Quick Tips for Therapists

How to Help a Teen Experiencing High Anxiety during a Session

By Lisa M. Schab, LCSW

Talking about sensitive personal topics in counseling can raise a teen’s anxiety. To help them rebalance, reflect that you recognize they’re feeling anxious, assure them this is OK, and explain you’ll help them manage it. Then, help reduce their anxiety in the moment using “Observe, Move, and Soothe.”


Teach teens that observing their anxiety takes them a step away from it. They can rate its intensity on a scale of one to ten; describe where they feel it in their body; identify the thoughts that triggered it; explain if they’ve felt this before; and/or tell what the anxiety would look like if it had color, texture, and form. 


Teach how physical movement releases anxiety by trying simple movements such as standing up and stretching their arms overhead, twisting their torso or swinging their arms gently from side to side, or opening and closing their fingers. (Consider physical safety before using movement.) Let them try walking around your room, or even down the hallway. Have them observe how the more they move, the more their anxiety dissipates.


Have a supply of self-soothing tools easily accessible so you can let your client choose from items like a dish of kinetic sand, “squishies” (small foam toys), worry stones, calming essential oils, playdough, soft hand lotion, crayons and a coloring book, a bubble wand, water beads, or blank paper to record anxious thoughts to be shredded or destroyed.


Trying the techniques with your teen client can show support, provide healthy modeling, and reduce discomfort about trying something new.

A light and positive attitude conveys confidence that they can calm down, that anxiety isn’t unusual, and that they don’t have to be afraid of it.

Celebrating any and all progress empowers the teen by proving they don’t have to be a victim to anxiety.

Lisa M. Schab, LCSW, is a practicing psychotherapist in the greater Chicago, IL, area, and author of eighteen self-help books, including The Anxiety Workbook for Teens and The Self-Esteem Workbook for Teens, as well as the teen guided journals Put Your Worries Here and Put Your Feelings Here. She has been interviewed as an expert on the Milwaukee television stations WTMJ-TV and WISN-TV, and for articles in The New York Times, Scholastic’s Choices magazine, Teen Vogue, Psych Central, and Your Teen Magazine. Schab has authored regular columns on tweens and teens for Chicago Parent, and on healthy families for The Sun Newspapers. She is a member of the National Association of Social Workers (NASW).

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Quick Tips for Therapists