Understanding Anxiety, Encouraging Courage: What Families Should Know About Social Anxiety

written by Nadine Vietmeier, Jasper Froehlich & Silas Rooß

Editorial Assistants: Lukas Repnik and Maren Giersiepen.

Note: An earlier version of this article has been published in the German version of In-Mind.

Social anxiety is among the most common psychological challenges in childhood and adolescence—and it also presents major challenges for parents. How can they support their children without overwhelming them? What role does parental behavior play in the development and maintenance of anxiety? This article introduces the SPACE therapy program—a research-based parent training that shows how mothers and fathers can empathetically support their children in gradually overcoming social anxiety.

When the teacher calls on Lina, it feels as if a bright spotlight is shining on her. The 12-year-old feels all eyes in the classroom on her, lowers her gaze, and blushes. “I can’t do this.” she thinks as her heart races. That evening, she lies in bed with a stomachache. The next day, her mother asks the teacher to excuse her from the next presentation. “She’s just very sensitive.” she explains. Out of care, she tries to spare Lina from uncomfortable situations. Yet, such protective behavior can actually reinforce Lina’s social anxiety in the long run.

Lina is not alone in her fears. Anxiety disorders are among the most common mental disorders in childhood and adolescence [1]. One specific type is social anxiety disorder, which often begins in childhood [1]. It is characterized by a pronounced and persistent fear of social situations—especially when children are the center of attention or might be judged by others ( ICD-11) [2]. This can cause considerable distress at school, during leisure activities, and within the family. Typical accompanying symptoms in children include headaches, stomachaches, rapid heartbeat, as well as withdrawal, crying, or aggressive behavior [1]. Their thoughts often revolve around how embarrassing or disastrous a situation could become—like Lina’s “I’m shaking, I can’t think of anything! This is so embarrassing!” Such thoughts intensify the anxiety—creating a vicious cycle.

Feeling nervous before presentations, exams, or new situations is entirely normal and part of development. However, a social anxiety disorder is diagnosed when such fears persist for a long time, are very intense, and significantly interfere with a child’s daily life [2]. Estimates suggest that about one in twenty children and one in twelve adolescents are affected by social anxiety disorder [3]. Early treatment is important, as the disorder can otherwise become chronic and impair self-esteem, academic performance, and social relationships [1], [4].

Figure 1. Cognitive distortions are a symptom of social anxiety disorder.

How Can Social Anxiety Disorder Be Treated?

The most effective treatment for social anxiety disorder in childhood and adolescence is cognitive behavioral therapy (CBT) [5]. A key element involves helping children gradually face their fears (so-called exposure therapy) and thereby correct their negative expectations. Situations that trigger fear are arranged in order of intensity on an anxiety hierarchy (e.g., on a scale from 0 to 10). Together with the child, a challenging but manageable situation is selected and discussed in advance. The child then faces the situation (e.g., ordering an ice cream). Afterwards, the feared outcomes are reviewed (“You were afraid you might stutter and the shop assistant might laugh—what actually happened? How did that feel?”). It is crucial to praise the child for facing the fear, so that the experience feels positive—even if the anxiety didn’t subside or the situation didn’t go perfectly (“That was really brave of you to do this despite your fear”).

Social skills—like maintaining eye contact, speaking up, or making a phone call—can also be practiced through role play or real-life exercises [5]. Another important element is psychoeducation—age-appropriate information about the nature and function of fear, and when it becomes problematic.

However, treating social anxiety disorder is often more difficult than treating other anxiety disorders: only about half of affected children and adolescents no longer meet diagnostic criteria after therapy [6], [7]. One way to improve treatment outcomes is to actively involve parents.

Parents as Part of the Solution—or the Problem?

Parents naturally want the best for their child. When their child struggles with anxiety, it’s understandable that they want to help—perhaps by avoiding anxiety-provoking situations or taking over certain tasks. This so-called accommodating behavior may reduce stress in the short term but prevents children from learning to manage their fears independently. The unspoken message: “You can’t handle this on your own.”

Some parents also experience social anxiety themselves [8] or worry that their child will be judged negatively by others [9]. Thus, they act as behavioral models in social situations [1]. Overprotective or overly controlling parenting can also maintain the child’s anxiety [10]. Often, such behavior stems from the desire to protect the child from overwhelm or failure—but excessive support can deprive children of the chance to build competence and may actually strengthen their fears [11].

Whether parental behavior causes or responds to the child’s anxiety is not always clear—but one thing is certain: supporting parents in how to strengthen their child is worthwhile.

SPACE: When Therapy Starts with the Parents

A novel approach from the U.S. takes exactly this route: Supportive Parenting for Anxious Childhood Emotions (SPACE) [4]. Unlike traditional therapy, SPACE is directed solely at parents—the child does not participate. The goal is to change parental behaviors that may unintentionally reinforce a child’s anxiety. This begins with small, everyday changes: parents learn, for example, to stop calling in sick for their child or ordering for them at a restaurant. Instead, they are trained to acknowledge the child’s anxiety empathetically—without giving in to it. Rather than saying, “It’s not a big deal” or “I’ll just do it for you,” they might say: “I see that this makes you anxious—but I’m sure you can do it.”

The program includes about ten to twelve sessions. In addition to learning how to reduce accommodating behavior, parents are taught how to support their child in stressful situations—using, for instance, positive self-talk (“I can do this”) or breathing techniques.

Figure 2. Parent training programs are a special form of intervention for social anxiety disorder.

When Change Doesn’t Come Easily

SPACE also includes special modules for parents dealing with intense emotional reactions—such as tantrums, withdrawal, or threats of self-harm. Additional sessions help parents collaborate more effectively when they disagree on parenting approaches.

How Effective Is SPACE?

Since its development, SPACE has been implemented internationally and is increasingly available in specialized treatment centers, outpatient clinics, and private psychotherapeutic practices. Research shows that the program is as effective as traditional CBT [12] and appears particularly suitable for families in which the child is unwilling or unable to participate directly in therapy. Ongoing studies are exploring its adaptation for additional psychological conditions. Certified SPACE providers can be found through the program’s official website: https://www.spacetreatment.net/. Parents or caregivers concerned about social anxiety in their child are encouraged to seek guidance from a pediatrician, mental health professional, or counseling service.

Figure 3. The effectiveness of SPACE has been confirmed in initial studies.

What Parents Can Take Away

Many of the SPACE principles can be applied in everyday life to help children cope with anxiety:

Validate emotions: Instead of saying “It’s not a big deal,” try “I see that you’re uncomfortable—but I believe in you.”
Encourage courage rather than avoidance: Don’t take over tasks—approach them together step by step (“I know this is hard, but we’ll try it together”).
Be clear and caring: Staying calm and setting kind but firm boundaries in stressful moments provides a sense of safety.
Handle stress together:
- Practice calm breathing (e.g., inhale for 4 seconds, exhale for 6).
- Reframe thoughts: Instead of “I can’t do this,” write down “I’ll try—and I don’t have to be perfect.”
- Establish rituals: A quiet evening, a walk after school, or a “wind-down” routine can help both children and parents stay calm.
- Be a role model: Parents who show constructive ways of handling stress also strengthen their child’s coping skills.

These strategies can help children regulate anxiety—whether or not a clinical diagnosis is present.

Summary

Social anxiety disorder can be a heavy burden for children and their families. Parental behavior plays a crucial role. The parent-training program SPACE [4] demonstrates how mothers and fathers can help their children overcome anxiety—with empathy, clarity, and trust in their abilities. Lina, too, could benefit from the SPACE approach—by having parents who learn to support her transparently and empathetically as she faces her fears.

Bibliography

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