Healthy Thinking for Younger Children

**For older children and teens, see Realistic Thinking for Teens

In general, anxious children think differently than other children. For example, they can easily come up with 101 ways that things can go wrong! They also tend to see the world as more threatening and dangerous. If a parent is late coming home, an anxious child may think “Mom got in a car accident!” What your child says to himself or herself is called “self-talk”.  Anxious children tend to have negative or anxious self-talk. Some examples include:

  • “I will fail the test.”  
  • “What if I can’t do it?”
  • “Things are not going to work out.” 
  • “They don’t like me.” 
  • “I’m stupid.”
  • “I’m going to get sick and die.”
  • “That dog is going to bite me!”

It is important for children to identify their self-talk, because anxious thoughts lead to anxious feelings, which lead to anxious behavior. For example: 

Situation = First day of school 

Thus, the first step is to get your child to start paying attention to his or her self-talk, especially anxious thoughts!     

HOW TO DO IT! 

Step 1: Teach younger child about thoughts or “self talk”

  • Thoughts are the words we say to ourselves without speaking out loud (self talk).
  • We have many thoughts each hour of the day.
  • Thoughts are private – other people don’t know what we’re thinking unless we tell them. 
  • People can have different thoughts about the same thing.

 Here is an example of how to explain thoughts:

“We all have thoughts about things. Thoughts are words we say to ourselves without saying them out loud. Other people can’t tell what you are thinking unless you tell them. Because we have thoughts all the time, we usually don’t pay attention to them.  They just come to us automatically! Let’s try and slow our thoughts down and pay attention to them.”

The What am I Thinking? activity can help with this explanation. You can also use picture books or movies to teach your child about thoughts. For example, point to a picture of a character and say, “Hmmm, I wonder what he is thinking?”   

Remember, it can be difficult for young children to understand the concept of what a thought is, and it can be especially difficult to tell the difference between a thought and a feeling. For example, your child may say his or her thought is “I’m scared” (which is actually a feeling) versus “That noise is a burglar trying to break in” (which is a real thought). It is important to expose the thoughts underneath the feelings! For example, “What is making you scared? What do you think that noise might be?” 

Hint:
One way to describe the difference between a thought and a feeling to a young child is to explain that a thought comes from your head, and a feeling comes from your heart.

Step 2: Help your child identify thoughts (or self-talk) that lead to feelings of anxiety. 

  • Often, we are unaware of what we are thinking, and it can take time to learn to identify our specific thoughts.
  • Questions to ask, in order to help your child identify his or her “anxious” or “worried” thoughts include:
        • What is making you feel scared?
        • What are you worried will happen?
        • What bad thing do you expect to happen in this situation?  

For young children, this may be as far as you can progress. Just identifying their thoughts is a big step in a long-term plan to help fight anxiety. One way to get your child to continue to pay attention to anxious thoughts is to use an actual stop sign as a visual reminder to “stop and pay attention”.   

Remind your child that just because he or she thinks something, doesn’t mean it’s true! For example, just because your child thinks the elevator will get stuck, doesn’t mean it actually will (even though it might feel really scary).  While children can usually describe thoughts that go with feelings of anxiety, in some cases children are unable to identify anxious thoughts, especially children who are very young or not very talkative. At any age, anxiety may be present before there are thoughts about the situation. If you and your child do not identify anxious thoughts, it is best not to press your child about this too much about this. By making too many suggestions, you may create anxious thoughts where there were none before. Instead, watch to see if your child mentions anxious thoughts in the future. The other approaches to managing anxiety work even when anxious thoughts are not identified. 
 
(The concepts below may be too difficult for younger children to grasp)   
 
Step 3:  Teach that what we think affects how we feel  
  • When we expect bad things to happen we feel anxious.  
  • What we think affects (or controls) how we feel.

For example, imagine you are out for a walk and you see a dog.  If you think the dog is cute, you’ll feel calm; however, if you think the dog will bite, you’ll feel scared. Use the Thoughts and Feelings sheet to help explain this idea to your child.   

Step 4: Changing unhelpful thoughts to helpful thoughts 

  • First, explain the difference between a helpful thought and an unhelpful thought:
Thousands of thoughts run through our head every day. Some of these thoughts are helpful thoughts, and some are unhelpful thoughts. A helpful thought makes us feel confident, happy, and brave. An unhelpful thought makes us feel worried, nervous, or sad. Can you think of some examples of helpful and unhelpful thoughts?
  • Once your child can identify the difference between helpful and unhelpful thoughts, ask him or her to imagine being in a particular scenario. It is best if the scenario is a bit uncertain. Ask: What is an unhelpful thought you could have?  What is a helpful thought? For example,
Situation Unhelpful Thoughts Helpful Thoughts
A group of kids looking at her and laughing Oh no, they are laughing at me. I must look stupid! They are probably laughing about something funny, and I just walked by.
I don't actually know that they were laughing at me!
Not being invited to a birthday party She doesn't like me. I bet I am the only one who didn't get invited in the whole class. They probably just forgot.
Or maybe it was just a small party.
I have other good friends.
Getting a low grade on a quiz I suck. I am never going to do well in spelling.

Well, I tried my hardest.
It's only one grade!I will practice more next time.

  • Once your child can come up with his or her own helpful thoughts, refer to the Developing and Using Cognitive Coping Cards guidelines, to help your child create, write down, and remember some of these helpful thoughts!

It is very useful to help a child identify unhelpful thoughts and create helpful thoughts. At the same time, anxious thoughts and feelings are normal. It is important to communicate that you and your child can accept anxious thoughts and feelings. They are not stupid or foolish. They are just one way of thinking and feeling, and there are lots of other ways of thinking and feeling.   

Step 5. Introduce the STOP Plan to your older child: 

1. Pay attention to signs of anxiety (= S)
2. Pay attention to anxious thoughts (= T)
3. Think of other helpful thoughts (= O)
4. Praise and Plan for next time (= P) 

Scared? Thoughts? Other helpful Thoughts? Praise and Plan
Sore tummy
Heart racing
Knees Trembling
I might throw up, and mom won't be here to help me. I can ask to go to the bathroom and do my calm breaths.

I can get a drink of water.

My teacher cares, he will help me.

Good job for remembering to use the STOP Plan!

Next time, I will remember that feeling panicky doesn't last forever, and drinking water helps.

Now, use the STOP Plan Handout with your child! You will need to print several copies. First, go through the chart together with your child. You will likely need to do this several times over a couple of days. Once your child gets the hang of it, have your child complete it alone when faced with a scary situation.  Eventually, your child will get used to the steps in the plan, and may not even need to write it down. Remember to praise and reward effort!