Mental health clinicians are often tasked with supporting children with anxiety. With a precarious return to the classroom during a pandemic, this situation is as complicated as it is unique. This is also the first time that as clinicians, we are collectively navigating the same storm as our clients. Many of us are experiencing an understandable uneasiness about letting go of some of the practices and behaviors that kept us safe over these past months and going back to old routines and structure.

Here are some strategies to help you support children under stress:

  1. Facilitate communication : Many children who experience stress and anxiety keep their worries to themselves. They may also fear burdening others with their worries or may not know that someone is interested or available to hear their fears. Help children create safe ways of communicating with their parents or teachers by using shared journals, writing prompts, or designated check-in chat times. Be explicit in asking what a child may need in order to feel calm and supported.
  2. Create a social support diagram: Work with a child to outline different types of social support such as emotional, tangible, and informational support and identify ways to build social support in each area. Encourage children to think outside of their immediate circle to include additional supports, like community support, mentorships, or volunteer opportunities. Children can then identify specific people or groups to fulfill those roles.
  3. Activate the brake: As children develop emotion regulation tools, it can help them to understand why strategies work and how they can be used to calm their nervous system. Teach them about activating the "rest and digest" parasympathetic nervous system. Try unconventional strategies such as humming, splashing cold water on their face, drinking ice-cold water, or doing progressive muscle relaxation.
  4. Create social stories : The pandemic reduced opportunities for social interaction and left many children unable to practice socialization. Help them navigate common social challenges, such as joining conversations, initiating play with others, or asserting their boundaries, by creating social stories with step-by-step guidance.
  5. Address inequities : COVID-19 has had a differential effect on various communities. In a 2020 survey, LGBTQIA+ students reported feeling that COVID-19 hindered their ability to express themselves. The survey also revealed LGBTQIA+ students experienced higher levels of anxiety and depression as compared to their peers. Likewise, BIPOC students and students from families with fewer financial resources have been unduly impacted by the pandemic. It is important to explore identity with students, acknowledge the impact of structural racism and systemic bias, and determine their unique needs for support.
  6. Move to improve : When the flight or fight system has been activated, movement helps the body complete the stress cycle signaling the end of perceived danger. Encourage children to find creative ways to move. Try relay races, obstacle courses, animal walks or turning up the music and dancing while getting ready in the morning.
  7. Take care of yourself : Social workers and other mental health professionals have carried a heavy burden throughout the pandemic. As helpers, we often prioritize the needs of others, risking our own mental health in the process. Remember to extend compassion to yourself as a clinician. Now is the time to challenge ourselves to practice what we teach! Recognize the value we can provide to others while also understanding our limits. Exercising good boundaries means not prioritizing others' needs over our own comfort. Practice the fundamentals of self-care such as proper sleep, exercise, and nutrition. Try a new hobby- particularly one that involves working with your hands. Repetitive tasks that do not require sustained mental effort allow our brains to have a break and can be excellent stress reducers!

While these strategies can help reduce children's anxiety, back-to-school adjustment is likely to ebb and flow for many kids. Initial excitement to return to school and connect with friends may fade quickly due to fatigue from new routines and increased social and academic demands. Encourage families to have patience and reasonable expectations as they navigate the return to the classroom and when the challenges arise, return to the strategies that have previously worked.