a busy intersection? Have you ever had a bad “gut feeling” about a person or situation that turned out to be right? Those are times when anxiety is good to have, even if it feels uncomfortable.

Because anxiety doesn’t feel good in the body, children often get anxious about being anxious: they notice their anxiety response starting to kick in, and worry that it means something is really wrong with them. In reality, their body is doing just what it is supposed to do by alerting them to danger…it just might be doing this at unhelpful times. Kids with anxiety have too much of a good thing: their “danger alarm” is going off more often than it really needs to. You can help your child understand that anxiety isn’t dangerous, it can’t hurt them, and that while you can’t eliminate anxiety (and you wouldn’t want to!) there are lots of ways to cope with the feelings to make them easier to deal with.

Practice Relaxation Every Day, Not Just When Your Child is Anxious

Helping anxious kids find ways to relax is usually one of the first goals in therapy. Many coping skills have been developed to help kids (and adults) unwind, but activities like exercise, art, and meditation can be just as helpful. In my opinion, it doesn’t really matter what coping skill you choose to use—what matters is how often you use it.

Practicing a relaxation technique is kind of like going to the gym. If you do it once, you might notice you feel a little better when you’re done. However, the boost probably won’t last very long. If you want to create lasting, positive changes, you’re going to have to do it regularly over a longer stretch of time. Deep relaxation techniques change the way our nervous system operates, helping us move out of the “fight-or-flight” mode that triggers anxiety and into the “rest-and-digest” mode that promotes calm. If a child is practicing a relaxation skill frequently, she may spend more time in this restful state and be able to access it more easily the next time she’s stressed, leading to less anxiety in the long run.

Practicing how to self-soothe daily has another benefit, as well: it helps kids master the technique before they really need it. You don’t want your child to be trying to figure out how to take deep belly breaths for the first time in the middle of a panic attack. Think of daily relaxation practice as being like a fire drill, helping your child master the coping skill while she’s calm, before she really needs it.

Focus on Your Child’s Strengths, Rather Than Worries

When a child is really anxious about something, it can be tempting to talk about it with them in detail in order to reassure them that their fears aren’t realistic. If your child is losing sleep at night due to fears of monsters in their room, for example, you may feel the urge to help them investigate in every closet and under all the furniture to prove that the room is 100% monster-free. While helping kids to spot unrealistic thoughts can be helpful, spending a lot of time talking about a fear in the moment can backfire and lead to more anxiety.

When we have a long conversation with a child about their worry, we might accidentally send them the message that it’s something worth being worried about. After all, if we’re spending all this time talking about it, it must be a possibility! Your child might wonder why you’d look under the bed in the first place if there wasn’t a chance the monster might be lurking under there. Long discussions can also encourage anxious children to ruminate, thinking about their worries again and again without coming to a resolution. This can make their anxiety increase, rather than decrease.

Instead of talking about the worry itself, focus on the positive strengths your child has that will help them deal with it. You might consider saying something like “I know you’re brave and you can do this,” “This is hard, but you’ve handled it before, and you can do it again,” or “You are so good at taking deep belly breaths!” This can help shift a child’s focus away from the problem, and toward a solution. It also sends the message that you understand how worried your child must feel, but you aren’t taking the worry itself seriously. You can be empathetic without reinforcing the fear itself.

Put the Oxygen Mask On Yourself First

You have probably heard this common advice from flight attendants applied to life outside of the airplane: put the oxygen mask on yourself first, before helping your child. It’s cliche, but it’s true! Helping a child to cope with anxiety is hard work, and it’s difficult to do if you’re feeling run-down or anxious yourself. Parents have to provide so much emotional labor for their kids every day, and they may find they’re giving and giving without getting much support back in return.

Kids are extremely attuned to how their parents are feeling. They look to the adults in their lives to determine how they should respond in a situation. During times of stress, your child is probably watching you closely, and paying attention to your facial expression and voice tones for clues to how you’re feeling. If a child senses that you’re feeling stressed, odds are good he’ll start to feel stressed out, too. This can lead to more anxiety or acting-out behaviors like tantrums and meltdowns. On the flip side, when a child sees that you’re managing your own stress, it sends the message that they can feel safe and relaxed, too.

When things are particularly stressful, a parent’s self-care might be the first activity to get crossed off the to-do list. If your child is struggling with anxiety, I’d encourage you to make your own self-care a priority. Figure out what helps you to cope emotionally, whether it’s taking an hour to exercise, going on a drive alone and listening to music, or calling a friend. Your kids will feel the effects of your improved mood, and you may find their anxiety decreases as your stress levels go down. When you practice self-care, you send the message to your children that coping with anxiety is a normal part of life. When your children see you managing your own stress, they learn that they can do it, too.

If your child’s anxiety is getting hard to handle at home, counseling can help make it more manageable, even during quarantine. You can read more about online counseling for kids here, or reach out to me to set up an appointment.

Why is My Child More Clingy During Quarantine, And How Can I Help?

You deserve to be able to go to the bathroom in peace! If your Self-Isolation is feeling a little crowded due to clinging, there are ways to help your child relax and adjust.

Kids react in all sorts of ways to stress, from anxiety and fearfulness to anger and irritability. If you’re a parent who is self-quarantining with children, you may be starting to see this wide array of stress responses at home. I have noticed that, among the kids in my practice, the past week or so has been a turning point for many children. While the first week off from school might have felt fun and novel, like a snow day, the second week of school feels more like the beginning of a new normal. The serious change of pace is bringing up anxiety for many kids, and one form you may notice it coming out in is increased clinginess to parents. If you expected your self-isolation to include a little more alone time, read on to learn why kids get clingy when stressed and how we as caregivers can help them adjust.

Why Do Kids Get Clingy During Stressful Times?

Children see their parents as their “safe base.” Mom or Dad is the person who is always predictable, will always protect them, and knows how to keep them safe. Usually, the older kids get, the more comfortable they feel straying farther and farther from their safe person, knowing that their parent will always be there for support if needed. During times of stress, like quarantine, the distance from parents that feels safe may shrink. This is especially true if there has been a loss of predictability due to changes in routine: if a child is no longer able to predict what happens next each day, a parent’s continued presence may feel less predictable, too.

It is also common for children’s behavior to regress during a period of trauma or stress. While it’s normal and common for infants and toddlers to have separation anxiety, preschoolers and older children who have move past this stage might revert back to it if they’re feeling vulnerable. This is usually a temporary phase, and kids will shift back to more age-appropriate behavior once the stress has resolved, especially if they have support in managing their anxious feelings.

How Can I Tell If My Child’s Clinginess Is Normal?

Separation anxiety and clinginess are a normal (and stressful!) part of child development for babies and toddlers, especially from the age of seven months old to about two and a half. Around this age, kids are learning that even when they can’t see a person, they still exist in the world and can still be relied upon to come back again. This is a concept called object permanence.

While some clinging is normal, it’s also possible for toddlers and older children to develop separation anxiety that is outside of the norm and cause added distress for everyone. Here are a few signs that a child may need help overcoming their clinginess:

• Your child can’t tolerate even brief separations from you: for example, a trip to the bathroom or to go outside to get the mail.

• Your child’s anxiety when away from you is so intense that they can’t cope.

• The clinginess is getting more intense with time, rather than less.

• The anxiety and clinging are more than you’d expect from a child of this age, and it’s interfering with daily activities.

It’s possible to reassure kids that they are safe and loved and help them to gradually increase their independence. You deserve to be able to go to the bathroom in peace, especially during these stressful times!

Make Your Child’s Routine Predictable

If you think your child’s clinging might be a response to their routine being thrown off, adding some structure to the day can be extremely helpful. For young children, predictability equals safety. Being able to anticipate what will happen each day and when allows them to trust that they’ll be taken care of and transition between activities more smoothly. When that predictability goes away, it can make children feel out of control and unsafe.

You don’t need to create an elaborate, Montessori-inspired routine in order to increase your child’s sense of safety. Simply setting established times for meals and snacks, playtime, and bedtime can go a long way in helping a child feel like their life is more in control. For bonus points, you can create a visual schedule of your day so that your child can follow along and know what to expect next.

Build Some Individual Playtime Into Your Day

A predictable routine is extra effective if your child knows they can rely on getting some individual, face-to-face time with you every day. I know this can be a tall order when everyone is working from home and cooped up with family 24/7. However, I have found that even 10 or 15 minutes of individual playtime with a parent is a huge help for kids with behavioral problems. Children crave focused attention from parents, and when they’re feeling insecure they often seek it out in unhelpful ways, like clinging and tantrums.

If you’d like to try this approach at home, find a time each day when you know you’re consistently available to spend time with your child. Right after dinner, after bathtime, or before bed might be good opportunities to sneak in a few minutes of togetherness. Make sure your child knows this is part of the routine, and if they start to cling to you at other times of the day, remind them that you’ll have special time to spend with them later on.

Praise or Reward Your Child For Being Independent

Most of us feel moved to speak out when someone around us isn’t doing the right thing, and this is especially true with kids. Good behavior, however, often goes unrecognized. Adults may be used to not getting praised every time they do what they’re supposed to do, but for kids, not getting praise for good behavior can accidentally reinforce behavior issues.

Kids crave attention from parents because it makes them feel safe. If a parent’s eyes are on you, it means they can look after you if something dangerous happens. As a result, children tend to repeat behaviors that have gotten them attention—positive or negative—in the past. If we get into the habit of ignoring good behavior, it’s less likely to happen again!

If your child has been struggling to separate from you at home, make sure you enthusiastically call out the times they succeed. If your child is playing independently, praise them for it! Kids who are really struggling to separate from a parent for any period of time often benefit from a reward chart. The positive reinforcement of earning a “prize” can motivate children to do the hard, scary work of separating.

Address Your Child’s Fears About The Coronavirus

Even young children are likely picking up more information about the coronavirus pandemic than you might expect. Lots of children I speak to understand that the virus is more serious for adults than for kids, and this has led to worry for some children that their parents might fall ill and not be able to care for them. This can lead to more anxiety about being away from a parent, and more clinging.

If you think this might be the case for your child, make sure they understand all the ways you’re keeping them and the family safe. For example, maybe your family is practicing social distancing, washing hands, getting groceries delivered, or even eating extra healthy during this time. It might also be reassuring for children to hear that there are lots of other caring adults in their extended family or neighborhood who will be ready and willing to help if the child ever needs them.

A child getting clingy during quarantine can be an added stress on parents during an already challenging time. Adding some structure and predictable opportunities to play each day can help your child adjust to their new normal feeling safe and secure. If you find that your child is still struggling even after trying these ideas, online child counseling or online parenting support can help you get back on track. Hang in there, parents! This phase won’t last forever.

3 Common Fears Kids Have About Coronavirus (And How to Help)

I don’t know about you, but I’m feeling pretty saturated with news about the coronavirus pandemic right about now. If you’re like me, you are getting coverage 24/7 from all sides: the news, social media, friends…it can be a lot to take in. While we adults are busy processing all of the sound bites we’re getting from various media sources, kids are listening in, too.

The urgent tone of the news coverage of coronavirus can be alarming for children, and increase their worries. The good news is that there is helpful, age-appropriate information we can be giving to children right now to ease their anxiety. Today I’m sharing 3 of the most common fears I’m hearing children mention this week, as well as what we as adults can say and do to help.

#1. Fear of Getting Sick, or Fear of a Family Member Getting Sick

“Am I safe?”

This is often the first question kids have in moments of change, crisis, or transition. It’s totally normal for kids (and adults, too!) to worry about their personal safety above all else. Because children are so dependent on their parents, children often worry about their parents’ safety, too. Many kids may worry about what will happen to them if a parent is ill or otherwise unable to take care of them during a crisis.

I’m hearing many children voice concerns right now that they might become seriously ill, as well as worries about parents, grandparents, and relatives who may be elderly or have preexisting health problems. If your child has similar fears, you can help by making sure your child understands that the coronavirus usually causes very mild symptoms in children, and sometimes no symptoms at all. You can explain that children have strong bodies that can fight off coronavirus germs easily, but they can still carry these germs to other people who might get sick. This is why school and other group activities have been canceled: not because lots of kids are in danger, but to avoid accidentally spreading germs that might make others ill.

It’s also useful to remind children about all the steps that you and other important adults in their lives are taking to stay healthy: for example, washing your hands, practicing social distancing, and eating healthy foods. You can remind your child of the big network of caring adults in their lives, which may include close friends, extended family, and neighbors. Your child may feel more secure in knowing that these people will be available to take care of them, too, if you were ever feeling sick.

#2. Fear About How the Virus is Transmitted

We are still learning details about how the coronavirus spreads between people, but we have a pretty good understanding of how the illness is spread from person to person: through respiratory droplets, or by touching a contaminated surface. However, the fact that we can’t see the coronavirus can make it feel extra scary: we’re not sure where it is and isn’t, which means everyone is taking extra precautions. I’m finding that many children aren’t totally sure how the virus is transmitted, and may have incorrect ideas about how it is spread that lead to more anxiety.

Kids don’t need to know every detail about the current pandemic, but giving some age-appropriate information about what the virus does and how it is spread can alleviate worries. For example, I’ve heard many children have concerns that they might catch the virus through an open window, or that it might come into their home in the air without a sick person being nearby. By helping children understand exactly how a person gets coronavirus, we can allow them to feel more empowered about preventing the spread.

You can explain to children that usually the virus needs help to get into our bodies, and it can hitch a ride on our hands if they have germs on them when we touch our eyes, nose, or mouth. By washing our hands and avoiding touching our faces with dirty hands, we can help to keep the virus outside of our bodies.

#3. Fear of the Unknown

Personally, it is easier for me to cope with a situation when I know the end date. Wouldn’t it be easier to self-quarantine if we all knew for sure when the outbreak would resolve? I think many kids feel this way, too. It is hard for them to not know when school will be back in session, or if they will be able to celebrate their spring birthday with friends, or even if their summer vacation will happen as planned. This uncertainty can lead to more anxiety.

Right now, kids may have questions that we don’t have answers for yet. If your child asks you a question you don’t know the answer to, it’s perfectly fine to tell them you’re not sure. We can reassure children that we do know that the outbreak won’t last forever, and that things will eventually go back to normal. It might also be helpful for children to know that when we practice social distancing, we’re helping doctors and nurses to fight the virus so that the pandemic won’t last as long as it might otherwise.

Although a lot of routines are changing in children’s lives, some things remain constant. Help your child to recognize the parts of life that have stayed the same during the pandemic: maybe your whole family still has dinner together each night, or they still get to talk to their grandparents on FaceTime every Saturday afternoon. By maintaining family traditions and routines and highlighting them for children, you can make the world more secure and predictable for kids.

How to Help Children with Coronavirus Fears

Children are looking to the adults in their lives right now to determine how they should think and feel about the pandemic. By talking to our children honestly, but calmly, we can help them to take the outbreak seriously without adding unnecessary worry. When children don’t get enough information about the coronavirus, they tend to “fill in the blanks” with ideas or assumptions that might not be correct, leading to more fear. Providing age-appropriate facts can empower kids and reduce this anxiety.

You can also support your child by making sure they get a little bit of individual playtime with you each day, since children use their creative play to process their feelings about the world. This is also an important time to practice your own self-care, so that you can share your own feelings of calm with your children. If your child’s anxiety symptoms are increasing during the pandemic and you think they might benefit from some extra support, you may want to consider online therapy. If you’re in the Davidson, NC area, I’m happy to help!

Is Online Therapy for Kids Legit?

A lot has happened in the world since my last post! If you’re in North Carolina, today marks the beginning of a 21-day shelter-in-place order to help prevent further outbreak of COVID-19 and, hopefully, flatten the curve. This is a big deal for kids and families, who may suddenly be adjusting to a “new normal” that involves a lot more togetherness, unstructured time, and canceled plans. Part of my own new normal has been diving headfirst into the world of online therapy for children, and in this post I’ll be telling you all about what I’ve learned so far.

Are You Skeptical About Virtual Therapy? It’s OK—I Was, Too

I wish I could tell you that I’ve been 100% enthusiastically on board with online therapy for years and years, but that just isn’t true. Like many therapists, I have clung to the belief that in-person is always better. To my mind, online therapy was a “second place” option at best. After all, therapy is all about the healing relationship and connecting with the kids in my office: how can that work as well over a computer screen? How would play therapy work without a playroom?

When the new coronavirus started circulating in my area, there was no doubt in my mind about switching over to online sessions. I didn’t want to risk spreading germs to my immunocompromised families, or send a child to visit with Grandma and Grandpa not knowing if they might have picked up the virus in my playroom. “Second place” therapy in this situation, I figured, was better than no therapy at all.

Then I started actually doing online sessions, and I quickly realized what online therapists have been saying for years: online therapy is different, but equal to in-office counseling. In fact, sometimes it has an edge over face-to-face therapy when it comes to helping kids and families.

What Online Counseling Looks Like With Kids

Online counseling—also called Teletherapy, or distance therapy, uses video conferencing so that clients and therapists can see and hear each other in real time. If your child is familiar with FaceTime, Skype, or even Snapchat, they’ll probably have an intuitive understanding of how to use an online therapy platform. Most video chatting platforms used in therapy are designed to look and feel a lot like Skype or Zoom, but with more protections in place to prevent hacking and safeguard sensitive health information.

In my practice, I ask that children participating in online therapy have access to a computer with high speed internet in a room with a door that closes, in order to protect their privacy. It’s also helpful for kids to have paper, pencils, and markers available to use in session, just like they’d have if they were in my office. That’s likely all that older kids will need to have a successful virtual counseling session, but younger kids often enjoy having a few of their own toys on hand, as well. I’ve been introduced to lots of loveys and other special childhood toys this month!

Today’s Children Have Grown Up Using Technology to Connect

I often try to remember how I felt or reacted to things when I was the same age as my kid clients. This is helpful a lot of the time, but it held me back when I started considering online therapy. I tried to picture how I would have felt at 7, 8, 9, or 10 years old, talking to a counselor on our big family computer in the living room. It felt foreign and weird to think about, and I imagined it as a cold and clinical experience. At that time in my life, computers were still new, and the technology felt like it was separate from my day-to-day life.

However, my kid clients didn’t grow up like I did—and they probably didn’t grow up like you did, either. They’ve been FaceTiming aunts and grandparents since before they could talk. Many of them log many hours a week chatting with friends while playing Roblox or other multiplayer games with friends online. Communicating through technology doesn’t feel cold and detached to these kids: for many of them, it feels more familiar and “safe” than sitting on a couch and talking to an adult in real life.

There is Research to Support Teletherapy for Kids

When I’m trying to decide if a therapy treatment is legit, I turn to the research. It’s important to me that the techniques I use with kids have evidence to back them up, which is one reason why I love cognitive behavioral therapy. Luckily, there’s a growing body of research on teletherapy, and it comes to the same conclusion I’ve reached watching my clients in online sessions: online therapy can be just as effective (and sometimes more effective) as face-to-face counseling, even for kids.

Several peer-reviewed studies have found that people with anxiety and depression can get relief from online therapy, and that their improved mood continues after treatment is over. Researchers have also studied how kids respond to computer-based therapy, and found that it can be helpful for both depression and anxiety. According to the study, kids spend so much time on their phones and other devices that this form of therapy may come more naturally to them.

My Verdict On Online Therapy for Kids: It Is, in Fact, Legit

While some play therapy activities can’t be done online (I miss my sandbox!) there are plenty of reasons to consider online therapy as a different but equal way to get mental health help. Your child might be surprised to find they feel more comfortable chatting with their counselor from home, surrounded by their toys and pets. It may not be what we’re used to, but it’s legit.

Still looking for a therapist, but need some online help? My self-help course for kids teaches coping skills from an educational perspective, rather than a counseling one. Worry-Free Tweens was designed to help anxious kids ages 8-12 feel more in control of anxiety.

Still wondering about whether teletherapy could work for your child? Reach out to me here to learn more about online therapy for kids in the Lake Norman area.

Why Playing With Both "Boy Toys" and "Girl Toys" Is Good for Kids

I really believe that kids benefit from having access to a diverse array of toys, regardless of their gender. Play therapists are fond of saying that “toys are a child’s words.” If this is the case, why not supply them with the broadest vocabulary we can? In this post, I’ll be digging into whether there really is such a thing as “boy toys” and “girl toys” and sharing some of the benefits of giving kids of all genders more play options.

Common Myths About Raising Boys

Not too long ago I was quoted in an article about old wives’ tales related to raising boys. While everyone has different values as a parent, some of the preconceived ideas we have about boys may not just be outdated, but actually negatively impacting their mental health. We inherit a lot of our ideas about gender from our own parents, which makes it easy for them to go unexamined. Their influence on our behavior can be pretty subtle, too, and we may pass on unhelpful ideas to kids without even realizing it.

One common misconception I hear in my therapy office is that playing with stereotypically “girly” toys might be damaging to boys or confuse them about their gender role. Parents are sometimes concerned about a male child’s interest in baby dolls or jewelry-making, or express that they want to make sure their child understands what it is to be a boy.

Will Playing with Girl Toys Confuse a Boy?

I can find no research to suggest that playing with toys has any influence on a child’s gender. Kids figure out their gender really early in life—by about two years old. Many psychologists believe that children learn about gender primarily by observing the behavior of the adults in their lives. While toys can help children to express their feelings, explore new ideas, and review what they’ve learned, playthings don’t have the power to shape a child’s gender identity.

It’s worth considering that many girls play with boy toys, enjoy more “masculine” rough-and-tumble sports, and aren’t as interested in girly play. Most people don’t think twice about a tomboy, or worry that boyish toys will impact her gender identity. It seems to be easier to think about girls enjoying “boy stuff” than when the roles are reversed. A lot of this might be rooted in old ideas about masculinity that aren’t super helpful to today’s boys.

Different Toys Teach Different Skills

Kids learn about the world and develop their cognitive abilities through the toys they play with. Research has found that toys aimed at girls and boys teach each gender different lessons, and encourage them to develop different types of skills through play. If your aim is for your child to grow up well-rounded, with strong cognitive, creative, and spatial skills, it makes sense to provide toys that promote all these types of learning.

How “Girl Toys” Shape Child Development

According to a study on girls’ and boys’ toys, “girly” toys tend to focus more on physical appearance and attractiveness. They were also more likely to promote nurturing, caregiving play, and to help children roleplay household skills like cooking and cleaning. If a little girl is only supplied with super-girly toys, she might strongly develop her nurturing skills but miss out on other areas of development. She might also get the idea that her appearance should be a top priority if she’s surrounded by toys that encourage this trait.

How “Boy Toys” Shape Child Development

The same study found that boys’ toys were more likely to be competitive, aggressive, and encourage risk-taking during play. Boys toys were also more likely to teach children about spatial relationships, science, and how to build structures. If a little boy is only given hyper-masculine toys, they may be exposed to lots of violent play that could encourage more aggressive reactions in real life. He might also miss out on some of the nurturing and family-oriented skills provided by more girly toys, which are important skills for future husbands and fathers to develop.

Interestingly, this study concluded that the toys that provided the best cognitive, artistic, musical, and physical enrichment for kids tended to be gender-neutral or slightly masculine toys. This means that having a variety of more neutral toys at home, along with a few strongly “girlish” or “boyish” items, is a good way to ensure kids have opportunities to develop all the skills they’ll need as they grow up.

Toy Stores Are Moving Away From Gendered Toy Aisles

While researching this post, I learned that for a good portion of the 70s and early 80s, toy stores did not market strongly gendered toys to kids. Before that time, especially in the 40s and 50s, toys tended to be strictly advertised as intended for little boys or little girls. In the mid-80s, the trend was picked back up, which might explain why I remember toy store aisles being clearly divided along pink and blue lines. Today, big chain stores like Target are changing their approach to selling toys, dividing items by type (dolls, trains, blocks) as opposed to by gender. While may not change the toys a child seeks out on a trip to the toy store, it might communicate that no toys are off-limits to consider when shopping.

What If My Son Is Really Into Trucks or My Daughter Loves Barbie—Is That OK?

It is OK! Kids like what they like. Plenty of little kids genuinely enjoy and are drawn to the toys designed for their gender. A study of infants showed that babies as young as 9 months old start to show a preference for gender-specific toys. This may mean that there are differences in biology between boys and girls that lead boys to be more interested in toys with wheels and moving parts, while girls prefer more fine-motor and nurturing play.

However, there’s also research to suggest that kids also learn from adults about what toys are acceptable for them to play with. In a study of 4-7 year old kids, children who were shown pictures of kids playing with toys: one group saw photos of boys and girls playing with gendered toys, while the other group saw photos of children playing together with all kinds of toys. Later, researchers asked the children about what toys boys and girls should play with. Children who had seen photos of kids playing with non-gender-specific toys were more likely to say that any child could play with any toy than the ones who’d seen gender-divided photos.

The bottom line: if you have a boy’s boy or a girly girl, that is great! Celebrate what they love, and provide some gender neutral toys to help them expand their learning. If you have a boy who loves dolls or a girl who loves trucks, that’s great too! Provide opportunities for all kids to broaden their horizons, and let them know that it’s OK for girls and boys to play with whatever toys they’d like.

Want to learn more about play therapy and how toys can help kids express themselves? Read my page on play therapy or drop me a line to inquire about scheduling an appointment.

Emotion Identification Activities for Preschoolers: 4 Ways to Practice Naming Feelings

“Use your words.”

Have you ever asked a young child to do this? Me too! Preschoolers and toddlers are notorious for acting out their feelings through tantrums, whining, hitting, and countless other behaviors that can be stressful for everyone involved. One of the reasons why preschoolers often resort to physical displays of emotion is that it’s hard for them to put their feelings and needs into words. When you aren’t able to tell people around you that something makes you angry, it’s easy to understand why you might resort to showing your feelings instead! When children can say “I’m mad”, it' makes them less likely to show their anger in other ways, like hitting.

I wish I could say that helping your preschooler name feelings would magically resolve all tantrums and naughty behavior. That’s not the case. I do notice, though, that young children in my office are often familiar with feelings words, but have a hard time applying those words to themselves or other people. Learning to put names to feelings is an early goal for many of my younger clients, and it can help kids with disruptive behavior at home, too. Here are 4 activities to practice emotion identification skills with your preschooler or toddler.

Make it a Game

Lots of children’s games can be modified to incorporate education about feelings. In my office, I have a wooden toy fishing set (this one) with photos of different emotions taped to the bottom of each fish. Whenever someone catches a fish, they have to name the feeling and mimic the facial expression shown. Kids really have fun with this, and I’ve found that after repeating the game a few times, it’s easier for them to correctly name the feelings.

You can apply this idea to all sorts of games. Here’s a few others to consider:

• Memory game: print 2 pairs of each facial expression and lay the images face-down.

• Charades: take turns portraying different emotions with your child, and guess what feeling the other is trying to communicate.

• Simple games like Candy Land and Jenga that require drawing or collecting blocks or cards can be tweaked to include emotion identification. Add an emoji sticker to each block or card, or use color coding to prompt children to identify or talk about a specific feeling whenever a card of that color is drawn.

TV and Books as Learning Opportunities

Any children’s story has lots of opportunities to prompt kids to reflect about feelings. When watching TV or reading a book with your child, you can model how to think about other peoples’ emotions. This can make it easier for your child to identify feelings in themselves and others, and also helps to develop empathy. You might want to pause stories to ask questions like:

• How do you think the character feels when someone is not nice to them?

• What kind of face is this character making?

• What feeling is the character’s body showing?

You can also select books to read at home that specifically introduce the subject of naming emotions. One book that I particularly like is The Color Monster by Anna Llenas. It’s a pop-up book that is bright and engaging enough to hold the attention of preschool children. It helps kids understand emotions by linking each feeling to a different color.

Help Your Child Label Emotions

Young children aren’t always aware of how they are feeling in the moment: their feelings may be intense and sudden, but hard to express in words. You can help your child develop their ability to connect her emotions to the physical sensations she feels in her body by calling out feelings when you see them. It’s also useful to practice naming your own feelings for kids, and guessing about the feelings of family members. Comments like these can help children feel more understood, and make it easier to name feelings:

• “Wow, your baby sister smiled and laughed when you did that! It made her feel really happy.”

• “I can see that your hands are making fists and you are feeling angry right now.”

• “It must be scary to see those monsters on TV.”

When labeling feelings for young children, stick to simple emotions: happy, mad, sad, and scared are a great place to start. As children get older, they will be ready to talk about more nuanced and complex feelings like surprise, frustration, and jealousy.

Use Visual Aids

Before children master the vocabulary to name feelings, they can often point to how they’re feeling if shown some options in pictures. If you went to school in the 90s, you might remember that ubiquitous “How Are You Feeling Today?” poster that had a ton of cartoon faces showing complex feelings like “lovestruck” and “ecstatic.” A large number of choices and advanced vocabulary are not super helpful for preschoolers, but lots of options exist for simpler, less busy feelings charts.

You can find tons of examples of feelings charts online, or make your own at home by gluing feelings faces to a piece of paper, or tacking them on to a bulletin board. Consider adding the basic emotions (happy, sad, angry, scared) and perhaps a few others your child might be working on mastering, such as surprised, tired, nervous, or excited. Ask your child each day to point to how he is feeling, and follow up by naming the feeling he selected and talking about why he feels that way today.

I often use a strip of cartoon or emoji faces that looks like the pain scale used in doctor’s offices to help children rate how intense their anxiety or anger is at a given moment. This can help children to understand that emotions don’t always have to be the same strength, and that using coping skills can reduce the intensity of a feeling.

I hope this list has given you some inspiration to start talking about feelings with your preschooler in a more deliberate way. While a good emotional vocabulary can’t solve every preschool problem, it can definitely help. If you think your preschooler could use some more help expressing feelings in a healthy way, reach out to learn more about play therapy and child counseling.

Internet Safety for Preteens and Teens

This is my second post in a series on internet safety. For part one, click here.

It’s rare to see a tween or teenage kid today without a smartphone. They can be an essential part of everyday life, allowing kids to share music and messages with friends, as well as giving them a way to reach out to parents in an emergency. However, access to a smartphone comes with serious risks for teens and tweens: research shows that half of teens are cyber bullied and one third of teen girls are sexually harassed online. The addictive nature of cell phones and the dangers children are exposed to on the internet have led some experts to recommend waiting until 8th grade to give a child a phone. Regardless of when you choose to let your child have a phone, here are some steps you can take to help your tween or teenage child stay safe online.

How Can Smartphones Cause Emotional Problems?

Too much time in front of a smartphone screen can lead to problems with emotional health, relationships, and safety. While some risks, like the risk of predators online seeking out children, are well-known, other risks are more subtle and less easy to recognize. Here are some points to consider when thinking about smartphone and internet safety for your preteen or teen:

• Many apps and social media platforms are designed to be addictive, making it difficult for teens to stop using them once they’ve started.

• Screen time cuts down on the face-to-face interaction a teen has with other people. Over time, this can lead to reduced empathy and a harder time recognizing other peoples’ emotions.

• Influencers on social media may lead teens to be more materialistic and competitive.

• Teens whose phone use isn’t monitored are at risk for being bullied by peers, which can contribute to anxiety and depression. This kind of harassment is surprisingly common, with at least half of teens reporting they’ve experienced it.

How Can Smartphones Be Dangerous for Teens?

Totally unsupervised smart phone use can expose teens and preteens to adult situations that put them at risk of being manipulated or abused. While many teens will never cone into contact with a predator online, for those who do the affects can be very damaging. Here are a few statistics about teens and crime on the internet:

• According to the FBI, more than 50% of sexual exploitation victims are kids between the ages of 12 and 15.

• The majority of attempts to make inappropriate advances on children happen in chatrooms or on platforms where users can direct message each other.

• 1 in 5 teens in the U.S. say they’ve received an unwanted sexual comment or advance online.

Given these stats, what can parents do to parents do to protect preteen and teenage kids from harm online without smothering them? Keep reading for some tips on how to keep preteens and teens safe online while still allowing them some freedom.

Internet Safety for Preteens

Preteens (ages 11-13) are often eager to imitate older teenage kids, including by getting on to social media platforms like TikTok, Snapchat and Instagram. Many preteens chat with their friends by text or through apps, and online friends are increasingly common for this age group. This can put preteens at risk, because it’s impossible to know exactly who your’e speaking to online, and preteens are still very susceptible to being manipulated or scammed by adults.

You can support your preteen by keeping their computer in a public area of the house, rather than their bedroom, and by filtering and monitoring their activities using parental control software. Children this age don’t need to be on social media platforms intended for adults, even though they are tempting. Although kids this age no longer need an adult constantly supervising their activity online, preteen kids should not have any email or social media accounts that parents do not have passwords or access to. At this age, parents should also be reviewing safety skills with kids, including the danger of speaking to strangers online, giving out personal information, or agreeing to meet an unknown person in real life.

Internet Safety for Teens

Teenagers (14-18) are getting ready to live their lives independently, but they still haven’t developed all the problem-solving skills they’ll need to navigate the adult situations that can arise online. It’s normal for teenagers to push the envelope by seeking out edgy or inappropriate content online, but searches for adult content can increase the risk of a teen being exposed to danger. Teenagers lack the life experience and history that adults have, which can make it harder to make informed decisions when it comes to issues like cyberbullying, sexting, communicating with strangers, and making online friends.

Many experts recommend that a teen’s online activities should still have an age-appropriate level of filtering and monitoring from parental control software. Similarly, it’s still recommended that a teenager use a computer in a public area of the house, as opposed to a private bedroom where there is no supervision at all. Parents should educate teens on how to be safe and responsible online, and the risks involved with sending people bullying or explicit messages. Many teenagers develop online friendships, and they may be eager to meet their friends in real life. Parents need to stay in touch with their teen children about their social lives online, and it is up to parents to decide whether an (accompanied) meetup with a new friend seems safe or not. Finally, any purchases that a teen makes online should be reviewed and monitored by parents to prevent illegal activity, identity theft, or overspending.

For More Information

I frequently recommend Internet Safety 101 as a resource for parents who are deciding on age-appropriate internet rules for their kids. You can also read more about the Wait Until 8th campaign, which advocates waiting until 8th grade to give children a smartphone. If your child has been affected by online bullying or harassment, my resource pages on anxiety and trauma may give you ideas on how to support your child through the experience. If you’re in the Davidson, NC area and interested in counseling for your child, you can contact me here.