“Though it is not the same as good psychotherapy, don’t underestimate the power of the basics,” she told me. “Making sure your young person is getting enough sleep, they’re getting enough physical activity, they’re eating a balanced diet. If possible, keep them busy with purposeful activities. These things go further than we sometimes expect.”
There are resources you can use at home, books and online programs, that can help your family. The online resources that come most recommended are often rooted in Cognitive Behavioral Therapy (C.B.T.), which “usually involves efforts to change thinking patterns,” according to the A.P.A. Patricia Frazier, a distinguished professor of psychology at the University of Minnesota, has, along with colleagues, studied the effects of internet-delivered C.B.T. programs (I.C.B.T.) on university students, and found that they were “feasible, acceptable and effective.”
These I.C.B.T. programs tend to be a combination of text, videos and exercises that help explain the roots of anxiety, then encourage users to identify what may be triggering overwhelming feelings, and then offer exercises to help address these feelings. For example, the free app MindShift C.B.T., from the nonprofit Anxiety Canada, allows you to log your daily feelings and then write a short journal entry about the reason behind the feeling. You can also list symptoms you may experience, like racing thoughts, chest tightness or nausea. It gives you a series of tools to use, like guided audio for calm breathing or test anxiety, or “coping cards” that provide affirmations like “Learning to sit with some uncertainty will help me worry less.”
Frazier told me the body of research on the effectiveness of I.C.B.T. programs is “incredibly strong.” She pointed me to this 2019 review in the Canadian Journal of Psychiatry, which found that “I.C.B.T. works and can be as effective as face-to-face therapy.” But it’s worth noting that these studies were done on adults, not on children or teenagers, and that many of them had a trained professional helping to run the I.C.B.T. programs.
Patrick McGrath, an emeritus professor of psychiatry at Dalhousie University in Nova Scotia who has studied the effectiveness of I.C.B.T. in adolescents, told me that parents looking for reputable resources should start with the websites of children’s hospitals and professional organizations. He recommended Magination Press Children’s Books from the American Psychological Association, as well as the “C.B.T. Toolbox” series of books. As for online resources, he said that he refers people to MAP, or My Anxiety Plan, also from Anxiety Canada, which has a multipart online course for teenagers.
McGrath mentioned CopingCat, which includes an online resource called Camp Cope-A-Lot. It’s an animated program that helps teach parents and kids ages 7-13 C.B.T. skills and that was developed by Khanna and Philip Kendall, a professor of psychology at Temple University. She told me that she sees the program as a learning resource, not necessarily as a therapeutic one. The C.B.T. skills she teaches in talk therapy, like identifying triggers of anxiety and using tools like journaling and breathing, “are learnable concepts, and therapists are just better and more trained to teach the concepts,” she said.