Anxiety Worksheets for Teens: A Toolkit for Managing Stress and Worry [Free PDF]

Written by Dr Lucy Russell DClinPsyc CPsychol AFBPsS
Dr Lucy Russell Clinical Psychologist Founder of They Are The Future
Author: Dr Lucy Russell, Clinical Psychologist

Worksheets can be such a helpful tool for increasing insight and awareness about stress and worry.

The right tools help to make abstract ideas more concrete and understandable for young people with feelings of anxiety.

I wanted to provide you with a set of free helpful worksheets which you can download for your child and get started with immediately.

Each free worksheet is based on cognitive behavioral therapy (CBT), an evidence-based therapeutic approach for anxiety.

Together they make up a brilliant anxiety workbook for teens.

Anxiety Worksheets & The Anxiety Epidemic

We are in the midst of an anxiety epidemic amongst teenagers.

In my clinic (Everlief Child Psychology in Buckinghamshire, UK) we are inundated with teenage clients whose daily lives have been interrupted by anxiety owing to personal and societal pressures.

As a parent, I know that you want to know what to do to help your child.

You want practical anxiety resources for teens to help them overcome anxiety.

I have used my 20 years of experience as a child clinical psychologist and parent to develop the most effective anxiety worksheets for teenagers.

Anxiety in Teenagers: The “Helping” (Hindering) Brain

Anxiety is such a difficult emotion. We have anxious thoughts because the brain is trying to keep us alive.

To the brain, survival is much more important than happiness.

So, the brain often conjures up worst case scenarios and “what ifs”, so that we can prepare for disaster.

The brain goes into survival mode even when the course of anxiety isn’t actually a life or death situation, like academic stress or general school pressures.

It can’t tell the difference.

teenage girl anxious thoughtful

The trouble is, the brain regularly gets it wrong.

By over-focusing on the worst possible outcomes the brain over-estimates the danger. This can make us anxious or miserable, or both.

At worst, a young person can feel completely at the mercy of their thoughts and out of control, which is likely to lead to panic disorder.

Your Anxious Teen: The Link With Sensitivity

We all have thoughts that could trigger symptoms of anxiety. However, some people are more sensitive to them than others.

Children and young adults with high sensitivity are particularly susceptible to the news and social media, which often present a skewed view of the world.

By their nature, media tends to over-represent and dramatise negative news, which can reinforce anxious thoughts and exacerbate teen anxiety.


CBT Worksheets for Anxiety in Teens

The 5 teenage anxiety worksheets contained in the free PDF are based on cognitive therapy. Together they make up a mini teen anxiety CBT workbook.

The techniques are used by mental health practitioners working on anxiety plans with young people, but I have carefully picked tools that teens can try for themselves at home.

close up of a boy blowing dandelion seeds

How to Download Your Teen Anxiety Worksheets

You can download these anxiety resources for teens here! Then see below for more detailed instructions on how to use them.

Your Anxiety Worksheets for Teens Explained

Together, my worksheets make up a practical “conquer anxiety workbook” for teenagers. The strategies in this therapeutic workbook are helpful for all types of anxiety.

The Importance of Anxiety Activities for Teens

Anxiety can cause us to feel very stuck. It can be like a downward spiral that we become sucked into.

Your teenager needs to take some simple, practical actions

Anxiety Worksheet 1: Anxiety Triggers

Worksheet 1 is going to help your child not only work out what is triggering their anxiety, but also their level of anxiety in each situation.

They will start to get better at naming the feelings of worry and making the connection between the triggers and the feelings.

Anxiety Worksheet 2: Body Strategies for Managing Anxiety

It’s vital that your teen learns the importance of the mind-body connection in anxiety.

When the body is in a state of anxiety, there are many effective tools your child can use to physically calm their nervous system.

The strategies below and inside your anxiety worksheet are considered mindfulness practices because they increase our awareness of bodily sensations and the connection between body and mind.

image of a serious teen boy

The following activities will tell your teenager’s nervous system “I’m safe” so that their brain and body can go back to a resting state rather than an alert state.

Each exercise will take a little practise to master. They can them all or just choose the one that appeals the most!

Anxiety Body Strategy A: Body Scan

Here are the instructions for the body scan technique, which is one of the first coping skills I tend to teach the young people I work with.

Body scanning can help teenagers to identify physical symptoms of anxiety, and learn to sit with these sensations until they pass.

It can also help young people to be more aware of what their body feels like when it’s calm and relaxed.

  • Find a quiet and comfortable place to sit or lie down, where you won’t be disturbed.
  • Start by closing your eyes and taking a few deep breaths to help you relax and focus on the present moment.
  • Bring your attention to the soles of your feet, and consciously release any tension or discomfort you may be feeling there.
  • Slowly move your awareness up your body, focusing on each body part in turn. Pay attention to any areas of tension or discomfort, and consciously release them.
  • As you move up your body, continue to take deep breaths and stay focused on your breath and your body.
  • When you reach the top of your head, take a moment to scan your entire body again, checking for any remaining areas of tension.
  • Finally, take a few more deep breaths, and when you are ready, slowly open your eyes.

Repeat this process as often as needed, especially when you’re feeling anxious or stressed.

body scan technique for anxiety

Anxiety Body Strategy B: Progressive Muscle Relaxation

The spaghetti exercise is a form of progressive muscle relaxation.

It’s one of my favourite coping strategies as it is fun and easy. It teaches your child how to feel the difference between tense muscles and relaxed muscles.

By deliberately relaxing our muscles, we can send a message to the brain that we are safe and there’s no danger.

image of raw spaghetti and cooked spaghetti

Here’s a 3-step guide for your teenager to begin using the spaghetti anxiety exercise to relax their muscles:

  1. Visualize raw spaghetti: Start by visualizing your muscles as raw spaghetti, stiff and tense.
  2. Cook the spaghetti: Imagine that your muscles are being slowly cooked, just like spaghetti in boiling water. As the spaghetti softens and becomes more relaxed, visualize your muscles doing the same.
  3. Release the tension: As the spaghetti is fully cooked and soft, imagine that your muscles are now relaxed and free of tension. Allow your muscles to sink into a state of deep relaxation, just like cooked spaghetti.

Your child should practise this exercise regularly, especially when they’re feeling tense or stressed. They should notice any effect on their mind.

Anxiety Body Strategy C: Finger Breathing

Finger breathing is a way of learning how to slow our breathing down.

Deep breathing calms the nervous system and helps us feel more relaxed. 

picture of a hand displaying how to do finger breathing for anxiety

Here are your instructions:

  • Hold one hand up. With a finger from the other hand, work your way slowly up from the outside of your hand to the tip of your thumb while you breathe slowly in through your nose, right into your belly.
  • Move your finger down into the crease between thumb and forefinger as you breathe out slowly through your nose.
  • Continue to the end of your hand, and then work your way back across.
  • Swap hands.

Anxiety Worksheet 3: Cognitive Restructuring

Cognitive restructuring is a powerful CBT tool for managing anxiety, and it’s an effective technique for helping teens overcome negative thought patterns and beliefs.

Cognitive means thinking.

The idea behind cognitive restructuring is to identify and challenge irrational or unhelpful thoughts and replace them with more positive and constructive ones.

This can help reduce anxiety and improve overall well-being.

To help your teen practice cognitive restructuring, you can start by encouraging them to identify unhelpful negative thoughts and beliefs when they arise.

Use the thought challenging CBT worksheet you will find in the anxiety worksheets pack.

Your teenager will learn to analyse their thought and ask questions such as:

“What is the evidence for this thought?”

“Is there another way to look at this situation?”

“What would I tell a friend in this situation?”

These questions can help your teen begin to gently challenge and adapt negative beliefs.

Once your teen has identified their unhelpful thoughts or negative thinking patterns, encourage them to replace them with more balanced and constructive ones.

This might involve focusing on the positive aspects of a situation, reframing negative thoughts in a more positive light, or developing a more realistic and accurate perspective.

With practice and support, your teen can learn to effectively manage anxiety through cognitive restructuring and gain greater control over their thoughts and emotions.

close up of an anxious teenage boy

Anxious people often have negative core beliefs about themselves and the world.

Core beliefs and regular beliefs are different in that core beliefs are underlying, fundamental, and central to a person’s self-concept, whereas regular beliefs are more specific and surface-level.

For example, a core belief is “I am not good enough”.

Core beliefs are often formed in childhood or early life experiences and are deeply ingrained in a person’s self-image, causing cognitive distortions that influence their thoughts, emotions, and behaviors.

Core beliefs are often more challenging to shift than regular beliefs because they are deeply ingrained and influence a person’s self-concept.

For example, a person with the core belief “I am worthless” may interpret events and experiences in a way that reinforces this belief, even if it’s not accurate or true.

So, always encourage your child to start by focusing on the more surface-level thoughts which are easier to shift.

Anxiety Worksheet 4: Disengaging from Anxious Thoughts (Thought Buses)

Thoughts are merely mental events.

Scary or anxious thoughts do not have any significant meaning.

For example, if a thought about something you fear pops into your head it is no more or less likely to happen, than if it did not pop into your head.

The problem is that these mental events are incredibly powerful. They have the power to trigger panic attacks, cause social anxiety in social situations, and excessive worry.

But anxious teens can learn how to identify and assess these potent thoughts before they trigger signs of anxiety.

They can learn to disengage from these mental events.

This is one of the most important life skills a teen can master, if they want to effectively manage anxiety. It’s essential in managing and preventing mental health issues in the teenage years and beyond.

image of thought buses exercise for anxiety

This technique is taught in cognitive-behavioral therapy but also other popular therapeutic approaches like ACT (acceptance and commitment therapy).

The good news is thoughts and feelings are events which pass.

When we are caught in the moment with them, we often feel as though these are permanent states which will last forever.

Young people are more likely to believe they will feel this way forever, because they have less life experience. A healthy way to put your child’s anxiety into perspective is to create a practical and visual representation.

Encourage your child to draw their own thought buses. You will be helping your teen with anxiety by teaching them a powerful new way of viewing their thoughts.

Your teenager will learn to tolerate anxious feelings, and let anxious moment sit with them in the knowledge that it will soon pass.

Anxiety Worksheet 5: Graded Exposure for Anxiety (Exposure Hierarchy)

This mental health worksheet is perfect if your teenager is avoiding something because of their anxiety.

It could be that they are avoiding a specific situation.

Or, they could have developed a phobia which leads them to avoid specific situations. For example, avoiding parks because of a fear of dogs.

Graded exposure is a therapeutic technique used to help children and adults overcome fears and phobias. It is also known as exposure therapy.

This technique involves gradually and systematically exposing an individual to the object or situation they fear. They start with the least frightening situation and and work their way up to the most frightening.

The idea behind graded exposure is to help your teenage overcome their anxiety by gradually desensitizing their brain to the cause of their anxiety.

Graded exposure can be an effective tool for teenagers who experience anxiety or phobias, as it can help them overcome their fears in a safe and controlled way.

It can be particularly useful for teenagers who fear social situations, such as speaking in public, meeting new people, or attending social events.

To use graded exposure, a teenager would start by identifying the specific object or situation they fear and developing a hierarchy of feared stimuli, starting with the least frightening and working their way up to the most frightening.

They would then gradually expose themselves to each step on the hierarchy, allowing themselves to experience and cope with the fear-provoking stimuli.

At each step, your teen should repeat it over and over until they feel little or no anxiety.

At this point they are ready to move on to the next step.

You will see an example on the anxiety worksheet.

Further Recommended Anxiety Resources For Teens

If you want to deepen your understanding about anxiety so you feel clear on exactly which steps will help for your child, consider our mini-course, Knowledge is Power!

Knowledge is Power: Understanding Anxiety in Children course

I regularly also recommend a book called Stuff That Sucks to my clients. It’s written for teens. The language is informal and it’s full of helpful graphics. The book gets great reviews from families I work with. It’s one of my favourite mental health resources.

Think Good Feel Good is a brilliant cognitive behavioural therapy anxiety workbook for teens and older children. It was written by a psychologist and I recommend it to many families in my clinic.

What to Do If Your Teenager Needs Further Support

If your teen’s general anxiety levels have a significant impact on their everyday life, they may have an anxiety disorder and you may need additional help to support them.

My online parent course called Outsmart Anxiety will empower you with a wealth of knowledge and strategies to support your teenager’s recovery. Online courses are fantastic for increasing your knowledge and helping you feel empowered, at your own pace and in your own home.

These anxiety worksheets for teens are most effective if your child’s anxiety is mild to moderate.

If their anxiety is more severe and you feel direct face-to-face professional help is needed for your child, ask your doctor or healthcare provider to refer your child to a local service offering evidence-based effective treatment such as cognitive behavioral therapy.

In the UK Many NHS services are overwhelmed at the moment and your child may not be accepted for therapy unless their anxiety is severe. In this case, if you are self-funding or you have private medical insurance covering all family members, the best way to find private support from mental health professionals is through ACHiPPP, the Association for Child Psychologists in Private Practice.

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Summary: Anxiety Worksheets For Teens

Young people need practical strategies to manage emotions in our demanding and uncertain world, especially with the added stressors of teenage life.

These anxiety worksheets for teens contain a lot of effective techniques that can form a part of your child’s overall recovery plan, helping them build new skills and feel more in control of their lives.

Use the strategies consistently and they will contribute towards positive outcomes.

If your child’s quality of life continues to be affected by significant anxiety even after trying self-help strategies, you should seek therapeutic support from a clinical psychologist or other mental health professional.

Dr Lucy Russell is a UK clinical psychologist who works with children and families. Her work involves both therapeutic support and autism assessments. She is the Clinical Director of Everlief Child Psychology, and also worked in the National Health Service for many years.

In 2019 Lucy launched They Are The Future, a support website for parents of school-aged children. Through TATF Lucy is passionate about giving practical, manageable strategies to parents and children who may otherwise struggle to find the support they need.

Lucy is a mum to two teenage children. She lives in Buckinghamshire with her husband, children, rescue dog and three rescue cats. She enjoys caravanning and outdoor living, singing and musical theatre.

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