Quality & Affordable Mental Health Support in Toronto

Cutting through Therapy Misconceptions

You don’t have to be in crisis to benefit from therapy. Here’s what to expect when you decide to reach out for support.

How to Support Your Anxious Teen

Teen Anxiety: How to Support Your Teen in a Changing World  By Aviva Boxer, Registered Psychotherapist    I have been thinking about teen anxiety a lot lately and comparing what things were like when I was a teenager with what they are like for my own teens today.  So I asked my son what the big sources of anxiety are for kids his age. When we compared them, I was struck by how similar they actually are.  School.  Friends.  Romantic relationships.  Post-secondary education and future plans.  The big things that worried teenagers in the 1980s are, in many ways, the same things that worry teenagers today.  But the world surrounding those worries has changed dramatically.  Teen anxiety hasn’t changed as much as the world around it  When I was a teenager, there were no smartphones, no social media and no internet. We didn’t even have email.  If something embarrassing happened at school, you could go home and, for the most part, leave it there. If you had an argument with a friend, you didn’t have to worry about seeing it replayed on Snapchat or wondering whether everyone else had seen the conversation.  We got our information from magazines like Seventeen and Teen Vogue, from our friends and, if we were lucky, from parents who were paying attention.  Parenting was different, too. Many of us had more independence than teenagers have today. We walked or biked to our friends’ houses, spent hours outside and made our own plans. Our parents were not receiving a constant stream of notifications about where we were, who we were with or what was happening in our social lives.  Today’s teenagers are growing up in a world where there is very little opportunity to truly disconnect.  Their social lives can continue long after the school day ends. Their friendships can play out publicly and digitally. They are exposed to news and world events almost constantly. And, at the same time, they are expected to make increasingly important decisions about school, careers and their futures.  It is a lot.  And while parents today may be more involved in their teenagers’ lives in many ways, that doesn’t necessarily make parenting through adolescence easier.  Teenagers don’t always tell us what is going on  Teenagers often come home from school or from seeing friends and say very little about how they are actually feeling.  They may answer “fine” when we ask how their day was.  They may close their bedroom door.  They may seem irritable, withdrawn or completely uninterested in talking to us.  And sometimes, underneath all of that, there is anxiety.  One of the most important things we can do as parents is create an environment where our teenagers know that they can bring us the good, the bad and the ugly.  They need to know that they can be themselves with us – even when they are moody, frustrated, overwhelmed or struggling to put their feelings into words.  This doesn't mean we have to fix every problem for them.  In fact, sometimes our instinct to fix can get in the way of what our teenager actually needs.  They may need us to listen before they need us to offer advice.  They may need us to say, “That sounds really hard,” before we say, “Here’s what you should do.”  And sometimes they may not want to talk at all.  Being available matters, even when the conversation doesn’t happen.  Anxiety can be difficult for parents, too  Supporting an anxious teenager can bring up a lot of feelings in us as parents.  We may become anxious when we see our child struggling. We may worry about whether they will be okay. We may want to step in and make the uncomfortable situation disappear.  But our own anxiety can sometimes make it harder for our teenagers to learn that they are capable of handling difficult feelings and situations.  The Canadian Paediatric Society recommends helping children and adolescents recognize and name their feelings, validating their anxiety without reinforcing it, and gently encouraging them to face things that feel difficult rather than automatically avoiding them.  That can be easier said than done.  It requires us to notice what is happening inside us, too.  If our teenager is anxious about an upcoming presentation, for example, we may want to reassure them repeatedly that everything will be fine. But we can also help them identify what they are worried about and think through one small step they can take to prepare.  The goal isn't to eliminate anxiety.  It is to help them discover that they can move through it.  Six ways to support your anxious teen  Help them name what they are feeling Sometimes teenagers know they feel awful but don't know exactly what they are feeling.  Is it anxiety? Embarrassment? Disappointment? Fear? Anger? Shame?  Helping them put words to their experience can make difficult emotions feel more manageable.  You might simply say, “It sounds like you're really worried about tomorrow.”  Gently encourage them to talk about their emotions You don't have to force a conversation.  Instead, look for low-pressure opportunities to connect – in the car, while walking the dog, making dinner or getting a coffee together.  Sometimes teenagers will talk when they aren't being directly asked to sit down and talk.  Validate their feelings without reinforcing the anxiety  Validation doesn't mean telling your teenager that their fears are definitely going to come true.  It can sound like:  “I can understand why that feels scary.”  And then:  “I also believe you can handle it.”  The Canadian Paediatric Society recommends empathizing with anxiety while also encouraging young people to move toward, rather than continually avoid, the things they fear.  Find low-key ways to stay connected Connection doesn't always have to involve a deep conversation.  Watch a show together. Go for a drive. Get ice cream. Sit beside them while they do homework.  Teenagers may not always want to talk about their feelings, but they still need to know that we are there.  Help them break overwhelming things into smaller steps An anxious brain can turn one problem into ten.  If your teenager is overwhelmed by an assignment, an upcoming exam or post-secondary applications, help them identify the next small, manageable step.  They don't have to solve everything today.  They just need to know what comes next.  Let them see you coping with stress Our teenagers learn from what we do as much as from what we say.  When something stressful happens, let them see you pause, take a breath, talk through a problem, ask for help or remind yourself that you can handle a difficult situation.  We don't have to model perfect calm.  We can model what it looks like to experience stress and take care of ourselves anyway.  We can't remove anxiety from our teenagers' lives  As parents, it is incredibly difficult to watch our children struggle.  We want to protect them from rejection, failure, heartbreak, uncertainty and all the other experiences that can make adolescence so challenging.  But anxiety is a normal part of being human. Our goal isn't to create an anxiety-free life for our teenagers – something that isn't possible.  Our job is to help them develop the skills, confidence and self-trust to navigate the anxiety that inevitably comes with life.  And sometimes, that begins with us doing our own work.  Because the more comfortable we become with our teenagers' uncomfortable feelings, the more space we can create for them to experience those feelings without believing that something is terribly wrong.  And when anxiety begins to interfere with a teenager's everyday life – including school, friendships, sleep or activities they usually enjoy – it may be time to seek additional support. The Canadian Paediatric Society notes that anxiety disorders are highly treatable and recommends psychotherapy as a first-line treatment.  If your teen is struggling with anxiety, therapy can give them a safe, supportive place to understand what they are experiencing and develop tools to manage it. It can also help parents learn how to support their teen without taking on the job of eliminating every difficult feeling.  Sometimes the most helpful thing we can give our teenagers isn't a solution.  It's the confidence that, whatever comes next, they don't have to face it alone – and they are capable of getting through it.  If your teen is struggling with anxiety  You don’t have to figure out how to support your teenager on your own. Therapy can give your teen a safe and supportive space to understand their anxiety, develop healthy coping strategies and build confidence in their ability to manage difficult emotions. It can also give parents guidance and support as they navigate this challenging stage of parenting.  If anxiety is getting in the way of your teen’s everyday life, therapy can help. Reach out to us for a free consultation to learn more about how support can make a difference.     

Managing Back‑to‑School Anxiety

Back-to-school anxiety: Helping children, teens and parents manage the transition   By Aviva Boxer, Registered Psychotherapist    We’re getting to that time in August when there is still some summer vacation left to enjoy, but it is easy to start thinking about the beginning of school. September is literally around the corner, and stores are already stocking fall merchandise, including Halloween and Thanksgiving-themed products.  Back to school can be an exciting time for children and parents, but it can also be filled with anxiety. And if your child is facing a milestone at school – starting school for the first time, moving into Grade 1, starting middle school or high school, or leaving home for university or college – anxiety may be very much part of the picture for both children and parents.  Children may feel nervous or fearful about starting something new. They may worry about making friends, finding their way around a new environment, navigating bigger classes or new teachers, or adjusting to increased expectations and homework. For older teens, there may be additional pressure, particularly if they are entering their final year of high school and beginning the post-secondary application process.  Some children may also experience separation anxiety, generalized anxiety or social anxiety. Separation anxiety is most common in younger children, particularly when they are starting school or moving from kindergarten into Grade 1, but it can occur throughout childhood and adolescence and even into early adulthood.  Separation anxiety can show up as a strong reluctance to be apart from a parent or caregiver, talking about worries about separation ahead of time, refusing to go to school or sleep alone, or having difficulty concentrating at school because of worries about being away from home.  How can you help your child with back-to-school anxiety?  Children need different kinds of support at different ages and stages, but some of the basic principles remain the same.  Start by acknowledging your child’s feelings. You might say something gentle like, “It sounds like you’re feeling worried about going back to school or being apart from me.”  It can be tempting to immediately reassure an anxious child by saying, “Don’t worry. You’ll be fine!” But sometimes children need their feelings acknowledged before they are ready to hear reassurance. Let them know that their anxiety makes sense while also helping them develop confidence that they can cope with the situation.  You might ask, “What are you most worried about?” or “Is there anything we can do together that would help you feel more prepared?”  Give anxiety somewhere to go  Encourage your child to talk about their worries rather than trying to talk them out of feeling anxious. You can also help them learn tools that may turn down the dial on anxiety, including mindfulness, deep breathing and progressive muscle relaxation.  Try a simple breathing exercise together: breathe in slowly through your nose for four counts and then breathe out through your mouth for six. A slower, longer exhale can help signal safety to the nervous system and may help reduce feelings of anxiety.  You can also explore child-friendly mindfulness exercises, meditations, music and stories through apps such as Insight Timer.  Prepare without feeding the anxiety  Preparation can make a big difference, particularly when a child is entering a new environment.  Depending on your child’s age, this might mean visiting the school ahead of time, walking through their new route, finding their classroom, meeting their teacher, practicing their morning routine or talking through what the first day might look like.  For a child leaving home for the first time, preparation might include talking about how they will stay connected with family, practicing some everyday tasks independently and discussing what they can do when they are feeling lonely or overwhelmed.  The goal isn’t to make sure your child feels completely confident before the transition. Some anxiety is normal when we are doing something new. Instead, you are helping your child learn, “I can feel nervous and still do this.”  Return to routine gradually  After a summer of later bedtimes, relaxed mornings and fewer commitments, returning to a school routine can be a big adjustment.  Start gradually. Move bedtime and wake-up times closer to the school schedule, reintroduce regular mealtimes and begin bringing some structure back into the day.  A predictable routine can help children feel more prepared emotionally for the start of school and for being away from home – whether that means being away for a few hours, the school day or an entire semester.  What about parents?  Back-to-school anxiety is not reserved for children. Parents feel it too.  There is the return to routine, lunches, homework, after-school activities and all the start-up stresses of a new school year, including forms, schedules, new teachers and a child’s new class.  Parents may also feel anxious about their child’s experience. Will they make friends? Will they be happy? Will they struggle academically? Will they be able to handle the transition?  And when a child is leaving home for university or college, parents may experience an entirely different kind of anxiety. It can be difficult to hold both excitement for your child’s next chapter and sadness or worry about the changes it represents for your family.  Parents need support, too.  Acknowledge your own feelings of worry with your partner, a close friend or someone else you trust. Processing your feelings can help you show up for your child without unintentionally adding to their anxiety.  This doesn’t mean you need to hide your emotions from your child. In fact, showing children that adults can experience anxiety and learn how to manage it can be an important lesson. You might say, “I’m feeling a little nervous about the first day too. New things can make me nervous, but I know we can handle it.”  When your teen or young adult leaves home  For some families, back-to-school anxiety is not about a child getting on the school bus. It is about saying goodbye at a university residence, helping a young adult move into an apartment or watching your teenager drive away for the first time.  Leaving home is a major transition for young people. Even when they are excited about university or college, they may also feel anxious about being responsible for themselves, making friends, managing their workload, navigating a new city or simply being far away from the people and routines that have made them feel safe.  Parents can experience their own complicated mix of emotions. You may be proud and excited to see your child taking this next step while also feeling grief about the end of an era. You may worry about whether they will be happy, whether they will manage on their own or what will happen if they struggle.  There can also be an adjustment in the relationship itself. You may have spent years knowing where your child was, what they were doing and when they would be home. Suddenly, you may have much less information about their day-to-day life.  This can be difficult.  Try to resist the urge to manage your young adult’s anxiety from a distance. Instead, talk together before they leave about how you will stay connected and what kind of support they would find helpful. Some young people may want a regular Sunday phone call, while others may prefer occasional texts or video calls.  It can also help to talk openly about homesickness and the fact that difficult feelings do not necessarily mean something is wrong. Your young adult may have a wonderful first week and still feel lonely. They may be thrilled about their new independence and still miss home. They may struggle at first and eventually find their footing.  The same message applies to parents: you can miss your child and still trust them to grow.  For both parents and young adults, this transition is an opportunity to practice tolerating uncertainty rather than trying to eliminate it. You cannot guarantee that your child will never feel lonely, anxious or overwhelmed. What you can do is help them know that difficult feelings are manageable and that they have people they can turn to when they need support.  And sometimes, the parent needs that support too.  Watch for the anxiety-avoidance cycle  When we see our child struggling with anxiety, our instinct is often to make the anxiety go away. We may let them stay home, repeatedly reassure them, avoid situations that make them uncomfortable or step in to solve every problem for them.  These responses come from love and concern. But over time, avoiding things that make us anxious can actually make the anxiety stronger.  Instead, try to support your child in taking manageable steps toward the things they are worried about. You can acknowledge that something feels scary while also communicating your confidence in their ability to cope.  The message is not, “There is nothing to be afraid of.”  It is, “I know this feels scary, and I believe you can handle it.”  When should you seek help?  Some back-to-school anxiety is completely normal. Starting something new involves uncertainty, and even children who are generally confident may experience some nervousness as September approaches.  However, if anxiety becomes overwhelming or begins interfering with your child’s ability to attend school, sleep, make friends, participate in activities or function at home, it may be time to seek professional support.  Therapy can give children and teens a safe place to understand their anxiety, develop coping strategies and build confidence in their ability to manage difficult emotions. It can also provide parents with support and practical strategies for responding to anxiety at home.  Back-to-school doesn’t have to mean leaving anxiety behind. It can be an opportunity for children and parents to learn something more valuable: we can feel anxious about change and still move forward.  If your child or teen is struggling with anxiety as the new school year approaches, therapy can help. Reach out to us for support. A NuVista mental health professional can work with your family to understand what is contributing to the anxiety and develop strategies to help you and your child feel more confident, capable and supported.   We’re getting to that time in August where there is still some summer vacation left to enjoy but it is easy to start thinking about the start of school because September is literally around the corner and stores are starting to stock fall merchandise, including Halloween and Thanksgiving themed products.   Back to school can be an exciting time for kids and parents, but it is also fraught with anxiety. And if your child is going into a milestone moment at school such as starting school altogether, starting Grade 1, middle school, high school or going away from home to university or college for the first time, anxiety may be very much on the menu for both kids and parents.  Kids may be feeling nervous and even fearful about starting something new, worrying about making friends, finding their way around their new environment, a change in expectations such as more homework, bigger classes, new teachers or making the year count if they are in their last year of high school and starting the application process this fall.  Kids may be dealing with separation anxiety, generalized anxiety, or social anxiety. (reference: Psych Today). Separation anxiety mainly happens when kids are little and either starting school for the first time or moving up from kindergarten to Grade 1, but it can happen throughout childhood, adolescence and into early adulthood. It shows up as not wanting to be apart from their parent or caregiver, talking about their anxiety about being apart ahead of time, not wanting to go to school, sleep alone, and sometimes difficulty concentrating at school because of worries about separation (Re: Rady Children’s Health)  How to help  Kids need different supports at different ages but the main themes are the same: acknowledge the feelings your child is having with something gentle like: “It sounds like you are feeling worried about going back to school or being apart.” And encourage your child to talk about their feelings and share their worries with you. (Re: Rady Children’s Health). Help them to turn down the dial on their anxiety with tools such as mindfullness, deep breathing or muscle relaxation (Rady Children’s Health). Check out Insight Timer app for many free meditations , music and stories to help kids get relief from anxiety.  Try the deep breathing technique of breathing in through your nose for 4 counts and breath out through your mouth for 6 counts. The longer out breath helps your nervous system to feel safe and bring down the anxious feelings. (Psych Today).    Start to return to routine – this can help kids prepare emotionally for the start of school and for being away from home either for a few hours, the day or a semester, depending on their age and stage.     Parents  Back to school anxiety is not reserved for kids alone. Parents feel it too. There’s the return to routine, lunches, homework, after school activities, all the start-up stresses of a new year such as forms, getting to know new teachers and a child’s new class. Parents also may feel anxious for their child starting or returning to school, hoping they make friends or have their friends in their classes with them. Parents need support too. Acknowledge your feelings of worry to your partner or a close friend, so you can show up for your child having processed your own feelings and help them sort out their without adding to your child’s worries (Child Mind Institute).