Creative Approaches to Treating Childhood Anxiety

Anxiety Is Everywhere—and It’s Hitting Our Kids Hard

We hear the word “anxiety” all the time—on social media, in schools, and even in everyday conversations. It’s become a bit of a buzzword, something people casually throw around to describe feeling nervous before a test or overwhelmed by a busy schedule. But for so many kids and teens, anxiety is much more than just a passing worry—it’s a daily struggle that impacts their ability to learn, grow, and enjoy life.

Right now, anxiety disorders are at an all-time high among young people. Studies show that nearly 1 in 3 adolescents (31.9 percent) will experience an anxiety disorder before they turn 18, with 8.3 percent facing severe impairment that disrupts their daily life. And the numbers keep rising—especially in a world that’s constantly changing and full of pressures, both online and in real life (NIMH, 2025).

As a child and teen therapist and founder of Grow and Glow Child Therapy LA, I see firsthand how anxiety shapes the way kids navigate school, friendships, and even their own sense of self. It can look like perfectionism, avoidance, constant worry, trouble sleeping, or even stomachaches before school. And if left unaddressed, anxiety can hold kids back from reaching their full potential.

But here’s the good news: Anxiety is treatable. Kids and teens don’t have to stay stuck in a cycle of fear and worry. With the right tools—whether it’s learning coping strategies, challenging anxious thoughts, or feeling supported by parents and teachers—kids can build confidence and resilience.

This article will explore what anxiety really is, how it’s affecting today’s youth, and, most importantly, my strategy in my private practice of personalizing and gamifying the treatment of anxiety. Because when kids feel understood and equipped with the right support, they can thrive and learn how to manage it.

Anxiety is a natural human response to stress, uncertainty, or potential threats. It’s that uneasy feeling before a big test, the nervous energy before speaking in front of a group, or the worry that comes with trying something new. In small doses, anxiety is actually helpful—it alerts us to danger, sharpens our focus, and can even motivate us to prepare for challenges. However, anxiety becomes a problem when it is excessive and persistent and starts interfering with daily life (Walter et al., 2020).

While experiencing occasional anxiety is normal, an anxiety disorder is diagnosed when:

• The worry or fear is excessive relative to the situation.
• Symptoms persist for weeks or months instead of coming and going.
• The anxiety interferes with daily life, such as school performance, friendships, or family interactions.
• The child or teen avoids situations due to their anxiety.
• There are physical symptoms like headaches, stomachaches, sleep issues, or rapid heartbeat.

Anxiety disorders typically have an early onset—with the median age of onset being 11 (Walter, 2020). Cognitive behavioral therapy (CBT) is the first-line treatment for anxiety disorders in children and adolescents. It helps kids recognize unhelpful thought patterns, reduce avoidance behaviors, and build coping strategies.

CBT is well-supported by research and has been shown to significantly reduce anxiety symptoms (Walter, 2020). In my private practice, I implement cognitive behavioral therapy to help my clients build skills to reframe thoughts and challenge negative thought loops that are contributing to their anxiety. Each kid I work with has a different personality, unique interests, and their own ways of absorbing information.

In the past month, I realized something very important—if I can adapt the CBT intervention into a digestible way for them to absorb, which is directly related to their interests (such as baking, video games, etc.), then the client will be able to relate to the content more. What does this look like? I have now started to create individualized frameworks and workbooks for each client I work with, which are based on their interests.

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At its core, CBT teaches kids that their thoughts, feelings, and behaviors are all connected, and by changing one, they can change the others. Research has shown that CBT is the gold standard for treating anxiety in children and adolescents, with studies demonstrating that it significantly reduces symptoms and improves daily functioning (Walter, 2020).

Here is an example of a workbook I made for one of my clients: an 8-year-old girl who loves cats.

“Chapter 1: Meet Your Brain — The Wise Cat and the Alarm Cat! ) Did you know that inside your brain, you have two very special cats? One is Wise Cat, and one is Alarm Cat. Wise Cat (Prefrontal Cortex) — This cat is calm, smart, and helps you solve problems. It’s like a wise leader, helping you make good choices, even when things feel hard. Alarm Cat (Amygdala) — This cat gets startled easily! When something feels scary or frustrating (like science), Alarm Cat gets really loud and makes you want to fight (hit or kick), run away, or freeze up. When you feel really mad or worried, it’s because Alarm Cat is taking over. But guess what? You can train Alarm Cat to listen to Wise Cat!”

Here is an example of one of the activities from the workbook: “Scavenger Hunt: Find the Cozy Cats.”

Goal: Help the client discover safe spaces in her environment where she can calm down and feel protected.

Why It Helps: When the client is anxious, she needs a predictable physical space where she can reset. This activity teaches her where she can go to self-soothe.

In-Session Activity:

1. Hide paper cats or stuffed cats around the room.
2. Each cat has a clue that leads to a calm-down space:
   • “Find the cat where you feel warm and snuggly.” (Near a blanket or couch)
   • “Find the cat where you take deep breaths.” (Near a pillow or chair)
3. At each cat, practice the relaxation strategy.

• “Find the cat where you feel warm and snuggly.” (Near a blanket or couch)
• “Find the cat where you take deep breaths.” (Near a pillow or chair)

At-Home Practice:

1. Parents hide small toy cats in calming areas.
2. When the client finds one, she must sit, take three deep breaths, and pet an imaginary cat.

Each section of the workbook includes one activity for the client and me to do in our session and one that the client can do at home. It is personalized based on their interests and designed to help them overcome challenging behavior. Also, I created two pages at the end of the workbook to educate the parents of the client on brain development in their child, as well as suggest tips and skills for the parents!

Studies suggest that play-based CBT and gamified interventions improve engagement and long-term retention of skills in children (Freeman et al., 2020). When kids feel empowered rather than pressured, they are more likely to use these strategies in their daily lives—making therapy not just effective but enjoyable, too!

Research supports the effectiveness of play-based CBT. A meta-analysis of child anxiety interventions found that CBT adapted with play elements resulted in greater engagement and symptom reduction than traditional talk-based CBT alone (Freeman et al., 2020). Additionally, a study published in the Journal of Child and Adolescent Psychiatry found that incorporating play and creative techniques into exposure therapy increased children’s willingness to participate in treatment and led to significant reductions in avoidance behaviors (Silverman et al., 2018). Given that younger children process emotions through imaginative play and hands-on activities, play-based CBT aligns well with their cognitive and emotional development, making it a powerful and developmentally appropriate intervention for childhood anxiety (Pereira, 2021).

As a child and teen psychotherapist, I am always trying to come up with fun and engaging ways to help my clients work through their anxiety. Creativity with kids and teens has become such a huge part of the success I see in my clients, who are able to conceptualize anxiety and work through it effectively. We can encourage play and creativity, as well as inspire our kids to learn and grow! We can even take techniques from cognitive behavioral therapy and use personalization, creativity, and individualization to make them more successful. I hope this article helps inspire you to use your imagination and spark creativity to help your child.