What’s inside this article: An overview of the Step Ladder Approach, a researched-based method of overcoming anxiety, with steps for how to use this approach to help children overcome their anxiety.
**Includes downloadable printable workbook to help you implement this approach successfully**
Anxiety is a normal human emotion that everyone experiences from time to time. Often, kids can overcome those feelings with a bit of support and reassurance from a parent.
Some children, however, have on-going anxiety that interferes with their lives.
This can manifest in a variety of ways. Separation anxiety, for example, may make school drop-offs extremely difficult and lead to your child avoiding situations where they’ll be separated from their you.
Sleep anxiety is common in children with ADHD and often presents as avoidance or opposition at bedtime.
Another common anxiety is social phobia, when children avoid social situations due to fear of embarrassment or judgment from peers.
Children may also struggle with generalized anxiety, having many triggers across various situations. And, children with autism often have a unique form of anxiety called distinct anxiety.
You may want to complete this common worry checklist with your child to get an idea of what situations are scary to them. This is helpful when opening a conversation about worry/anxiety with children.
This checklist can lead to more in-depth conversations with your child about how often people worry and how to manage that worry.
The Reason Why People Have Anxiety
Anxiety is like our brain’s security system, built to protect us from danger. Any real or perceived threat triggers our internal alarm system (the sympathetic nervous system), leading to a stress response. It’s a normal and necessary human emotion that everybody experiences from time to time.
However, some of us, like kids with anxiety disorders or who struggle with emotional self-regulation, have very sensitive alarm systems that go off too easily. These “false alarms” feel very real and scary, even though there isn’t real danger.
If your child’s anxiety is affecting the way they live their life, it’s a good idea to speak to their primary healthcare provider. About 13% of kids and teenagers have a diagnosed anxiety disorder, and many others experience symptoms without a clinical diagnosis.
Ways to Reduce Anxiety
There are many ways to reduce anxiety, such as:
- Regular exercise decreases anxiety and improves mood
- Having a toolbox of coping strategies for difficult situations
- Eating healthy
- Journaling
- Mindfulness
- Talking to someone you trust
- For some, therapy and/or medication are needed.
One specific strategy for overcoming anxiety is the step ladder approach. This article explains what that approach is and how to use it in-depth so you can use it to help your child overcome their anxieties.
The Step Ladder Approach
The step ladder approach for anxiety is a cognitive-behavioral therapy (CBT) technique used to gradually expose individuals to situations or stimuli that cause anxiety in a systematic and controlled manner.
It’s often employed in the treatment of specific phobias, social anxiety disorder, and other anxiety-related conditions.
It involves breaking down your child’s fears into smaller steps (hence, the step ladder) and working through them from easiest/least scary to most challenging/most scary.
This strategy works best when your child is directly involved in creating their step ladder.
It’s up to them to determine what’s easiest and what’s hardest because what we, as the adults supporting them, think isn’t always what they think.
However, this method can work for all ages, and if your child is too young or not developmentally ready to participate, the step ladder approach can still be quite successful.
Exposure Therapy
The step ladder approach was created based on exposure therapy, which is a behavioral therapy used to help people with anxiety and phobias.
When people are fearful of something, they tend to avoid the feared objects, activities,, or situations. Although this avoidance might help reduce feelings of fear in the short term, over the long term, it can make the fear even worse.
Exposure therapy addresses this by gradually and systematically exposing the individual to the activity or situation causing them distress. This is scientifically proven to improve anxiety by:
- Helping build new, more realistic beliefs about a situation
- Weakening previously learned fears and associations around a situation
- Showing the individual that they are capable of coping and handling their anxiety in stressful situations
Benefits of the Step Ladder approach
The step ladder approach has several benefits for children:
- They can get used to situations that make them anxious at their own pace. This reduces avoidance and ensures they don’t feel too distressed in the process.
- They have an opportunity to practice the coping skills they’ve learned.
- They see how capable they are and feel a strong sense of achievement as they move up each rung of the step ladder
- Helps build self-confidence and a growth mindset
- Diminishes negative thinking patterns and beliefs
How to Use the Step Ladder Approach:
This is a step-by-step guide for breaking down a situation or fear and implementing the step ladder approach with your child to help them overcome their anxiety.
You can find a printable workbook at the end of this article to use with your child.
Step 1: Motivating Your Child to Want to Address Anxiety
Facing your fears head-on is a scary, intimidating thought. If your child feels motivated to take on this feat, they are far more likely to achieve their goals.
Make a list of 7-10 strengths your child has. This includes personality traits, special knowledge or skills, and characteristics your child has.
Then, make a list of 3-4 challenges they are having. These could be directly or indirectly related to the situation you’re addressing with the step ladder approach.
The goal of this task is to help your child see there is far more positive about them than there is negative, and that these strengths can help them.
Example: A child with social anxiety, but their goal is to make a friend.
You should point out strengths such as being accepting, caring, thoughtful, funny, good at taking turns, and fun to play games with. These are all great qualities to have in a friend.
Their challenges could be that they are shy, nervous to start a conversation and worry they will embarrass themselves.
Helping your child see they have a lot to offer in a friendship can build confidence and motivate them to work through their challenges.
Step 2: Psychoeducation
Psychoeducation means providing information about the mental health issue (in this case, anxiety) to your child so they can better understand what’s happening inside their body and why.
A lot of the time, children don’t even understand their emotions, so simply having big, uncomfortable feelings, like being anxious, is completely overwhelming. Then, kids can feel like there is something wrong with them.
But, what most kids don’t know, and many parents don’t either, is that anxiety, worry, stress, fear, etc are all caused by a completely normal brain response. The problem is that it’s happening more frequently and/or intensely than it should be due to an anxiety disorder.
And that normal brain response, which most people have heard of before, is the fight or flight instinct.
Your Brain: Explaining Fight or Flight to Kids is a free 15-page, easy-to-understand narrative that helps children and teens understand how their brains work and what the fight-or-flight instinct is. This tool is useful for psychoeducation.
Your Brain: Explaining Fight or Flight to KidsStep 3: Set Your Goal
You need to begin with a goal – what is something your child wants to do, but anxiety is getting in the way?
This should be a specific situation or goal you can target and work on. For example, you could go to class, give a presentation, make a friend, stay home alone, or try a new hobby.
Step 4: Brainstorm
Once you know what the goal is, start brainstorming every single component of that situation or activity. You really want to break down all the small details and the different ways you can gradually expose your child to the situation.
This brainstorming works best if your child is directly involved so they can share their input. The parts of a situation that trigger anxiety aren’t always what they seem from an adult’s perspective. Getting the steps in the step ladder in the correct order is important for its success.
However, if your child isn’t developmentally able to participate in the process, it’s still possible to create an effective step ladder. Start with small, achievable goals and move slowly.
For example, if the goal is going to class, you need to walk down the hall, enter the classroom, greet the teacher, go to your desk, interact with other students, and spend time in that environment during different activities where the level of noise is changing, the level of participation expected is changing, there may be different odors at lunchtime, etc.
When the brainstorm is finished, have your child rate, on a scale of 1-10, how scary each of the ideas are.
Continuing with the same example, spending the entire day in class with all the other students might be a 10/10 for your child. But walking to the classroom inside might be just a 6/10, and going inside to quickly grab something from their desk may be a 7/10.
With this information, you can start building your step ladder.
Step 5: Put Together Your Step Ladder
Finally, you’re ready to piece together what the step ladder will look like.
You’ll start with the smallest, easiest steps to achieve. Remember, this is what feels easiest to your child.
The number of steps required will depend on the goal.
Step 6: Rewards
Choose a unique reward for achieving each step of the step ladder. Rewards should grow in size as your child gets close to their final goal, starting with something small for the first step, and ending with a big reward to celebrate their accomplishments at the end.
Rewards should be motivating to your child and based on their personal interests.
It’s also important to use positive reinforcement and words of encouragement throughout the entire step ladder process. This will help build your child’s confidence.
Acknowledge that climbing the step ladder isn’t an easy task and that they should feel proud for working hard, and you’re proud of them for working to overcome their fears.
Make sure that you acknowledge your preschooler’s efforts every single time in the
Step 7: Start working through the Step Ladder
Now that you’ve set a goal, mapped out the steps involved, and chosen rewards, it’s time to start working your way through the step ladder.
Remember, this is extremely important; you need to work through the steps at your child’s pace.
This may be a slow process. They should not move on to the next step until they’re able to complete the current step comfortably and with minimal anxiety/fear.
Sometimes, this will only require two or three repetitions, but other times, it may take a long time of practicing a step before they are comfortable enough to move on to the next step.
Do not rush them. This is key to their success.
Example of Using Step Ladder Approach
Here’s an example of the steps for a child with social anxiety who is anxious attending class.
- Walking past the classroom, looking in at everybody.
- Entering the classroom to retrieve school supplies from their desk and leaving
- Spending time in the classroom alone while other students are in a specialty class (for example, gym or music)
- Spending time in the classroom with the teacher and a couple of other students
- Spending time in the class with a larger group of students
- Spending time with the entire class during a quiet, independent activity, such as silent reading
- Spending time with the entire class during regular instruction time
- Raising hand to ask or answer a question during class
- Finally, building up duration of time with the entire class, taking short breaks as needed
Tips for Success
The following tips will help your child use the step ladder approach successfully
- Let your child decide what tasks to add to their ladder. If they need help with this, make a few suggestions, but let your child choose. Your child needs to feel like an active participant in this process and that they have control over how they work through their anxiety.
- Before you start, teach your child some strategies for managing their anxiety. Strategies like deep breathing exercises, positive affirmations, or zones of regulation can help your child get through challenging situations.
- Wait until your child has mastered one step on their ladder before moving on to the next. This might take one attempt, or it might take ten or 100 tries before a step is no longer considered anxiety-provoking. It’s always best to work at your child’s pace.
- Be a good role model. Children learn so much from us. Consider what you say and how you behave when you become anxious. It might help to work through your own step ladder at the same time as your child. Choose something simple that they can see you working on.
Download The Anxiety Step Ladder Work Sheets:
The Anxiety Step Ladder Work Sheets will help you piece together and plan your step ladder with your child.
Step Ladder Work Book
