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Supporting Young Athletes Struggling with Anxiety

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Millions of families watched this summer’s Olympics, which may inspire countless children to join a soccer team or take up swimming lessons. While youth sports bring many physical and mental health benefits to children, they also can elicit worry and anxiety. Anxiety may manifest as a child who complains of a stomachache before every Little League practice, or one who is overly self-critical of their performance on the track team. There are several approaches you can take to assist your clients in working through sports-related anxiety. 

 

Normalize the Experience

Kids who experience sports-related anxiety may feel different from or isolated from peers who express only excitement about participation in athletics. Therefore, clients can experience some initial relief by learning that anxiety is a common experience, and one that they can learn to manage. Early in the therapy process, you can provide general psychoeducation about anxiety using age-appropriate books. My favorites include Ruby Finds a Worry by Tom Percival and Wilma Jean the Worry Machine by Julia Cook. More specific to sports, Olympic medalist Laurie Hernandez authored a children’s book called She’s Got This about a young athlete who finds courage to continue her gymnastics routine after falling down.

Openness about mental health is becoming increasingly common among professional athletes. Most recently, tennis star Naomi Osaka and Olympic champion Simone Biles have withdrawn from major competitions to care for their mental health. The significance of this public acknowledgement of mental health challenges – including anxiety – cannot be underestimated. You might help clients identify athletes that play their chosen sports and have been open about pre-game worries and anxiety. Depending on your client’s age and developmental level, you might share interviews that athletes have given to the press in which they discuss pre-game coping strategies or share that they work with a therapist. Youth benefit greatly from role models and may take comfort in the knowledge that their sports heroes take steps to care for their mental health.

Teach Coping Skills

Learning some specific coping techniques to manage anxiety can empower children to take control of their own experiences in sports. Anxiety is exacerbated in uncertainty, so coping skills should focus on building predictability. When children develop an understanding of what happens in their body when they worry, they become better able to gain control of their anxiety. You can help clients build body awareness using simple exercises. For example, with Hopscotch’s Physical Symptoms Identifier, clients can use an image of a body to indicate their physical responses to stress and anxiety. When they click on a body part, they are able to select symptoms that apply to them. You can refer to the exercise as you teach coping skills to your client. You might say something like, “I see that you feel your worries in your belly. Let’s practice some exercises that help your belly feel better before baseball practice.” 

Introduce Visualization Techniques

One skill set that can be valuable to a child who experiences anxiety prior to a sports practice or competition involves visualization. Depending on the nature of the client’s anxiety, you might help them to visualize stepping onto the playing field or imagining themselves having fun during the game. While building up visual imagery, encourage clients to imagine what each of their five senses might be experiencing (example: “I smell the grass. I hear the referee’s whistle. I see my teammates sitting on the bench”). Having a clear image of what they can expect to experience during their game or practice removes the uncertainty that fuels anxiety. This exercise is particularly helpful for kids who become most anxious on the way to their sports practice or game.

Target Relaxation Exercises

There are many benefits to learning relaxation exercises, and kids can use such exercises before, during, or after practices or games.  A very common exercise, sometimes called “Belly Breathing,” encourages one to place their hands on their stomach before taking deep breaths in and out. Often when we ask someone who is anxious to take deep breaths, it is hard for them to do so. Have a hand on the stomach allows one to feel breaths going in and out; if the breaths are deep enough, one can feel the stomach moving in and out.  Teach your clients to slowly count while doing this exercise: they can count to three while inhaling, count to one while holding their breath in, and count to three again while exhaling. You may need to work with your client to find a rhythm that feels most comfortable for them. Children can learn to use this exercise whenever they feel anxiety spike, and it is important for them to practice it during calm moments to build up their comfort in using the technique.

Partner with Parents

Parents can play an important role in helping children play sports in a fun and safe manner. It’s important to partner with parents as you support your client in developing a coping plan for anxiety. Parents may be confused as to why their child begs not to go to their sports practice, yet always seems to have fun when they finally set foot on the field. This can be a frustrating experience for parents, and it’s important to convey empathy to the entire family. You can provide parents with psychoeducation about anxiety and invite them into the planning process for your client’s coping plan. 

 

Does your client’s anxiety spike on the car ride to practice? Encourage parents to keep conversations light or listen to some upbeat music on the way. Does your client tend to worry about the score of the game or focus on mistakes that they have made? Encourage parents to use language that highlights what the client has done well, or parts of the game that the client appeared to be having fun (Example: “I think I saw you laughing on the bench while your team was batting. I’m so glad you are having fun on the baseball team”). Parents can set the tone for their children’s experiences in sports. If a parent focuses conversations on having fun, learning new skills, and teamwork; a child is less likely to become hyper focused on winning or individual mistakes.

Know When to Refer Out

Some young clients, particularly adolescents, may experience sports-related performance anxiety that requires more specialized intervention. If a client is a high-performance athlete, one that has hopes to compete in the NCAA or the Olympics, a qualified sports psychologist could become a valuable part of the treatment team. Sports psychologists are trained to help athletes optimize their performance and can assist athletes in working through mental blocks. You can find a qualified sports psychologist through Division 47 of the APA (Sports and Exercise) or the Association for Applied Sports Psychology.

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Katharine_WenocurAbout the Author

Katharine Wenocur, DSW, LCSW, RPT-S is a visiting assistant professor in the Community and Trauma Counseling master’s program at Thomas Jefferson University, and coordinates the program’s Child Trauma and Play Therapy concentration. She maintains a private practice in child and adolescent therapy. She is also a former competitive gymnast who coached the sport for several years.