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Anger management in children: how parents can help

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Why is my child angry? Advice for coping with anger issues in children and young people from our team of experts.

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Sexual Consent: Do you get it? - Pause, Play, Stop

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Making sure you get and give active consent before having any kind of sex with another person really matters. If it's not your body, it's not your decision.

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Online safety

Children regularly use different websites and apps from their parents, and it can be hard to keep up in this ever-changing digital world.

But the things that help keep children safe online are often similar to the things that keep them safe offline.

Half of ten-year olds now own their own smartphone (Ofcom 2019)

70% of 12-15-year olds now have a social media profile, with Snapchat being the most prominent platform in this age group (Ofcom 2019)

Children aged 5-15 now spend over 14 hours a week online, just over two hours a day (Ofcom 2019)

Watch the video below to find out how to protect children in the digital world, how to report harmful content and to develop skills for healthy screen time.

Online Safety

Children regularly use different websites and apps from their parents, and it can be hard to keep up in this ever-changing digital world.

But the things that help keep children safe online are often similar to the things that keep them safe offline.

Talk about what they think is normal online and what behaviour to expect from others and from themselves.

Encourage them to think critically and question what they see online. Talk to them about where they go to get information they trust, talk about fake news, fake followers and scams. Help them develop a healthy suspicion of whether people are who they say they are.

Share your knowledge and experience of relationships. For example, sometimes people seem nice at first and then they turn out to be mean. Let them know that you know this, they can talk to you about it. And that you won't panic or punish them if they do.

Show them how to report any worrying behaviour they see online - for example through Child Exploitation and Online Protection Command or the Internet Watch Foundation.

We are helping prepare our children for their futures if we help them go online safely and responsibly. Many people worry about amounts of screen time, but there can be lots of positives about what your child is doing online - entertainment, keeping in touch with friends and researching homework - so quality screen time is what's important.

WANT TO KNOW MORE?

If you want to know more how to prevent child sexual abuse, you can watch the rest of our short films .

If you're worried about how an adult or young person you know behaves around children, you can get confidential support from the Stop It Now! helpline: 0808 1000 900.If you're not ready to speak to someone yet, you can use our live chat or send a secure message.

You can use the links below to read about:

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Keep children safe online and protect them in the digital world with these internet safety tips, including reporting harmful content.

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Support and advice with parenting

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Our Mission Our Mission To improve the life experiences and outcomes of children, young people and their families by providing services and support at a time when they are most needed. Learn about our services Our Family Wellbeing Pathway Our Family Wellbeing Pathway The Parenting Project of…

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Quickly find what you're looking for:

Who can call the Stop It Now! helpline?

Anyone with a concern about child sexual abuse and its prevention can anonymously call the Stop It Now! helpline. We encourage you to trust your gut and call, whatever your worry or level of concern.

Our advisors can support anyone struggling with their own or a loved one's sexual thoughts, feelings and behaviours towards children. We also support anyone worried about a child or young person's sexual behaviour around other children, or if they've got into trouble online.

You can also call the helpline if you're an adult concerned about a child or young person who may have been abused, a professional calling for case advice or an adult survivor of child sexual abuse.

Learn more about the helpline and how it works.

How can I call the Stop It Now! helpline?

You can call the helpline for free on the following numbers:

If you are in the UK: 0808 1000 900

If you are in Ireland: +44 1372 847 161

We can also arrange for you to speak to someone in Welsh.

We are not a reporting agency. To report a person, offence, website or illegal images, please contact one of the following organisations:

Crimestoppers: an independent charity where you can anonymously report any crime, including child sexual abuse, which is then passed to the relevant authorities

IWF: to report online sexual images of children

CEOP: to report someone's online sexual behaviour with a child

Your local police force (or 101): if you suspect someone is sexually abusing a child

Please contact our confidential helpline if you need further support.

Is the Stop It Now! helpline confidential?

The helpline is confidential and you don't have to give us your full name or any other details that will identify you. But if you do, and you then give us information that identifies a child who has been - or is at risk of being - abused, or any information that may suggest that any other person is at risk of harm, we will pass that information on to the appropriate agencies. We will also pass on details of any criminal offence committed.

What happens when I call the helpline?

Our confidentiality policy is explained to callers at the beginning of the call.

Our experienced advisors will:

talk through the issues, helping callers clarify their concerns

explore any immediate child protection considerations

provide information and support to help callers make sense of their situation and think about next steps

discuss available options, including referral to another agency or our own follow-up services

advise callers about actions to consider and agree one or more protective actions callers will take.

When is the Stop It Now! helpline open?

Monday - Thursday: 9am - 9pm
Friday: 9am - 5pm

We're closed on weekends and bank holidays.

Is there an alternative to calling the helpline?

If you're not ready to speak to someone yet, you can use our confidential live chat, send us a secure message or look at our advice online.

When is the live chat available?

Monday: 9am - 12pm
Wednesday: 6pm - 9pm
Friday: 9am - 12pm

We're closed on weekends and bank holidays.

We are a part of the Helplines Partnership.

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Contact the Stop It Now! child sexual abuse helpline - Stop It Now

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Quickly find what you're looking for: Anyone with a concern about child sexual abuse and its prevention can anonymously call the Stop It Now! helpline. We encourage you to trust your gut and call, whatever your worry or level of concern.

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The Lucy Faithfull Foundation | Preventing Child Sex Abuse

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We are the only UK-wide charity dedicated solely to preventing child sexual abuse. Find out more.

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A daily journal for children aged 6 to 12, based on scientifically proven methods that promote happiness, develop healthy habits for life and nurture enquiring minds.

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Avoidant restrictive food intake disorder, more commonly known as ARFID, is a condition characterised by the person avoiding certain foods

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Buckinghamshire Healthcare NHS Trust - CYP Website

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School nursing - Buckinghamshire Healthcare NHS Trust - CYP Website

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We support children and young people in Buckinghamshire schools with medical, social, emotional or physical needs. We work in schools and the local community to help each person achieve their […]

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Feeling stressed, anxious, low or struggling to sleep? Every Mind Matters can help with expert advice, practical tips and personalised actions to help stay on top of your mental wellbeing.

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'Finding the reasons for challenging behaviour - part 2' is the second information sheet in this series. It is recommended that it is read alongside 'Understanding Challenging Behaviour: Part 1' and 'Positive Behaviour Support Planning: Part 3' (see links at bottom of page) Download: Finding the reasons for challenging behaviour - part 2
All behaviour happens for a reason, and being aware of the causes is key. Always check for health problems as they may cause challenging behaviour or make it worse.

The first step to reducing it is to find out what the reasons are. Some common reasons are:

Social attention: It may be a good way of getting other people's attention, even if it is negative, e.g., shouting

To get something: A person may learn behaviours that get them things they want, e.g., food, objects etc

Escape: It may help to avoid things a person doesn't like e.g. dentist

Sensory: Sometimes people enjoy the feeling that certain behaviours give them, i.e. repetitive rocking, humming, etc.

Quick read

Different stages of behaviour

Challenging behaviour is unlikely to come 'out of the blue', it usually develops in stages:

Green 'Proactive' phase: where a person is mostly calm and relaxed

Amber 'Active' phase: where a person starts to become anxious. Quick action must be taken to avoid challenging behaviour

Red 'Reactive' phase: where challenging behaviour occurs

Blue 'Post-Reactive' phase: where the person starts to relax again

Assessment of behaviour

A functional assessment is a good way to find out the exact causes of a person's behaviour. This is usually carried out by a Psychologist or behaviour nurse.

Keeping a record can help us find out why a person is behaving in a certain way. It is important to record:

1. Description of the behaviour i.e. exactly what happens

2. Early warning signs, e.g. becoming red in the face

3. What happens before the behaviour, e.g. does something trigger the behaviours? E.g. noisy environment, being told no, etc.

4. What happens after the event, i.e. what is the person getting or not getting from the behaviour that makes them do it again?

The next step is to use the information to plan how to reduce challenging behaviour or lessen the impact on the person and those caring for them.
Download: Finding the reasons for challenging behaviour - part 2

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All challenging behaviour happens for a reason, and being aware of the causes is key.

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Buckinghamshire Guidance - Emotionally Based School Avoidance (EBSA) Toolkit

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About the toolkit

The EBSA toolkit provides guidance and resources for professionals working in or with schools. It should be used to develop an understanding of what leads children and young people to feel that they must avoid school.

The toolkit provides practical guidance on decision-making as well as detailed guidance on:

preventative strategies

assessing needs

intervention planning.

It should be used in partnership with children, young people and their parent/carers to ensure that reintegration planning is informed and collaborative.

If you have any questions relating to the toolkit email EBSA@buckinghamshire.gov.uk
View the EBSA Toolkit (PDF 671KB)
Please download the appendices (referenced in the toolkit) to be able to type directly onto the document. This can then be saved digitally or printed.

Appendices 1 to 5 include screening and audit tools for whole-school early identification of pupils at risk of becoming EBSA, identifying gaps in provision for students, and tasks to help teachers and parents help support individuals.

Appendix 6 (EBSA formulation tool) is a document designed to be continually updated as you develop your understanding of the needs underpinning a student's EBSA. Schools are encouraged to submit this document when making requests for advice from the Integrated SEND service or the Educational Psychology team.

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Emotionally Based School Avoidance (EBSA) Toolkit

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Emotionally Based School Avoidance (EBSA) Toolkit

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What are eating disorders?

Eating disorders are serious mental health conditions that can have a huge impact on someone's mental and physical health. They can affect anyone with any body shape or lifestyle - regardless of their gender, culture, age or ethnicity.

Lots of young people who develop an eating problem or disorder are also going through other mental health issues. This can include anxiety or stress, feeling low or depressed, or struggling with their self-esteem.

Young people can use their behaviour around food and eating to try to cope with these difficult thoughts, feelings and experiences. They might limit how much they eat, consume large quantities of food quickly, or use methods such as making themselves sick to get rid of food from their body.

While it can sometimes be hard to understand from the outside, doing these kinds of things might:

make someone feel they have a way of coping when things are difficult

make someone feel in control, or give them a way of reducing anxiety or panic when they're overwhelmed

numb or reduce uncomfortable or distressing feelings

Over time, these kinds of thoughts and behaviours around food might become very fixed and difficult to change - and may start to take over daily life. When this happens, it can have a hugely negative effect on a young person's social life and their relationships with friends and family. It can also lead to very serious physical health problems, and affect a young person's physical growth and development. In very serious cases, and without the right kind of support and treatment, eating disorders can cause death.

But if someone gets the right professional help, the eating disorder can be treated and they can get better. The earlier they get help, the easier this will be. There are lots of common stereotypes about what someone with an eating disorder will look like. As a parent or carer, it's important to understand that a young person's weight or appearance does not determine whether they have a problem. Whatever's going on, it's important to find help as soon as you notice behaviours around food that are concerning. The sooner they get support, the easier it will be for the young person to change their behaviour and find other ways of coping. Getting help early can also prevent physical health problems from developing.

Different types of eating disorders

Some eating problems develop or fit into a certain type of eating disorder. But if your child has an eating problem that's affecting their day-to-day life, they still need professional help to find out what's going on - even if you're not sure that they have an eating disorder.

There are some common eating disorder diagnoses.

People with anorexia generally try to keep their weight low by limiting how much food they eat or doing lots of exercise, or both. They may have "rules" about what they eat, or when and where they eat. And they may think they are bigger than they are, and feel very scared about gaining weight.

Some people with anorexia also try to 'get rid' of food from their body, for example by making themselves sick or using laxatives.
Without support, anorexia can lead to serious physical health problems - so it's important to get help as early as possible.

ARFID stands for 'avoidant/restrictive food intake disorder'. This used to be known as selective eating disorder.

People with ARFID avoid certain foods or types of food, restrict the amount of food they eat, or both. Unlike with anorexia, people with ARFID don't necessarily do this to lose weight.

Common reasons people with ARFID may limit their food intake include:

sensory sensitivity to the appearance, smell, texture, temperature or taste of certain foods

feeling scared about eating if they have had a frightening experience with choking or vomiting after eating

having a limited interest in food, including not realising when they feel hungry

People with bulimia "binge-eat" or over-eat, and then "purge" to get rid of the food. They might do this by making themselves sick, using laxatives or over-exercising. They may feel guilty about what they have eaten and want to remove the food from their body. Or, completing a cycle of bingeing and purging might feel like it's giving them a sense of control when things are difficult.

Bulimia can cause serious damage to someone's body, so it's important to get help as early as possible.

People with binge-eating disorder regularly eat large quantities of food in a short time. They feel like they are not in control of this, or that they are unable to stop. In a binge-eating episode, people may eat a lot faster than usual or eat when they're not hungry, and feel embarrassment or shame afterwards.

Unlike with bulimia, people with binge-eating disorder do not usually "purge" afterwards (try to get rid of food in their body).

OSFED stands for 'other specified feeding or eating disorder'. This is the diagnosis often given to someone if their symptoms do not fit with anorexia, bulimia or binge-eating disorder. This is the most common eating disorder in the UK.

People with OSFED may experience a range of different symptoms. Some examples of what OSFED might look like include:

Atypical anorexia - where someone is experiencing all the symptoms of anorexia, but their weight remains in a "normal" range.

Lower frequency binge-eating disorder - where someone experiences the symptoms of binge eating disorder, but episodes of binge eating do not happen as often.

Lower frequency bulimia - where someone experiences the symptoms of bulimia, but the cycles of bingeing and purging do not happen as often.

Night eating syndrome - where someone eats a lot at night or after dinner, or wakes up in the night to eat.

Purging disorder - where someone purges, as with bulimia, but it is not part of a binge/purge cycle.

Pica involves experiencing cravings to consume things that are not for eating, or feeling like you cannot stop yourself from eating these things. This can include substances such as soap, chalk or dirt. Sometimes, the person may feel urges to consume substances that are dangerous, so it's important to get help as early as possible.

You can find out more about each of these conditions on the Beat website.

If you'd like to hear from other parents and carers who have supported their child with an eating disorder, and personal stories from those who have struggled with them, you might like to listen to this BBC podcast. Please keep in mind that this podcast discusses some very serious experiences - only listen if it's helpful for you, and at a time that's right for you.

Signs that your child might be developing an eating problem or disorder

Every child and young person will show, or not show, what's going on in different ways. The signs that they're struggling might also look different depending on what type of eating problem they have.

While it's not always easy to tell, some early signs that your child is developing an eating problem or disorder might include:

becoming more controlling or limiting about what, how much or when they eat - including avoiding eating with other people

obsessing about their body shape, having an inaccurate view of their body shape, or feeling afraid of putting on weight

leaving the table quickly after meals (for example to hide food or be sick)

exercising a lot, or much more than they used to

seeming different in themselves - including seeming more tired than usual, or finding it difficult to concentrate

wearing loose or baggy clothes to hide their weight loss

losing or gaining weight

As a parent or carer, it's not always easy to know what's going on - and a young person with an eating problem may try to hide what they're doing. But you know your child, and you know when something is wrong.

If you've noticed changes that are worrying you, the next steps are to open up a conversation with your child and to get professional advice. You don't need to wait for your child to lose or gain weight before getting professional help - ask for advice now.

Getting help and treatment

1. Making an appointment with a GP

If you're worried that your child is developing an unhealthy relationship with food, it's important to make an appointment with a GP. This is the first step to getting them the right help.

Make a list before the appointment of the concerning behaviours you have noticed. Or, if your child wants to go by themselves, encourage them to make a list of the things they're experiencing. The more honest and specific you can be, the easier it will be to get the right help.

Beat have a really useful resource on seeking GP treatment that you can both use to help you prepare for the appointment. They also have a binge-eating disorder leaflet you can take to the GP if your child is struggling with binge-eating problems.

People with eating disorders can find it hard to see they have a problem. Be clear about the fact that you're concerned and that you can see they need some help.

If your child will not go to an appointment at the moment, you can still speak to the GP yourself to get advice about what to do next.

For more advice, see our guide to getting help from the GP.

Getting support from the GP

Seeing your GP as quickly as possible, and asking for support for your child is essential. Early intervention is key to your child's recovery. If your GP does not take your concerns seriously, keep persisting in asking for a referral to an eating disorders team.

2. Getting a GP referral for specialist help

After talking to your child, the GP can make a referral for a specialist assessment. Depending on where you live and your child's age, this is usually done by one of the following services:

CAMHS, which is the NHS mental health service for children and young people

your local adult NHS mental health service

a specialist eating disorder unit

Professionals working in one of these teams will talk to your child to find out what the problem is. They will then decide what kind of treatment will help. While this is happening, the GP may also refer your child to a paediatrician for a physical health assessment.

The National Institute for Health and Care Excellence (NICE) provides guidelines for NHS treatments. They very clearly recommend that GPs should make a referral for specialist assessments if there is any concern that a young person has an eating disorder. The NICE guidelines specifically state that they should not wait to see whether things get worse before doing this.

This is because getting early help can make a big difference - and because it's important to get help before an eating disorder starts to affect a young person's physical development.

If you do not think the GP is taking enough action, you can always ask the surgery to make you an appointment with a different doctor. You can also outline what the NICE guidelines say.

Depending on where you live, your child may be able to contact CAMHS or adult mental health services directly. You may also be able to refer them as their parent or carer. You can find this information online, or ask your GP surgery how things work in your area.

3. Receiving specialist treatment

The type of support and treatment your child has will depend on the type of eating disorder they have been diagnosed with. It may include:

family therapy

individual therapy developed specifically for eating disorders

group therapy developed specially for eating disorders

Your child's physical health may also be monitored during and after treatment.

Your child may receive treatment locally while they're at home. Or, if their symptoms are more serious, they may go into hospital to get treatment and support.

If you are worried about your child's physical health or they become very unwell, for example if they are experiencing chest pains or feeling faint, they need to see a doctor straightaway.

Take them straight to A&E or call 999 for an ambulance.

You can also call 111 if you're concerned but they do not need to be seen immediately.

If your child needs urgent mental health support, for example if you are worried that they are feeling suicidal or experiencing a mental health crisis, you can find advice on our urgent help page.

Educate yourself around eating disorders, this will enable you to give your child the best possible support. Charities such as Beat offer peer support and online development for carers on similar journeys to those you are facing.

How can I support my child?

Getting professional advice as early as you can is one of the most important things you can do to support your child. Eating disorders are complex mental health conditions that need specialist treatment - and the earlier your child gets support, the easier it will be for them to change their thinking and behaviour.

Alongside getting professional help, there are also things you can do to support your child at home.

Beat have a really useful resource to help you start a conversation if you're worried about your child.

Young people who have been through this say it helps when parents:

show they are able to talk about it and do not shy away from the issue

remember that this might be a difficult conversation for their child to have

are open minded and focus on finding out what it's like for their child

avoid making assumptions about why their child is behaving in this way

address what they want to talk about directly and use 'I' statements - for example, you could say, 'I've noticed that ...', or 'I'm really concerned because ...', and then ask, 'can we have a chat about it?'

You can find some simple tips on things you can do to help your child to feel understood in our blog on how to really listen to your child.

It's completely understandable if things feel all-consuming at times. But try to keep your focus on the person your child is, rather than just seeing the eating disorder. Talk about other things and spend quality time together doing activities you both enjoy. Keep normal routines and family life going as much as possible. This might feel hard sometimes, but young people who have been through this say just how important it is.

Certain points of the day, such as meal times, might feel really challenging. This is understandable, but if things feel tense, it can be more anxiety-provoking for your child.

It can help to:

give yourself permission to step away for a moment if you feel yourself becoming stressed, and come back when you're calmer

think about activities you could do during meals, such as playing a game together or watching TV, which can help to take the pressure off everyone

avoid having serious conversations during mealtimes or other family activities, so that your child can enjoy the social time too

There are stories of recovery on social media that can be positive for young people to see. But some social media content promotes disordered eating and can be damaging for young people with eating problems. This is often called 'pro-anorexia' (or 'pro-ana') and 'pro-bulimia' (or 'pro-mia') content. Social media will also advertise things like weight loss programmes that can be harmful to see.

Talk to your child about what they're seeing online, and about how they can make sure it's having a positive influence on them. Your child can use our advice on creating a positive social media community in our young person's guide to social media and mental health. Or they could try finding an online community at Beat (their online chat spaces are fully moderated).

It's really important that young people feel able to socialise with friends and family. But it can be difficult when social events often revolve around food. Think together about events such as big family meals or trips with friends ahead of time.

Young people who have been through this say it can be helpful to:

decide what they are going to eat beforehand, for example if they are going to a restaurant with friends

plan in downtime around social events to help them cope with stress

have a back-up plan if things feel too difficult - for example, eating in a separate room just with you if eating with everyone together is too much

allow themselves to enjoy the event and socialise too, without the occasion being all about what they're eating

When things feel tough, remind yourself that your child is not choosing to do this and cannot simply decide to stop. Eating disorders are complex mental health conditions and it does take time for things to get better. Try not to take their behaviour personally and remember to see yourselves as a team working together.

It is essential that the carer takes good care of their own mental health, and that other family members do too. Reach out to friends and family members who are willing to listen and to offer support.

Looking after yourself

This can be an incredibly tough, or in some cases traumatic, thing for parents and carers to go through. You may be feeling really worried about your child's mental and physical health. When the situation is very serious, some parents tell us they feel like they're firefighting all the time. This is exhausting, and can start to affect your wellbeing too.

Our tips can help you to look after yourself during this time as well your child.

Alongside looking after yourself, it's also important to think about how your other children might be affected by the situation. Remember to check-in with them about how they're doing, and to make space for quality time together.

Useful helplines and websites

While we take care to ensure that the organisations we signpost to provide high quality information and advice, we cannot take responsibility for any specific pieces of advice they may offer. We encourage parents and carers to always explore the website of a linked service or organisation to understand who they are and what support they offer before engaging with them.

You may also find helpful...

This page was reviewed in June 2023. It was created with a parent or carer with lived experience of supporting their child or young person with an eating disorder. We will next review the page in 2026. YoungMinds is a proud member of PIF TICK - the UK's quality mark for trusted health information.
Whether you love the page or think something is missing, we appreciate your feedback. It all helps us to support more young people with their mental health.

Please be aware that this form isn't a mental health support service. If your child is in crisis right now and you want to talk to someone urgently, find out who to contact on our urgent help page.

At YoungMinds we take your privacy seriously. If you'd like to read more about how we keep the information we collect safe, take a look at our privacy policy.

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Eating Disorders and Problems | Parent Guide

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If you're worried your child has an eating disorder or problem, read our tips and advice on how to find professional help and how to support them at home.

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Domestic violence or abuse can happen to anyone. Find out how to recognise the signs and where to get help.
If you're worried someone might see you have visited this page, the Women's Aid website tells you how to cover your tracks online.

Domestic violence, also called domestic abuse, includes physical, emotional and sexual abuse in couple relationships or between family members.

Domestic violence can happen against anyone, and anybody can be an abuser.

Getting help and support for domestic violence

You do not have to wait for an emergency situation to find help. If domestic abuse is happening to you, it's important to tell someone and remember you're not alone.

Other ways to get support:

You can also email for support. It is important that you specify when and if it is safe to respond and to which email address:

The Survivor's Handbook from the charity Women's Aid is free and provides information for women on a wide range of issues, such as housing, money, helping your children, and your legal rights.

If you are worried that you are abusive, you can contact the free Respect helpline on 0808 802 4040.

Signs of domestic violence and abuse

There are different kinds of abuse, but it's always about having power and control over you.

If you answer yes to any of the following questions, you might be in an abusive relationship or experiencing domestic abuse.

Emotional abuse

Does your partner or someone you live with ever:

belittle you, or put you down?

blame you for the abuse or arguments?

deny that abuse is happening, or downplay it?

isolate you from your family and friends?

stop you going to college or work?

make unreasonable demands for your attention?

accuse you of flirting or having affairs?

tell you what to wear, who to see, where to go, and what to think?

control your money, or not give you enough to buy food or other essential things?

monitor your social media profiles, share photos or videos of you without your consent or use GPS locators to know where you are?

Threats and intimidation

Does your partner or someone you live with ever:

threaten to hurt or kill you?

destroy things that belong to you?

stand over you, invade your personal space?

threaten to kill themselves or the children?

read your emails, texts or letters?

harass or follow you?

Physical abuse

The person abusing you may hurt you in a number of ways.

Does your partner or someone you live with ever:

slap, hit or punch you?

push or shove you?

bite or kick you?

burn you?

choke you or hold you down?

throw things?

Sexual abuse

Sexual abuse can happen to anyone.

Does your partner or someone you live with ever:

touch you in a way you do not want to be touched?

make unwanted sexual demands?

hurt you during sex?

pressure you to have unsafe sex - for example, not using a condom?

pressure you to have sex?

If anyone has sex with you when you do not want to, this is rape. It is still rape if that person is your partner.

Have you ever felt afraid of your partner?

Have you ever changed your behaviour because you're afraid of what your partner might do?

If you think you may be in an abusive relationship, there are lots of people who can help you.

Domestic violence and abuse against women often starts during pregnancy. If the relationship is already abusive, it can get worse.

Find out more about domestic abuse in pregnancy.

If you decide to leave

The first step in escaping an abusive situation is realising that you're not alone and it's not your fault.

Before you go, try to get advice from an organisation such as:

If you're considering leaving, be careful who you tell. It's important the person abusing you does not know where you're going.

Women's Aid has useful information about making a safety plan that applies to both women and men, including advice if you decide to leave.

Helping a friend if they're being abused

If you're worried a friend is being abused, let them know you've noticed something is wrong.

They might not be ready to talk, but try to find quiet times when they can talk if they choose to.

If someone confides in you that they're suffering domestic abuse:

listen, and take care not to blame them

acknowledge it takes strength to talk to someone about experiencing abuse

give them time to talk, but do not push them to talk if they do not want to

acknowledge they're in a frightening and difficult situation

tell them nobody deserves to be threatened or beaten, despite what the abuser has said

support them as a friend, encourage them to express their feelings, and allow them to make their own decisions

do not tell them to leave the relationship or leave home if they're not ready - that's their decision

ask if they have suffered physical harm and if they have, offer to go with them to a hospital or GP

help them report the assault to the police if they choose to

be ready to provide information about organisations that offer help for people experiencing domestic abuse

Video: domestic violence

In this video, 2 women describe their experiences of domestic abuse.

Sexual assault

Anyone who has been sexually assaulted can get confidential help, treatment and support at a sexual assault referral centre.
Read more about getting help after rape and sexual assault Find your nearest sexual assault referral centre

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Getting help for domestic violence and abuse

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Find out about the signs of domestic violence and abuse, and where to get help. Domestic violence and abuse can happen against women and against men, and anyone can be an abuser.

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How are children affected by domestic abuse?

Children who witness domestic abuse are at risk of both short and long-term physical and mental health problems. Every child will be affected differently to the trauma of domestic abuse.

Short-terms effects of domestic abuse:

For young children this can include:

For school aged children this can include:

a loss of drive to participate in activities and school

lower grades in school

feeling guilty and to blame for the abuse happening to them

getting into trouble more often

For teenagers this can include:

.

Long-term effects of domestic abuse:

mental health problems, such as becoming anxious or depressed. Low mental health can also lead to big impacts on physical health, including self-harm or developing an eating disorder

having a lowered sense of self-worth

Since the Domestic Abuse Act 2021, children that have been exposed to domestic abuse are now recognised as victims of domestic abuse in their own right, rather than just witnesses.

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Learn more about domestic abuse and it's affect on children from our specialists.

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Find out what to do if you or a young person you know is affected by domestic abuse.

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When someone you know dies, the grief that follows can be a really difficult and painful process. People are sometimes surprised by just how painful it can be, and just how long the process can last.

This short video won't take that pain away, but it does have some ideas based on what other young people have said, that might help you through it.

Below the video we've included links to some charities who offer a range of support for young people who may be grieving. You can look at each organisation, read their advice and contact them direct if you would like someone to talk to or need support.

A guide on traumatic bereavement for children and young people has been created by the UK Trauma Council . The guide will help you learn about traumatic bereavement and what might help if you are worried about yourself or someone else.

The UK Trauma Council is hosted and supported by Anna Freud.

Do you need help right now?

The AFC Crisis Messenger text service provides free, 24/7 crisis support for young people across the UK.

If you are experiencing a mental health crisis and need support, you can text AFC to 85258. Read more about the AFC Crisis Messenger service .

Download the AFC Crisis Messenger poster for your school, college or workplace.

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Ideas and support on how to deal with a loss or bereavement.

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Life can be really tough at times and it can make you feel down and unable to cope. Sometimes you may know what's causing you to feel this way, and other times there may be no clear reason. This can be really worrying, but it's normal. We all feel low at points in our lives.

When we feel down, everyday things like going to school, hanging out with friends or even getting dressed can feel harder. We may also find that we don't get as much pleasure from things we used to enjoy. Although it can be really hard to feel hopeful, there are things you can do to help you feel better.

There are many reasons why you might feel down or unable to cope. It might be because of something that you're finding difficult, like exams, or you might be struggling with a mental health problem like depression.

Understanding what is making you feel this way can really help. If you're not sure, try thinking about how different areas of your life are making you feel, like: friendships, family, home, school, work, or relationships. This can help you to see what makes you feel good in your life but also what might be bringing you down.

If you are feeling like this, try setting small goals each day to help you build a routine. Your goals don't have to be big tasks; they can be things like getting out of bed or putting on some different clothes. This may feel strange at first, but it can really help.

Mental health problems like depression can sometimes feel like they are taking over your life. You might feel like they are stopping you from doing things you want to do, or you might feel scared that you will always feel this way. But remember, these feelings are temporary. You can get through this.

If a mental health problem is making you feel down, read our guides for tips and advice:

Anxiety - if you feel worried, nervous or panicky all the time, you might be struggling with anxiety.

Depression - if you're feeling down all the time, unable to enjoy life, and you are having a lot of negative thoughts, you might be experiencing depression.

Bipolar disorder - if you're having very extreme mood swings, it could be a sign of bipolar disorder.

Psychosis - if you're experiencing 'out of the ordinary' things, like hearing voices, or having hallucinations, these could be episodes of psychosis. In some cases, this might also be a sign of schizophrenia.

PTSD - if you have experienced something extremely frightening, upsetting or a life-threating situation you might notice changes to your mood and behaviour.

Whether it is something that has happened to you in the past or is happening right now, experiencing trauma can have a long-term impact on your emotional wellbeing.

Going through something traumatic can affect your mood, how you feel about yourself and how you interact with others. Whatever has happened, you are not alone. You are loved and you deserve support.

You might have experienced or be experiencing things like:

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Feeling Down And Unable To Cope | Help And Advice

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Sometimes, life can be really tough and can make you feel down and unable to cope. We have tips and advice that can help you if you feel this way.

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How do you know when you're depressed? Discover the signs of depression and what to do if you're low in mood.

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Are you or your child struggling with anxious thoughts? Psychologist Dr Anna Colton explains seven quick, easy and simple techniques that you can try at home, with your child or by yourself, to manage these thoughts and tackle day-to-day anxiety.

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How to tackle anxiety with Dr Anna Colton

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Are you or your child having trouble with anxious thoughts? Try these super-quick and easy techniques from psychologist Dr Anna Colton. Part of the Parents' Toolkit.

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Feeling anxious sometimes is normal. But if worried thoughts are disrupting your life, it can become a real problem. Our information explains anxiety issues, and where to get help.

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Our children and young people's wellbeing resources aim to empower young people to make informed choices about their mental health & wellbeing. These pages have been co-produced by young people to help other young people.

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Our children and young people's wellbeing resources aim to empower young people to make informed choices about their mental health & wellbeing. These pages have been co-produced by young people to help other young people.

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Improving Bereavement Support in Schools, funded by the True Colours Trust, surveyed over 1000 teachers and staff in pastoral, outreach and management roles within primary and secondary schools. In addition, case studies were gathered from seven schools from Scotland, South Wales, South West England, South Central England and North West England, and seventeen in-depth interviews with teachers were undertaken. The research aimed to gain a better understanding of the drivers and barriers for schools in accessing training and effectively supporting bereaved pupils.

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Our short films are delivered by support practitioners and cover a range of topics on grief and bereavement, providing guidance on what can help. Read more

A list of books and resources relating to grief and bereavement and what may help. Read more

Some bereaved families find it helpful to read about other peoples' experiences and how the support they have received has helped them. Read more

Improving bereavement support in schools, Summary Research Report (as PDF)

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charity bereavement child death grief loss baby stillbirth miscarriage suicide young people

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Improving Bereavement Support in Schools, funded by the True Colours Trust, surveyed over 1000 teachers and staff in pastoral, outreach and management roles within primary and secondary schools. In addition, case studies were gathered from seven schools from Scotland, South Wales, South West England, South Central England and North West England, and seventeen in-depth interviews with teachers were undertaken.

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Badger’s Parting Gifts 35th Anniversary Edition | Child Bereavement UK

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Child Bereavement UK have partnered with publisher Andersen Press to provide information and guidance for adults using Susan Varley's much-loved picture book Badger's Parting Gifts to help children understand and talk about death.

Published in 1984, Susan Varley set out to write something that might help others, having experienced the death of her own grandmother. Since then, the beautifully illustrated, sensitive and accessible story, gently exploring grief and loss, has aided parents, teachers and grandparents alike in starting conversations with young children about death of any kind.

The new, 35 th anniversary edition of the book features a reading guide from Child Bereavement UK that provides tips for reading Badger's Parting Gifts with children and helping them better understand grief.

Our online information sheet Talking With and Supporting Bereaved Childrenwith further notes and guidance, using examples and illustrations from the book, can be downloaded .

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charity bereavement child death grief loss baby stillbirth miscarriage suicide young people

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Badger's Parting Gifts 35th Anniversary Edition

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Child Bereavement UK have partnered with publisher Andersen Press to provide information and guidance for adults using Susan Varley's much-loved picture book Badger's Parting Gifts to help children understand and talk about death.

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Rainbows Bereavement Support GB is a well respected national charity offering high quality training in bereavement and loss.

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Who self-harms?

There is no such thing as a typical young person who self-harms. Self-harm is something that can affect anyone. It's believed that around 10% of young people self-harm, but it could be as high as 20%. If you self-harm, there are a lot of people who also know what you're going through.

'Most young people reported that they started to hurt themselves around the age of 12.'

While it is true that anyone can be affected by self-harm, some people are more likely to self-harm than others because of things that have happened in their lives - where they live, things that are happening with friends, family or at school, or a combination of these. This means that some people are more at risk of self-harm than others.
Some factors that might make someone more at risk are:
It is important to remember that although these risk factors can make someone more likely to self-harm, having any of these does not mean someone will self-harm. Similarly, someone who self-harms might not experience any of these. Anyone can be affected.

Why do people self-harm?

Everyone has different things that cause stress and worry them. Some people can manage these troubles by talking to friends and family, while others may find these difficulties overwhelming. When we don't express our emotions and talk about the things that make us distressed, angry or upset, the pressure can build up and become unbearable. Some people turn this in on themselves and use their bodies as a way to express the thoughts and feelings they can't say aloud. People often harm themselves when this all gets too much. If you self-harm, you might find that when you feel angry, distressed, worried or depressed, you feel the urge to hurt yourself even more.

Someone's reason for self-harm can be very different from other people who self-harm. Some of the reasons that young people report as triggers or reasons that lead them to self-harm include:

difficulties at home

arguments or problems with friends

school pressures

bullying

depression

anxiety

low self-esteem

transitions and changes, such as changing schools

When a few of these issues come together, they can quickly feel overwhelming and become too much for one person to deal with. As one young person said, many people self-harm to 'get out the hurt, anger and pain' caused by pressures in their lives. They hurt themselves because they didn't know what else to do and didn't feel like they had any other options. Talking to someone you trust or a healthcare professional can help you find other options for coping with the emotional pain you are feeling.

Breaking down the myths about self-harm

There are lots of myths attached to self-harm. This isn't surprising - myths and misunderstandings often arise when a problem like self-harm is poorly understood. Negative stereotypes can be powerful. They need to be challenged because they stop people talking about their issues and asking for help. These myths also mean that professionals, family and friends can misunderstand people who self-harm.
MYTH: 'Self-harm is 'attention-seeking''
One of the most common stereotypes is that self-harm is about 'attention seeking'. This is not the case. Many people who self-harm don't talk to anyone about what they are going through for a long time, and it can be very hard for them to find enough courage to ask for help.
MYTH: 'Self-harm is a goth thing'
Self-harm has been stereotyped to be seen as part of youth subcultures such as "goth" or "emo". While some research suggests a link, there is no conclusive evidence of this, with little or no evidence supporting the belief that self-harm is part of any particular young person's subculture.
MYTH: 'Only girls self-harm'
It is often assumed that girls are more likely than boys to self-harm. However, it isn't clear if this is true. Boys and girls may engage in different self-harming behaviours or have different reasons for hurting themselves, but this doesn't make it any less serious.
MYTH: 'People who self-harm must enjoy it'
Some people believe that people who self-harm take pleasure in the pain or risk associated with the behaviour. There is no evidence that people who self-harm feel pain differently than anyone else. The harmful behaviour often causes people great pain. For some, being depressed has left them numb, and they want to feel anything to remind them they are alive, even if it hurts. Others have described this pain as punishment.
MYTH: 'People who self-harm are suicidal'
Self-harm is sometimes viewed as a suicide attempt by people who don't understand it. For many people, self-harm is about coping with difficult feelings and circumstances. Some people have described it as a way of staying alive and surviving these difficulties. However, some people who self-harm can feel suicidal and might attempt to take their own life, which is why it must always be taken seriously.

'People often link self-harm to suicide but for me it was something very different; it was my alternative to suicide, my way of coping even though sometimes I wished that my world would end.'

Getting help for self-harm

Should I tell someone?
Yes. Talking to someone is often the first step to getting out of the cycle.
It isn't easy to do, and you might find it difficult to talk about your self-harm and the reasons behind it. This is normal - many young people who self-harm find asking for help very difficult. But it is an important step toward recovery and feeling better.

'Telling someone about your self-harm shows strength and courage; it can often be a huge relief to be able to let go of such a secret, or at least share it

Don't be afraid to ask for help whenever and however you need to. Talking about your feelings isn't a sign of weakness. It shows that you are taking charge of your well-being and doing what you need to stay healthy. It isn't always easy to express how you are feeling. If you can't think of one word to describe a feeling, use as many as you need to illustrate how you feel.

Talking can be a way of coping with a problem you've been carrying around in your head for a while. Feeling listened to can help you feel more supported. And it works both ways: if you open up, it might encourage others to do the same.

Who can I talk to?

There are lots of people you can talk to about what you are going through. It is important to tell someone you trust and feel comfortable with, as they will be able to help and support you. Young people told us that they have been able to talk to:

friends

family

someone at school, such as a trusted teacher, school nurse or pastoral care staff

a youth worker

their GP or healthcare professionals such as a counsellor or nurse

charities and helplines (some of which are listed below).

There are no rules about how you should tell someone. Most importantly, you feel comfortable and trust the person you decide to tell. Set time aside to talk to them. Remember you can set the pace, and it is up to you how much you want to tell them.

If you find speaking about it too difficult, you can tell someone in writing or an email. You can even ask a friend to speak to a trusted adult on your behalf. Let them know you need help with how you are feeling. There is no need to give details about how you have harmed yourself, and you don't need to talk about things you feel uncomfortable talking about. Try to focus on the thoughts and feelings behind your self-harm rather than the behaviours.

If you decide to talk to a GP or other health professional, you can take a friend or family member with you to support you.

'Sometimes, after telling someone, you may feel worse. That's normal. But remember that once you get over this hurdle, support and help are available.'

If you're worried that when you tell someone, they won't understand, or if you have experienced this, try giving them a copy of this booklet or suggest they talk to an expert in the field to try to understand more about self-harm.

Remember that health professionals, GPs and teachers are familiar with this issue and are there to help.

Don't let the fear of a bad reaction put you off seeking the help you need and deserve. As hard as telling someone, sharing will take the pressure off you and help you get the right support and help available.

What help is available for me?

There are lots of support services and treatments available when you feel ready to seek help. If you look for help from your GP, they will likely offer you counselling, where a professional will listen and help you work on solutions and strategies to cope with the problems you are dealing with.

Talking therapies such as cognitive behavioural therapy (CBT) focus on building coping strategies and problem-solving skills and be very effective in helping to reduce self-harm.

Other forms of counselling, like psychodynamic therapy, will help you identify the problems that are causing you distress and leading you to self-harm. It is important that you talk to your GP or a trusted health professional who will help decide the best treatment option for you.

There are also many charities and self-help groups throughout the UK that can support you through this experience. People who have self-harmed have said that it can be helpful to hear from other young people who have experienced self-harm. More information about these sources of support is available at the end of this booklet.

'I feel a lot more confident. I've learned to be more open about my feelings and been able to move on. I felt that, without them knowing, I was being held back. I've been able to come out of myself and explain what I do, and make sense of it, not keep having to lie and cover up what I did. I no longer feel ashamed as I know people are supporting me.'

Recovery from self-harm

It's important to remember that you won't always feel the way you do now. The problems that are causing you to self-harm can, with help and support, become more manageable over time or even go away. Things can and do get better!

'Take time and be patient with yourself. Recovery doesn't happen overnight - it can be a slow process. Start to learn how to care for yourself.'

Young people who have recovered from self-harm say that changes in life and life circumstances (for example, moving home, changing schools, finishing exams, going to university, changing jobs or changing financial circumstances) helped them recover. Once one or two of the main factors that were causing them to self-harm (such as their family situation or bullying at school) were removed, they felt they didn't have to use self-harm as a coping strategy.

Others explained that recovery was about finding new coping strategies and more helpful ways of dealing with emotions or distress. This is also an important factor in recovery from self-harm.

'It dawned on me that continually harming myself was not allowing me to grow; it was just proving that I was still here and I could feel. But wasn't letting me push things forward, and unless I stopped doing that, I would be in the same situation forever.'

How can I stop harming myself?

Asking for help and having support is very important if you are trying to stop self-harming. You must do this when you feel ready to talk about it. It doesn't matter who you talk to, as long as it's someone you trust and feel comfortable with. Talking to someone is what is important. You don't have to feel that you need to deal with this on your own. For young people used to carrying burdens on their own, it can be hard to receive support. Part of recovery is trusting people enough to let them help you.

Talking to someone you trust can help you discover why you self-harm and help to find new ways to cope with difficulties. Finding out what makes you happy, sad, angry, isolated, vulnerable or strong can help you develop other ways of dealing with these feelings. Counselling is a good way of exploring these thoughts and feelings and is available through your GP.

Other young people who have self-harmed have found 'distraction techniques' to be a very useful strategy to reduce or stop self-harming. These techniques find a release for the emotional pressure you feel without the need to harm.

'If you feel the need to harm yourself, try to give yourself a goal of getting through the next ten minutes without doing so.'

Distraction techniques from self-harm

When you feel the urge to self-harm, distraction techniques can be a useful way to 'ride the wave' of emotion and overcome the urge to harm yourself. Young people shared their most helpful ones with us:

Write down thoughts and feelings that are distressing you; crumple the page up, rip it apart and throw them out as a way to let go of that thought

Get some play-dough: stretch it or squeeze it to relieve tension

Hit a pillow or cushion to vent your anger and frustration

Have a good scream into a pillow or cushion

Take a minute and breathe or meditate

Go for a walk to take yourself away from triggers. Being in a public place gives you the time and space to reduce the urge to hurt yourself

Make lots of noise, either with a musical instrument or just banging on pots and pans

Scribble on a large piece of paper with a red crayon or pen

Call a friend or family member and talk to them. This doesn't have to be about self-harm

Do something creative: make a collage of colours to represent your mood or to remind you of your favourite things

Listen to music you like or watch a film you enjoy

Go online and look at self-help websites

Talk to someone about what is triggering you or seek help from a professional

'I've tried so many distraction techniques - from writing down my thoughts, hitting a pillow, listening to music, writing down pros and cons. But the most helpful to my recovery was the five minutes rule, where if you feel like you want to self-harm, you wait for five minutes before you do it, then see if you can go another five minutes, and so on till eventually the feeling that you need to is over.'

Tips for looking after yourself if you self-harm

Keeping safe

Self-harm is not a positive way to deal with things. However, it can be difficult to stop if you are self-harming, especially when you feel distressed or upset. If you don't feel you can stop right now, you must keep yourself safe.

Wounds and injuries of any type can be dangerous and carry the risk of infection, which can be serious, so they need to be looked after. If you have a serious injury, feel unwell or feel that you are going into shock (fast breathing, racing heart, feeling faint or panicked), you should seek help immediately. If you find yourself in this situation, find a trusted adult or friend who can get you the medical attention you need. This doesn't mean you have to discuss your self-harm with them (although it may help); it is about allowing someone to support you medically in a moment of crisis.

Make a 'safe box'

You can create a safe box to help you through times when you feel overwhelmed by emotion and have the urge to harm yourself. Fill it with things that make you happy and calm to help you to get through this feeling. Some suggestions: activities such as crosswords, your favourite book, CD or movie. You could also include a list of things to do that calm you when feeling triggered.

Talk to someone

When you feel overwhelmed, talk to a friend, family member or trusted adult. Let them know what you are thinking. This can help relieve the pressure that you are feeling. Make a list of people you can talk to at these times and keep it somewhere safe. Knowing who you can talk to in times of crisis at 3 am, at weekends or when you are at school can make it easier to ask for help when needed. Add these to your safe box. This will remind you that you are not alone and there are people you can talk to when you need to.

Avoid alcohol and drugs

We often drink alcohol or take drugs to change our mood or to avoid our feelings. Some people drink to deal with fear or loneliness, but like self-harm, the effect is only temporary and can make you feel worse. Alcohol is a depressant, which means it slows down brain activity. This changes how you think and feel so can increase feelings of anxiety and depression. When it wears off, you can feel worse because of its effects on your brain and your body.

Drinking alcohol or taking drugs can leave you feeling depressed or anxious and can lower your inhibitions physically, leading you back to harming yourself. Visit drinkaware for more information.

Do something you enjoy

Remember that there is more to you than self-harm. Do things that remind you of this and make you happy. Maybe this is a sport or a hobby you like doing, such as writing.

Doing things that you enjoy and make you happy helps you look after your mental health. It helps to improve your self-esteem and can help you remember that you are important and have value.

Don't be too hard on yourself

Many young people who self-harm can be perfectionists and high achievers. You might pressure yourself to do things in a certain way or feel that nothing you do is good enough.

Try not to be so hard on yourself about not getting things perfect. Recovery is about knowing that it is okay for your work or performance to be 'good enough'.

'Many people stop hurting themselves when the time is right for them. Everyone is different and if they feel the need to self-harm at the moment, they shouldn't feel guilty about it - it is a way of surviving, and doing it now does NOT mean that they will need to do it forever. It is a huge step towards stopping when they begin to talk about it, because it means that they are starting to think about what might take its place eventually.'

I am worried about someone else who may be self-harming

If you are worried that someone you know is self-harming, it is important to know what to look out for and what to do. Below is some information to help you.

Signs to look out for

It can be difficult to tell whether someone is self-harming. Here are some signs that might suggest someone could be self-harming:

Withdrawal or isolation from everyday life

Signs of depression include low mood, tearfulness, lack of motivation, or interest in anything

Mood changes

Changes in eating/sleeping habits

Changes in activity and mood, e.g. more aggressive than usual

Talking about self-harming or suicide

Abusing drugs or alcohol

Expressing feelings of failure, uselessness or loss of hope

Risk-taking behaviour (substance misuse, unprotected sex)

Signs of low self-esteem such as blaming themselves for any problems or saying they are not good enough

Unexplained cuts, bruises or marks

Covering up all the time, when in hot weather

Being quieter than usual

Lacking energy

It is important to know that these may be signs of other things and don't always mean someone is self-harming. Also, there may be no warning signs at all. It is therefore important that if you suspect someone you know is self-harming, you ask them openly and honestly.

What to do if you are worried about someone

If you are worried that someone you know is self-harming, it can be difficult to know what to do. When you are aware there is an issue, it is important that you do not wait. Waiting and hoping they will come to you for help might lose valuable time in getting them the best support and treatment to help them.

Be mindful that they might not feel ready or able to talk about their self-harm. Let them lead the discussion at their own pace, and don't pressure them to tell you details they aren't ready to discuss. It takes a lot of trust and courage to open up about self-harm. You might be the first person they have been able to talk to about this.

Some tips for talking to someone about self-harm:

Set plenty of time aside to talk to them where you will be free from interruption. If you don't have time at that particular moment, make sure to put time later in the day when you can listen to them.

If possible, remove distractions such as computers and phones being on. This will allow you to give your full attention, letting them know you are there to listen to and support them.

Acknowledge how difficult it might be to open up about their self-harm but don't focus on or encourage them to tell you details about specific injuries or behaviours. Instead, talk about how they are feeling and what they are going through.

Try not to react shocked or disgusted. This can be hard as it can be difficult to understand why someone would harm themselves, but negative reactions can hurt the other person and may put them off talking to you.

Know your limits. Someone who has experienced self-harm might tell you to keep it a secret and not tell anyone else. If you believe they are in immediate danger or have injuries that need medical attention, you must take action to ensure they are safe.

Reassure them that you are there for them and that many sources of support are available to them. You might not understand what they are going through or why they do it but remind them you are there for them regardless.

Avoid giving ultimatums, for example, 'stop or else...' as these rarely work and may drive behaviours underground. Furthermore, this may stop them from talking to you, and you might not get the chance to discuss the topic again.

Offer them help in seeking professional support and provide information on ways to do this. You might want to offer to go to the GP with them or help them talk to a trusted adult or family member. Try not to take control and allow them to make decisions.

Be positive and let them know that things will improve and that recovery is possible!

Key points:

make time

listen

be open and honest

don't judge

offer support

remember the person behind the behaviour.

If it is a family member or close friend you are concerned about, they might not want to talk to you. Try not to take this personally: telling someone you love about self-harm can be difficult as you are close to them, and they might be worried they are hurting you.

Whether you approach someone you are worried about, or someone opens up to you about their self-harm, you must respond in a non-judgemental, caring and respectful way. This can be hard when you see someone in distress, and it can be difficult to understand why someone would hurt themselves. However, you should try to see the person and the reasons they have harmed themselves rather than focusing on the behaviours.

Further help, information and support

If you are worried about the immediate well-being of yourself or someone else you should call 999 or go straight to A & E. For non-emergency help you should talk to your GP or contact 111 or NHS Direct on 08454647.

You can also get more information or support through the websites below:

Alumina (previously SelfHarmUK) - a free, online 7 week course for young people struggling with self-harm.

YoungMinds - the UK's leading charity committed to improving the emotional well-being and mental health of children and young people. Driven by their experiences we campaign, research and influence policy and practice.

Some websites that have been recommended to us by young people include:

Some telephone helplines offer specialist advice on self-harm, others operate only as a 'friendly listening ear' - something many young people have said they value, particularly when they feel they have no-one else that they can turn to. Again, it's important that information about reputable phone lines is widely available to young people. Helpful telephone numbers include:

ChildLine - 0800 1111

Samaritans - 116 123

Family Lives - 0808 800 2222

Young Minds - 0808 802 5544 (Parents Helpline); text YM to 85258 (young people)

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This booklet explains what self-harm is, what to do if you or someone you know is self-harming, and how to get help.

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If you need help right now

If you feel like you are about to self-harm now, there are things you can do to help keep your mind off it. Watch the video about the TIPP technique - a simple technique you can use to help you in the moment.
If you are in an emergency or worried for your life you should call 999.

Self-harm is when you intentionally cause harm to yourself as a way of dealing with difficult feelings, traumatic experiences or memories, neglect, or situations that you find overwhelming. People sometimes self-harm when life feels hard to cope with.

Self-harm can look different for different people. You might find yourself doing things which are harmful, but not think of them as 'self-harm'. But that doesn't make your experience any less valid.

Self-harm can look like:

cutting yourself

using drugs or alcohol to cope with your problems

not eating, over-eating, or forcing yourself to throw up

spending all your time on addictive behaviours like gaming, social media or gambling

over-exercising and/or exercising when you are injured

biting, hitting or burning yourself

hitting walls

getting into situations on purpose where you risk getting hurt, including fights or risky sexual behaviour

Often self-harming only brings temporary relief. You might also have negative feelings after self-harming, such as guilt, shame or fear. When difficult feelings start to build up again, you might feel like you have to harm again. It can be really hard to break out of this cycle. Self-harming can become a habit and it can be upsetting to think that this is your only way to cope. But there are things you can do to stop self-harming and get better. And with support, you can learn other ways of coping when things feel too much.

People self-harm for many different reasons. Some people find it hard to explain why they do it, but often it's a way for people to let out feelings that are hard to explain or control.

There are many reasons why you might self-harm and these reasons will be different for everyone. You might be dealing with lots of intense thoughts and feelings and hurting yourself might feel like the only way to let those feelings out. Or you might feel numb and want to hurt yourself so that you can feel something.

For some people, self-harm feels like a way to show the feelings they have inside on the outside. It can be a way of:

People often start self-harming due to something stressful or upsetting that is going on in their life that is difficult to deal with . This could be something like:

suffering abuse

experiencing a traumatic incident

family problems like a divorce

money worries

bullying

a sudden change in your life, like a death, a relationship ending or moving school

exam stress or extreme pressure or criticism from family, friends, teachers or at work

low self-esteem or issues with body image

difficult feelings like loneliness, anxiety, depression or anger

an illness or health problem

feelings of guilt, failure, or being unloved

experiencing discrimination against your race, religion, sexuality, gender or disability

These are just examples. Whatever the reason you started self-harming, your feelings matter and you can get through this.

You may not always know the reason why you are self-harming. If you're unsure why, or don't understand the reasons, you are not alone and you can still get help.

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Artwork credit: @the_mini_ADHD_coach

An illustration of a face with eyes closed. Text reads: 'It's ok to feel overwhelmed.'

Things can happen in life that can leave us feeling overwhelmed, angry and hurt. Instead of finding ways to express those feelings to the world, we might start to take this pain and anger out on ourselves.

We might self-harm because we have learnt that in order to be accepted or loved we have to be 'perfect'. When we don't live up to this 'perfect' image we can feel like a 'failure'. The constant guilt, or worry about disappointing people, can make us feel like we need to punish ourselves for not being 'good enough'. If this resonates with you, you're not alone. With the right support, you can stop feeling this way, and learn to love yourself for who you are.

Sometimes people make comments about self-harm being attention-seeking. Comments like this can be hurtful and make you feel judged, alone or misunderstood. Those who self-harm actually often keep this private. However, if you do self-harm as a way of bringing attention to yourself, remember that there is nothing wrong with wanting people to notice you more and wanting to have your feelings taken seriously. You deserve to feel loved by those around you and you deserve support.

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Artwork credit: @ohhappydani

An illustration of six arms all of different skin tones. On each arm reads the word 'worthy'.

Overall, the most important thing which I hope everyone knows is you don't have to go through this alone.

I was only 14 when I started to self-harm. I was never intending to hurt myself. I was doing it for the sense of relief it provided. I felt like the only way I could function and leave my room was if I had that release.

Ways to keep yourself safe now

It's really important to keep yourself as safe as possible and reduce your risk of serious self-injury. Even though you want to stop self-harming, you might not feel able to stop straight away. Sometimes it can take time to find new ways to cope, and that's normal.

If you are unable to stop self-harming right now, make sure you are at least doing it as safely as possible. This means using sterile equipment, keeping your wounds clean, and avoiding mixing drugs and alcohol with other forms of self-harm. You can also call Samaritans at any time - whether you're thinking about self-harm or have already harmed yourself.
If you are in an emergency or worried for your life you should call 999 or go to A&E.

Things you can do to help

There are also lots of things you can do in the moment to help you not self-harm.

When you feel the urge to self-harm building, you could try to:

go for a walk or do some gentle exercise

distract yourself by focusing on your breathing

text a friend and let them know you need them to help you take your mind off things

play music and sing or dance along

hold an ice cube

write down your thoughts

hit a cushion or pillow

tear up a magazine or newspaper

make a self-soothe box

go to a public place like a park or a cafe

You might find the TIPP technique helps to stop your urge to self-harm.

This video explains how to use the TIPP technique to help you feel calmer.

Ways to keep yourself safe in the long term

There are also a number of ways to help yourself in the long term and support your recovery journey.

Talking about self-harm can feel difficult. It is understandable that you might feel nervous to talk to someone, feel like you'll be judged or feel you won't be understood. But talking about how you're feeling with someone you trust can help you to get the right support.

Try talking to someone you feel comfortable and safe with, like a friend or family member. If you don't feel like you can talk to friends or family, you could talk to someone in your wider community, such as a teacher, a school counsellor/nurse, a faith leader or a youth worker. Think about who you would feel most comfortable communicating with and how, whether it's face to face, over the phone, by text or email.

In some communities it can feel more difficult to reach out for help because of certain stigmas around mental health. If you reach out for help and the person you talk to does not react the way you hoped, remember that this reaction is about them, not you. Don't let their reaction discourage you from reaching out again. If you don't feel like you can reach out to someone you know, remember that there are still lots of people who can help. You may prefer to get support from a professional, a helpline or through a charity. Take a look at our list of organisations that can help, and don't struggle on your own.

Speaking to a professional about self-harm can feel scary, but it's often an important step to recovery. You may be worried that you'll be misunderstood or judged, but there are lots of trained people that you can talk to who understand and really care. That's because they speak to lots of young people who are going through this too. They are there to listen and support you.

It is helpful to tell the GP exactly what you are doing and what your worries are. If you need medical treatment for injuries, do make sure you get it. Don't be afraid or embarrassed to go to your GP or hospital for this - they are there to help you get better and it is not their job to judge you.

Your GP will listen and discuss the best options to support you. They might offer you an assessment with a local community mental health team, or if you are under 18, they can refer you to Child and Adolescent Mental Health Services (CAMHS) for an assessment. These assessments are so they can help you to find the right treatment, such as counselling or talking therapy, where you can talk with a trained mental health professional about what you are feeling and ways you can cope.

The types of talking therapy you might be offered include:

cognitive behavioural therapy (CBT) - a type of therapy that focuses on how your thoughts, beliefs and attitudes affect your feelings and actions

dialectical behaviour therapy (DBT) - a type of CBT adapted specifically for people who experience emotions very intensely

mentalisation-based therapy (MBT) - a type of therapy that focuses on helping you to make sense of your own and other people's thoughts, feelings and actions

Find out more about counselling and therapy in our guide.

Sometimes the first person you speak to won't help, but that doesn't make your feelings invalid. If you are finding it hard to get the right support from your GP, you may find it helpful to turn to other support, such as your school nurse or a specialist organisation such as Samaritans. For more tips and advice getting the right support from your GP, including information about your rights as a patient, visit our guide on how to speak to your GP about mental health.

Journaling can be a helpful way to let out your emotions. It can also help you to recognise what is bothering you and any patterns in what triggers you or causes you to feel bad.

Take a few minutes every day to write down how you are feeling. If you don't like writing, try doodling, drawing or recording a voice note. Remember this is just a way to express yourself - there's no right or wrong way to do this and nobody has to see it but you.

If you want to, you could show your journal to any mental health professionals who are supporting you, to help them understand what you are going through.

Sometimes just making small changes to your daily routine can help improve your mood. Consider trying some of these changes:

Make sure you get enough sleep and stay hydrated - staying physically healthy can help you to feel happier.

Take time out when you need to - this could be going for a walk, doing some drawing or relaxing however you like to.

Think of three things you are proud of each day - you could do this when you first wake up or just before you go to sleep.

Be as kind to yourself as you would be to your best friend - think about the advice and support you would give someone else if you heard they were struggling.

The internet can be a helpful space for those who self-harm. It offers a lot of information, advice and support. You may also find that it's easier to speak openly about your feelings through social media, rather than face-to-face. However, there is also a lot of content about self-harm on the internet that can be distressing or make you feel worse. We also know that those who have peers that self-harm are more likely to self-harm themselves. Think about how your use of social media is affecting your mood and what content is best for you. Make sure to only follow accounts that make you feel positive and safe.

Some people find it really helpful to create a 'safety plan' that they can use when the urge to self-harm is really strong. This can include whatever you think would be helpful, but generally it includes ideas of what you can do to distract yourself, who you can speak to, and what else you can do to keep yourself safe. Papyrus have a useful guide to creating a safety plan, which might help if you'd like to create your own. Although the focus of their guide is for suicidal feelings, you can use it for self-harm as well.

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Artwork credit: @crazyheadcomics

An image of a bendy road titled 'the road to recovery'. Text along the road reads: 'start', 'progress', 'hope', 'relapse', 'second attempt', 'setback', 'growth', 'change', 'calm'.

If you have self-harmed by cutting or wounding yourself in some way, you are likely to have scars on your body from this. You may find that you have a number of emotions and feelings associated with these scars, such as guilt, regret or difficulties accepting your body image. This can be particularly difficult if you are experiencing stigma around your self-harm.

For advice on how to manage stigma around self-harm within your community, take a look at Louisa's blog.

If you're really struggling with the scars left on your body, you may be able to find treatment that can help. You can find information about scar treatments on the NHS website. Scars will look different for everyone depending on skin tone, where the scar is and the type of wound that caused the scar, and this will lead to different treatment options. Not everyone will want to do this and that is completely okay - it is your body and you should only do what feels comfortable for you.

It can be really difficult if you know a friend or loved one is self-harming. It's hard to see someone you love hurting themself in that way, and it can be difficult to know how best to support them.

Just being there and letting them know they're not alone can be very helpful, but it's also important to remember that you may not be able to help them on your own.

Remember there is always support available.

Recognising the signs and symptoms of self-harm

There are lots of different ways that someone might self-harm and this can make it difficult to spot the signs. Your loved one is likely to be in both physical and emotional pain during this time. Here are some signs to look out for.

If your loved one is self-harming by cutting or wounding themself, you may be able to notice some physical signs. This could include:

keeping their body fully covered all the time, even when it is hot, like wearing long sleeves to conceal scars (this is only a sign of self-harm if they do not normally wear long sleeves or clothes that cover the whole body)

having cuts, bruises or burn marks on their body that are unexplained

unexplained scarring on their skin

unexplained blood stains on clothing or tissues

any signs that they are pulling out their hair, for example hair loss or large clumps of hair lying around

Self-harm takes lots of different forms, not just physically hurting yourself. So it's important to also be aware of the emotional signs. These might include:

becoming very withdrawn and talking less than usual to others

unusual changes in mood, such as feeling low, teary or demotivated

making suicidal comments e.g. talking about not wanting to go on

expressing feelings of self-blame, hopelessness or failure

Supporting a loved one with self-harm now
If a friend or family member has self-harmed and has injuries that need medical attention, you should take them to A&E to seek medical help.
The most important thing you can do to support someone is be there to listen. Talking about self-harm is difficult, but having that conversation can help your loved one take the first step to recovery.

Take a look at our tips below for having a sensitive conversation.

Supporting a loved one with self-harm in the long term

Here are some tips on how you can give ongoing support to someone in your life who is self-harming.

Recovery can only happen when your loved one takes steps towards this for themself. You can't force someone to get better. It can be very difficult to see someone you love struggle with self-harm, but letting them be in control of their decisions will support their recovery in the long term. But remember you should always get them medical attention if needed.

You may find it helpful to develop a 'safety plan' with your loved one. This is a tool you can use to help communicate with each other and keep your loved one safe. Samaritans have advice on this as well as a safety plan template you can use.

Speaking to a GP about self-harm may be a scary thought for your loved one, but encouraging them to do this is important so they get the right support. If they really don't want to talk to a GP, there are also lots of charity services and helplines that can help.

This page was reviewed in June 2023. It was co-created by young people with lived experience of self-harm. We will next review the page in 2026. YoungMinds is a proud member of PIF TICK - the UK's quality mark for trusted health information.
Whether you love the page or think something is missing, we appreciate your feedback. It all helps us to support more young people with their mental health.

Please be aware that this form isn't a mental health support service. If you are in crisis right now and want to talk to someone urgently, find out who to contact on our urgent help page.

At YoungMinds we take your privacy seriously. If you'd like to read more about how we keep the information we collect safe, take a look at our privacy policy.

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Self-harm | Advice for young people | Get help

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Self-harm is when you intentionally harm yourself as a way of dealing with difficult feelings or experiences. Find out about self-harm and how to get help.

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"The Invisible String”  addresses the issue of separation by reassuring children that even though they can’t always physically be with their loved ones, there is an invisible string always connecting them to the people they love, even from afar.

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Do you have an anxiety monster that is big, and wild, and likes to visit you? Is there any way to tame him? Can he be a helpful monster that you just might not mind having around? While learning new coping strategies to deal with his anxiety, his monster shrinks. He may not be able to make his monster go away completely, but he can learn to tame him!

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Sometimes the world seems scary-too scary. This is a comforting story for pre-school children when their world becomes unsettled. It explains anxiety and teaches children why anxiety feels the way it does and how to stop worries growing out of control

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WHEN I AM WORRIED | Kids Book Read Aloud | Readaloud | Anxiety Book | Childrens Books | Kids Books

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"Worried About Worry" A Short Story by James Arnold Taylor

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How are you feeling today? By Molly Potter

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BOOKENDS with Julia Cook: Wilma Jean the Worry Machine

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Using the PACE approach: Playfulness, acceptance, curiosity and empathy

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Using the PACE approach: Playfulness, acceptance, curiosity and empathy

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PACE is a way of thinking, feeling, communicating and behaving that aims to make the child feel safe. It is based upon how parents connect with their very young infants. As with young toddlers, with safety the child can begin to explore.

With PACE, the troubled child can start to look at himself and let others start to see him, or get closer emotionally. He can start to trust.

Playfulness

This is about creating an atmosphere of lightness and interest when you communicate. It means learning how to use a light tone with your voice, like you might use when story telling, rather than an irritated or lecturing tone. It's about having fun, and expressing a sense of joy.

It is similar to parent-infant interactions when both parent and infant are delighting in being with each other and getting to know each other. Both are feeling safe and relaxed. Neither feels judged nor criticised. Playful moments reassure both that their conflicts and separations are temporary and will never harm the strength of their relationship.

Having a playful stance isn't about being funny all the time or making jokes when a child is sad. It's about helping children be more open to and experience what is positive in their life, one step at a time.

Sometimes a troubled child has given up on the idea of having good times and doesn't want to experience and share fun or enjoyment. Some children don't like affection or reject hugs. A playful stance can allow closeness but without the scary parts.

When children find it hard to regulate their feelings, anger can become rage, fear, terror, and sadness, despair. If this is the case, then children may also find it hard to regulate feelings of excitement, joy and love. Feeling these emotions can sometimes turns to anxiety.

Playfulness allows children to cope with positive feelings. It also gives hope. If you can help the child discover his own emerging sense of humour, this can help him wonder a little more about his life and how come he behaves in the ways that he does. When children laugh and giggle, they become less defensive or withdrawn and more reflective.

A playful stance adds elements of fun and enjoyment in day-to-day life and can also diffuse a difficult or tense situation. The child is less likely to respond with anger and defensiveness when the parent has a touch of playfulness in his or her discipline. While such a response would not be appropriate at the time of major misbehavior, when applied to minor behaviours, playfulness can help keep it all in perspective.

Acceptance

Unconditional acceptance is at the core of the child's sense of safety.

Acceptance is about actively communicating to the child that you accept the wishes, feelings, thoughts, urges, motives and perceptions that are underneath the outward behaviour. It is about accepting, without judgment or evaluation, her inner life. The child's inner life simply is; it is not right or wrong.

Accepting the child's intentions does not imply accepting behavior, which may be hurtful or harmful to another person or to self. The parent may be very firm in limiting behavior while at the same time accepting the motives for the behaviour.

One hopes that the child learns that while behavior may be criticised and limited, this is not the same as criticising the child's self. The child then becomes more confident that conflict and discipline involves behavior, not the relationship with parents nor her self-worth.

Curiosity is the foundation of acceptance of whatever underlies the behaviour. Making sense of how the child has learnt to behave in certain ways can help with acceptance.

Curiosity

Curiosity, without judgment, is how we help children become aware of their inner life, reflect upon the reasons for their behaviour, and then communicate it to their parents or therapist. Curiosity is wondering about the meaning behind the behaviour for the child. Curiosity lets the child know that the adults understand.

Children often know that their behavior was not appropriate. They often do not know why they did it or are reluctant to tell adults why.

With curiosity the adults are conveying their intention to simply understand why and to help the child with understanding. The adult's intentions are to truly understand and help the child, not to lecture or convey that the child's inner life is wrong in some way.

Curiosity involves a quiet, accepting tone that conveys a simple desire to understand the child: "What do you think was going on? What do you think that was about?" or "I wonder what...?"

You say this without anticipating an answer or response from a child.

This is different from asking the child, "Why did you do that?" with the expectation of a reply.

It is not interpretation or fact gathering. It's just about getting to know the child and letting her know that.

Curiosity must be communicated without annoyance about the behaviour. Being curious can, for example, include an attitude of being sad rather than angry when the child makes a mistake. A light curious tone and stance can get through to a child in a way that anger cannot.

You might make guesses about what a child may be thinking and feeling, saying this aloud, and keeping it connected to the present. It can be about having a conversation, almost with yourself, with the child in the room, without anticipating a response.

If an adult can stay curious about why their child is behaving as they are, the child and adult are less likely to feel cross or frustrated. As curiosity is non-judgemental, this can help the child to be open to how she, and other people, are thinking and feeling. Curiosity lets the child stay open and engaged in conversations.

Children then start to reflect upon their own inner life with their parent and therapist and start to understand themselves. As the understanding deepens, the child can discover that her behavior does not reflect something bad inside her, but rather a thought, feeling, perception, or motive that was stressful, frightening, or confusing and could only be expressed through her behavior.

As the child communicates this to the adults, the need for the behaviour may reduce, and with that the behaviour itself. The child's feelings about the behaviour may change, with less defensiveness and shame but more guilt, leading to less of the behaviour.

Empathy

Empathy lets the child feel the adult's compassion for her. Being empathic means the adult actively showing the child that the child's inner life is important to the adult and he or she wants to be with the child in her hard times.

Brené Brown on Empathy, RSA Shorts

With empathy, when the child is sad or in distress the adult is feeling the sadness and distress with her and lets the child know that.

The adult is demonstrating that he or she knows how difficult an experience is for the child. The adult is telling the child that she will not have to deal with the distress alone.

The adult will stay with the child emotionally, providing comfort and support, and will not abandon her when she needs the adult the most.

The adult is also communicating strength, love and commitment, with confidence that sharing the child's distress will not be too much. Together they will get through it.

The impact of communication using the principles of PACE

PACE focuses on the whole child, not simply the behavior. It helps children be more secure with the adults and reflect upon themselves, their thoughts, feelings and behaviour, building the skills that are so necessary for maintaining a successful and satisfying life. The child discovers that they are doing the best that they can, and are not bad or lazy or selfish. Problems diminish as the need for them reduces.

Through PACE and feeling safer, children discover that they can now do better. They learn to rely on adults, particularly their parents, and trust them to truly know them. They learn that their parents can look after them in a way that they could never do on their own.

When children experience the adults doing the best they can to understand them and trying to work out together more effective ways for the child to understand, make sense of and manage their emotions, thoughts and behaviour they start to believe that the adults really will keep on trying until things get better for all of them.

For adults, using PACE most of the time, they can reduce the level of conflict, defensiveness and withdrawal that tends to be ever present in the lives of troubled children. Using PACE enables the adult to see the strengths and positive features that lie underneath more negative and challenging behaviour.

Further reading from the Resource Library
All Resources concerning PACE

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Playfulness, acceptance, curiosity and empathy. PACE is a way of thinking, feeling, communicating and behaving that aims to make the child feel safe. It is based upon how parents connect with their very young infants. As with young toddlers, with safety the child can begin to explore.

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Downloads

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A Downloadable Resource for supporting your child.

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Mental Health Resources For Children and Young People

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Free mental health resources, posters, lesson plans and activity sheets for primary and secondary school staff, and mental health professionals working with children and young people.

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A sleep diary that your child complete themselves. Thsi will help yoru chidl to feel more in control of decisions.

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Getting your little ones to sleep can be tricky. Here are 10 tips that may help your kids settle into bed.

Sleep is an important part of maintaining good health, but issues with falling asleep aren't just problems that come with adulthood. Kids can have trouble getting enough rest, and when they can't sleep... you can't sleep.

Bedtime can become a battle zone when little ones won't settle in and fall asleep. But there are ways to even the odds of victory. Try using these 10 tips to learn how to fight the battle... and win!

School-age children need between 9 and 11 hours of sleep each night, according to the National Sleep Foundation. But there's a lot of variability in sleep needs and patterns. Most kids have patterns that don't change much, no matter what you do.

Early risers will still rise early even if you put them to bed later, and night owls won't fall asleep until their bodies are ready.

That's why it's important for parents to work with their children in setting a responsible bedtime that allows them to get plenty of sleep and awake on time, says Ashanti Woods, MD, a pediatrician in Baltimore, Maryland.

Set a wake-up time based on how much sleep your child needs and what time they go to bed. Woods recommends creating a wake-up routine as early as the preschool years to help prevent stress for parents down the road.

And remember to be consistent with the schedule. Allowing your child to sleep later on weekends is generous, but could backfire in the long run.

Those extra hours of sleep will make it hard for their body to feel tired at bedtime. But if you can try to make bedtime and wake-up time the same, within an hour or so every day, you'll be making everyone's lives sooooo much easier.

Routines are especially important for infants, toddlers, and preschoolers. Woods recommends that after dinner the remainder of the evening should include light playtime, bath, brushing teeth, a bedtime story, and then bed.

Aim for a routine that is comforting and relaxing, setting the ideal bedtime atmosphere. Before long, your child's body may automatically start to become sleepy at the beginning of the routine.

Melatonin is an important piece of sleep-wake cycles. When melatonin levels are at their highest, most people are sleepy and ready for bed.

Research from 2011 found that blue light from a television screen, phone, or computer monitor can interfere with the production of the hormone melatonin.

Watching TV, playing video games, or scrolling web pages on a phone or computer right before bed keep your child up an extra 30 to 60 minutes, according to this 2017 study.

Make the bedroom a screen-free zone or at least make sure all screens are dark at bedtime. And keep your phone on silent when you're in your child's room - or don't carry it in there at all.

Instead of screen time, Abhinav Singh, MD, director of the Indiana Sleep Center, recommends reading to your child in the evening to allow their brain to rest.

Another hormone that plays a role in sleep is cortisol, also known as the "stress hormone." When cortisol levels are high, your child's body won't be able to shut down and go to sleep.

Keep pre-bedtime activities calm. This can help avoid excess amounts of cortisol in your child's system. "You need to reduce stress to make it easier to fall asleep," says Dr. Sarah Mitchell, chiropractor and sleep consultant.

Soft sheets, room darkening shades, and relative quiet can help your child differentiate between day and night, making it easier to fall asleep.

"Creating a sleep-inducing environment is important because it sets the stage for sleep by reducing distractions," says Mitchell. "When you're calm you are not distracted, and can fall asleep more quickly and with less help."

Your child's sleep cycle isn't just dependent on light (or the lack thereof). It's also sensitive to temperature. Melatonin levels help to regulate the drop of internal body temperature needed to sleep.

However, you can help regulate the external temperature. Don't bundle your child up too much or set the heat too high.

Whitney Roban, PhD, clinical psychologist and sleep specialist, recommends dressing your child in breathable cotton pajamas and keeping the bedroom temperature around 65 to 70°F (18.3 to 21.1°C) at night.

Ghosts and other scary creatures may not actually roam around at night, but instead of dismissing bedtime fears, address them with your child.

If simple reassurance doesn't work, try using a special toy to stand guard at night or spray the room with "monster spray" before bed.

Roban recommends scheduling time during the day to address any fears and avoiding using bedtime for these type of conversations.

"Children are very smart and will quickly learn that they can stall bedtime if they use the time to express their bedtime fears," she says.

Kids can have trouble shutting their brains off for the night. So, instead of increasing that anxiety by insisting that it's time to go to bed ("now!"), consider focusing more on relaxation and keeping your child calm.

Tryteaching your child a deep breathing technique to calm their body. "Breathe in through your nose for 4 seconds, hold for 5 seconds, exhale through your mouth for 6 seconds," says Roban.

Younger children can just practice taking long, deep breaths in and out, she says.

Sometimes, your best-laid plans just don't yield the results that you want. (Hello, welcome to parenthood!)

If your child has trouble falling asleep, has persistent nightmares, snores, or breathes through their mouth, they might have a sleep disorder, says Mitchell.

Always talk to your pediatrician if you have any concerns about your child's sleeping habits. They may recommend a sleep consultant or have other suggestions for you to try so the entire family can get a good night's sleep!

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Bedtime can become a battle when little bodies don't abide by the clock. Here are 10 tips to learn how to win the fight.

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Grief is confusing. And while it's completely natural for parents to worry about their children and want to protect them, the best thing is to give them honest, age-appropriate information about a death. Someone who knows the child really well should break the news. Children understand the world through other people; family primarily, but also carers, teachers, extended family, and friends. Support from all these people is vital.

Children process information by age and stage. How they grieve varies depending on their personality, age and level of understanding of death, but all children need clear information. Use words they understand, and be honest and reassuring. Children experience 'puddle grief': they tend not to be sad all the time, instead they dip in and out, getting diverted by playing with friends, or doing routine things such as going to school.

Factors to consider in a child's reactions to bereavement:

Who has died?

How did they die?

What was the child's relationship with the deceased?

How do the family express feelings and communicate?

What else is going on in their life?

What supports are available in the family, and among friends and community?

Children feel the loss over a lifetime, and in different ways: as they grow and learn to understand the real meaning of death and loss; as they revisit their grief, especially around milestones such as anniversaries, Christmas, or moving from primary to secondary.
How can families and friends show their support?

Acknowledge that the loss is important, and that it matters.

Listen to their thoughts, feelings and opinions. Let them know it is fine to ask questions.

Give age-appropriate information.

Maintain day-to-day routine as much as possible.

If things have to change, include the child in decisions, explain the changes and reassure them.

If they want to, let the child take part in the goodbye rituals.

Make sure they need to know it's okay not to be sad all the time.

Give them time to show their feelings, even anger, which can be an expression of deep hurt and unfairness.

Let them talk about their relationship with the person who has died.

As the child matures, they may need new 'explanations', which can involve revisiting the loss and what it means.

They need to know that they are not to blame; anything they thought or said did not cause the death.

With sudden deaths, where there is no opportunity to say goodbye, they may be angry or act out in protest.

Meeting other bereaved children can help them see that they are not alone.

Help them develop coping strategies and resilience to live with loss.

Reassure them that they are loved, and that they will be cared for no matter how difficult grief is for the family.

With good support, most children will not need professional help.

Reading with children can be a good way to support them in talking about their feeling and concerns. See our book list suggestions

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Families - Irish Childhood Bereavement Network

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Grief is confusing. And while it's completely natural for parents to worry about their children and want to protect them, the best thing is to give them honest, age-appropriate information about a death. Someone who knows the child really well should break the news.

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Naturally we want to shield children from pain. Giving a child difficult news about a death or serious illness is not easy at a time when you can be overwhelmed by grief yourself. It's normal to be unsure about what to say, and how to find the words your child can understand.

Conversations about death are steps in a journey. Once you tell a child about a death or serious illness, you will need to have ongoing conversations as the child takes in and processes the information. The importance of support from family, friends and care settings (such as crèche or school) cannot be underestimated - much of children's understanding of the world comes through family and the significant adults in their lives.

Children grieve in different ways depending on their personality, age and their understanding of death. Children need information and explanations in order to make some sense of what has happened. Be honest and talk in language that children understand. Information and reassurance help a child make sense of a loss.
Children can experience a variety of grief reactions
Emotional responses may include fear, anxiety, confusion, anger, sadness, relief,
loneliness, guilt, isolation.
Physical responses may include low energy, interrupted sleep or eating patterns, unexplained aches and pains.
Behavioural responses may include lack of concentration, temporary dis-improvement in
school work, memory loss, 'acting out', aggression, irritability or regression to behaviour
more commonly associated with a younger age (such as bed wetting, thumb-sucking, or baby talk).
Social responses may include loss of self-esteem and confidence, withdrawal from
friends and activities, or a fall-off in school attendance.

Children may exhibit none, some, or many of these responses. All bereaved children and young people need to be heard and have their need for information, simple explanations and
reassurance met after a loss.
Talking to children about suicide
This is often considered one of the most difficult conversations to have. However, it is better a child hears it from a parent or someone in their immediate family circle rather than indirectly. How much information you give depends on the child's age and personality. Suicide can be explained in stages, in the first instance you might explain that the person has died, and then there may be details of when and where, and that the person caused themselves to die because in their mind living had become too hard for them. Be aware of the shock factor. Repeat key information later. Check with them as to what they have understood.

The child may be angry and frustrated and have questions you can't answer, and you may have to explain that you don't have all the answers.Very often children imagine that they caused the person to die, and with suicide children worry that they could have done something to prevent it. Reassure them that this is not the case.

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The First Steps in Talking to Children about Grief - Irish Childhood Bereavement Network

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Sharing difficult news with children Naturally we want to shield children from pain. Giving a child difficult news about a death or serious illness is not easy at a time when you can be overwhelmed by grief yourself.

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0:00 / 8:29•Watch full video

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British Heart Foundation - The Small Creature, an animated story to help bereaved children

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We help children, young people, parents, and families to rebuild their lives when a child grieves or when a child dies.

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Parenting and Family Support - Family Lives (Parentline Plus) | Family Lives

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Parenting and family support from Family Lives (formerly Parentline Plus) through our website, helpline 0808 800 2222, email service at askus@familylives.org.uk, live chat and local services.

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How to not need a holiday after the holidays

The holidays can be a stressful time for single parents, Natalie is a volunteer in our Wellbeing Digital Group and recently held an online workshop where she shared her 'go to' tools for managing the...

Read more

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We are Gingerbread, the charity for single parent families. We provide expert advice and practical support for single mums and dads in England and Wales.

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therapy resources | therapy comics | sleep

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A workbook on sleep hygiene using comics instead of text

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Fortunately, specific behavioral changes and adjustments to the sleep environment will help most children with insomnia. We've compiled the top tips that are proven to help kids sleep. The recommendations outlined here are best suited for toddlers through early adolescence. Both babies and teens will have specific considerations of their own.

These lists may seem long, but you don't need to implement them all at once. It's better to focus on trying a few small changes, giving them time to work, and then adjusting your approach based on how your child responds.

Keep in mind that every child's sleep needs will vary based on their age, genetics, and cultural differences. Therefore, not all approaches will work equally well for all children, and there can be an element of trial and error. However, your patience will be rewarded in time as your little one learns to fall asleep quickly on their own and keep sleeping soundly through the night.

Sleep hygiene - a collection of habits and behaviors that promote good sleep - is vital for children. Many sleep struggles are caused or made worse by poor sleep hygiene. When practicing sleep hygiene, remember that consistency is key. Sleep strategies take time and repetition to be effective.

Create a Routine: Humans are creatures of habit. A lets your child's body and mind know that it's time to settle down and prepare for sleep. The actual routine can be specific to your child, but it should last around 20 minutes and consist of three to four quiet, soothing activities such as putting on PJs, brushing teeth, a warm bath, and reading. Bedtime routines provide children with a sense of familiarity and comfort, which acts in direct opposition to the uncertainty of insomnia.

Set a Bedtime: A sleep schedule works with your child's natural biological clock to promote dozing off with regularity. Bedtimes are most useful when they're consistent, so try to keep the same bedtime on weekends as on school nights. Altering bedtimes during the weekend will make it more difficult for kids to maintain their normal weekday schedules.

Implement a Screen Curfew: The ubiquity of screens makes this rule hard to implement, but it's well worth it. Mobile devices, TVs, and tablets emit a type of blue light that suppresses melatonin, a hormone that promotes sleep. Children may be to the effects of light from screens. Screen time also stimulates the brain, making it harder to wind down for sleep. Electronic devices should be kept out of the bedroom and ideally not used within one hour of bedtime. Consider using the created by the American Academy of Pediatrics.

Get Exercise: Physical activity is proven to help people of all ages . Most children need at least of exercise per day. Just make sure to avoid vigorous activity within two hours of bedtime. Otherwise, your child may feel wound-up and find it harder to fall asleep.

Avoid Scary or Violent Content: Feeling scared or worried is a common reason kids can't sleep. So it's no wonder that scary or violent movies, TV, video games, and even books in the evening are in children. If your kiddo likes the gory or spooky stuff, save it for the daytime.

Nix Caffeine: This is a no brainer. Caffeine is a stimulant that can both make it harder to fall asleep and reduce the quality of sleep. In addition to the usual suspects like soda, coffee, and energy drinks, watch out for more discreet sources like tea, decaf coffee (which still has trace amounts of caffeine) and chocolate. Even small amounts of caffeine can have a in a little body. Don't let your child consume caffeine , or preferably, avoid it all together.

Don't Sleep With a Pet: While it's tempting for tots to snuggle Fido in bed, a pet's movements and noises during the night can awaken them from a peaceful slumber. Try having your furry family member sleep outside of your child's bedroom for a few nights to see if that helps. To make the transition easier, include saying goodnight to pets in the bedtime routine.

Optimizing your child's bedroom is an integral part of inducing quick and seamless shuteye. People with insomnia are more likely to be distracted by an uncomfortable bedroom National Library of Medicine, Biotech Information The National Center for Biotechnology Information advances science and health by providing access to biomedical and genomic information. View Source , which makes sleep even harder. These tips can help you create the perfect sleep setup for your little one:

Room Temperature: The body and brain both in preparation for sleep, and this can be disrupted by a stuffy bedroom. To avoid this, try to keep the thermostat around 65 degrees.

Noise: Research suggests that even mild sound disturbances can , even if the sleeper never awakens. Consider noise-blocking curtains to cut down on street noise. You can also use a fan or white noise machine to drown out unpredictable or distracting sounds.

Light Level: Start dimming indoor lights as bedtime approaches, and keep your child's bedroom as dark as possible. This and . If your child is afraid of the dark, a small nightlight is okay.

Soothing smells: Calming scents like can have mild sedative effects. You might try using essential oils, a room diffuser, or dried potpourri sachet to provide a soothing, sleep-inducing smell.

Unfortunately, childhood anxiety is steadily rising Centers for Disease Control and Prevention (CDC) As the nation's health protection agency, CDC saves lives and protects people from health threats. known to disrupt sleep Anxiety and Depression Association of America (ADAA) ADAA's mission focuses on improving quality of life for those with anxiety, depression, OCD, PTSD, and co-occurring disorders through education, practice, and research. View Source . Stress is View Source in all ages, so anything that can reduce worrying before bed is helpful. Help your child learn to manage their concerns with these tactics:

Write In a Journal: Encourage your child to get their anxious thoughts out of their head and onto paper. It can also help for them to write about the good things that happened in the day. Focusing on the positive will help children feel more secure.

Mindfulness Exercises: Mindfulness exercises like meditation are proven to . There are many kid-friendly meditations that parents and children can do together. These often consist of simple breathing techniques, body awareness, or guided imagery. Look to books, tapes, and even smartphone apps for ideas.

Create a Worry Time: It's okay to discuss worries, just not at bedtime. Set aside a specific time during the day for your children to discuss their concerns and how to cope with them. This can free children of the need to dwell on worries before bed.

It's normal for even the best little sleepers to awaken from slumber and ask for a parent. When your child cries out for you, it's okay to tend to them. However, you should do so with intention. This is not the time to give in to demands, as doing so can increase stimulation and make it harder to fall asleep. Fulfilling your child's every request can also reinforce an unhelpful pattern of relying on parental assistance for sleep.

Instead, keep the checks short and simple. The point is to provide your child with reassurance that they're safe and cared for, while still fostering their ability to self-soothe and sleep on their own. Some parents may even wait a few seconds before answering a call so that their child has the opportunity to fall back asleep on their own.

If you have any doubt over whether your child's nighttime checks are appropriate, consult your child's doctor for guidance.

If your child continues to have trouble sleeping despite your best efforts, it may be time to check in with their pediatrician. Although uncommon, there can be more serious causes of childhood insomnia, such as childhood sleep apnea or restless leg syndrome.

Any of these reasons are cause to involve a doctor:

Significant daytime sleepiness

Frequent or severe snoring or other abnormal breathing during sleep

Suspected psychological or developmental condition

Considering medications or supplements to aid in sleep

For a couple of weeks before the doctor appointment, it can help to keep a sleep diary. This is a nightly recording of your child's bed time, nap times, sleep length, and activities. A sleep diary helps to identify patterns and possible problems to address.

Learn more about our Editorial Team

References

Esparham, A. (2020, January 2). Melatonin and Children's Sleep. HealthyChildren.Org.
https://www.healthychildren.org/English/healthy-living/sleep/Pages/Melatonin-and-Childrens-Sleep.aspx

Mindell, J. A., Li, A. M., Sadeh, A., Kwon, R., & Goh, D. Y. (2015). Bedtime routines for young children: a dose-dependent association with sleep outcomes. Sleep, 38(5), 717-722.
https://pubmed.ncbi.nlm.nih.gov/25325483/

LeBourgeois, M. K., Hale, L., Chang, A. M., Akacem, L. D., Montgomery-Downs, H. E., & Buxton, O. M. (2017). Digital media and sleep in childhood and adolescence. Pediatrics, 140(Suppl 2), S92-S96.
https://pubmed.ncbi.nlm.nih.gov/29093040/

Family Media Use Plan. (n.d.)., Retrieved September 23, 2020, from
https://www.healthychildren.org/English/media/Pages/default.aspx

A.D.A.M. Medical Encyclopedia. (2017, August 30). Benefits of Exercise., Retrieved August 30, 2020, from
https://medlineplus.gov/benefitsofexercise.html

A.D.A.M. Medical Encyclopedia. (2017, August 30). How Much Exercise Do I Need?., Retrieved August 30, 2020, from
https://medlineplus.gov/howmuchexercisedoineed.html

Garrison, M. M., Liekweg, K., & Christakis, D. A. (2011). Media use and child sleep: the impact of content, timing, and environment. Pediatrics, 128(1), 29-35.
https://pubmed.ncbi.nlm.nih.gov/21708803/

Temple J. L. (2019). Review: Trends, Safety, and Recommendations for Caffeine Use in Children and Adolescents. Journal of the American Academy of Child and Adolescent Psychiatry, 58(1), 36-45.
https://linkinghub.elsevier.com/retrieve/pii/S0890856718318847

Drake, C., Roehrs, T., Shambroom, J., & Roth, T. (2013). Caffeine effects on sleep taken 0, 3, or 6 hours before going to bed. Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine, 9(11), 1195-1200.
https://pubmed.ncbi.nlm.nih.gov/24235903/

Narisawa H. (2013). Anxiety and its related factors at bedtime are associated with difficulty in falling asleep. The Tohoku journal of experimental medicine, 231(1), 37-43.
https://www.jstage.jst.go.jp/article/tjem/231/1/231_37/_article

Harding, E. C., Franks, N. P., & Wisden, W. (2019). The temperature dependence of sleep. Frontiers in Neuroscience, 13, 336.
https://pubmed.ncbi.nlm.nih.gov/31105512/

Van Der Werf, Y. D., Altena, E., Schoonheim, M. M., Sanz-Arigita, E. J., Vis, J. C., De Rijke, W., & Van Someren, E. J. (2009). Sleep benefits subsequent hippocampal functioning. Nature neuroscience, 12(2), 122-123.
http://www.nature.com/articles/nn.2253

Burgess, H. J., & Molina, T. A. (2014). Home lighting before usual bedtime impacts circadian timing: a field study. Photochemistry and photobiology, 90(3), 723-726.
https://pubmed.ncbi.nlm.nih.gov/24918238/

Gooley, J. J., Chamberlain, K., Smith, K. A., Khalsa, S. B., Rajaratnam, S. M., Van Reen, E., Zeitzer, J. M., Czeisler, C. A., & Lockley, S. W. (2011). Exposure to room light before bedtime suppresses melatonin onset and shortens melatonin duration in humans. The Journal of Clinical Endocrinology and Metabolism, 96(3), E463-E472.
https://pubmed.ncbi.nlm.nih.gov/21193540/

Koulivand, P. H., Khaleghi Ghadiri, M., & Gorji, A. (2013). Lavender and the nervous system. Evidence-based complementary and alternative medicine : eCAM, 2013, 681304.
https://www.hindawi.com/journals/ecam/2013/681304/

National Center on Birth Defects and Developmental Disabilities. (2020, June 15). Data and Statistics on Children's Mental Health. Centers for Disease Control and Prevention.
https://www.cdc.gov/childrensmentalhealth/data.html

Anxiety and Depression Association of America. (n.d.). Sleep Disorders., Retrieved August 31, 2020, from
https://adaa.org/understanding-anxiety/related-illnesses/sleep-disorders

Ong, J. C., Manber, R., Segal, Z., Xia, Y., Shapiro, S., & Wyatt, J. K. (2014). A randomized controlled trial of mindfulness meditation for chronic insomnia. Sleep, 37(9), 1553-1563.
https://pubmed.ncbi.nlm.nih.gov/25142566/

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Sleep Strategies for Children | Sleep Foundation

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Wondering about sleep aids for kids? These proven sleep tips will help children learn to fall asleep quickly and stay asleep.

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A collection of resources based on the idea of sleep hygiene
Suitable for settings working with all ages (age suitability marked on each resource within this collection)

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Fight Flight Freeze – A Guide to Anxiety for Kids

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Anxiety

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Emotions Wheel

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Emotions wheel art therapy - Elsa Support for emotional literacy

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Emotions wheel art therapy. Children can explore what each emotion means to them and also be creative as they do it. Great for discussion.

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Downloads

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New guide for parents who are coping with their child's self-harm: 'You are not alone'

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Young people's self-harm can leave families confused, anxious and feeling like there's nowhere to turn. Now, based on in-depth research with parents, a team from Oxford University's Centre for Suicide Research are launching a guide to help parents and carers who are trying to cope with this difficult situation.

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Winston's Wish is the UK's childhood bereavement charity. We support children and their families after the death of someone important.

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panic attacks

Panic attacks, Panic Disorder and Agoraphobia are common problems and respond well to psychological treatment.

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One of the main treatments is graded exposure. This is a behavioural intervention that can be illustrated in an easy to understand way. Elements of this booklet may also be useful in the treatment of other anxiety disorders.

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This booklet covers the main principles of graded exposure. It is designed to be used with a therapist explaining how to carry out the intervention, and the booklet illustrates the main concepts. Outside of sessions the illustrations will have enough information to act as a reminder to the client.

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Instead of having a traditional "Exposure Diary", there is a graph where individuals can track their experience of exposure exercises. They can log their level of anxiety before, at the start, and at the end of each exposure exercise, and this will let them see the process of habituation.

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It's recommended that one graph sheet is used per step on their graded exposure hierarchy.

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therapy resources | thrapycomics | panic

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A workbook to treat panic attacks and panic disorder using graded exposure. Uses comics instead of text.

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It's normal for children and young people to feel worried about something that's happening at school - for example, when starting a new school or during exams. Sometimes, however, school can become challenging, stressful or distressing over a much longer period of time.

If your child is feeling anxious about school, or not able to go, it can be exhausting for both of you. Mornings in particular can become really stressful for the whole family, as you try to juggle your child's feelings alongside the need to get them to school and get on with your other responsibilities such as work. Even if you manage to get your child to the school gate, you might know how difficult they're going to find the day - or know that you'll be facing the same problem tomorrow morning.

If you're in this situation, we've got advice to help you explore what's going on with your child, make changes at school that can help, and find the support you need if your child can't go to school.

About the term 'school refusal'

When anxiety builds up to the point that a young person cannot go to school, this is often called 'school refusal' - and you might hear the school or other professionals using this term. However, many young people and parents do not like this term because it implies that 'refusing' school is a choice, and you may prefer to use terms such as emotionally-based school avoidance (ESBA) or anxiety-related absence.

What makes young people feel anxious about school?

Young people can feel anxious about school for lots of different reasons. They might be worried about making friends or fitting in, find schoolwork or lessons confusing, feel pressured to learn in a certain way or find their relationships with teachers difficult.

Sometimes, going through difficult experiences outside of school - such as bereavement, an illness in the family or being a young carer - can also make it harder for a child to feel settled at school.

For some young people, the school environment isn't right for them, and trying to fit into it can create a huge amount of stress. This might be the case if they are struggling with their mental health, or have a neurodiverse condition or Special Educational Need (SEN) such as autism, ADHD, dyslexia or dyspraxia. This can make the school environment anxiety-provoking and exhausting, especially if their condition or need is undiagnosed or not being well supported.

Young people might show they're feeling anxious about school by:

not wanting to get up and get ready

saying they can't go

worrying a lot about small issues, such as having the right equipment for a lesson

feeling sick, or having stomach aches or headaches

not sleeping well

not doing schoolwork, or their grades dropping

being angry or upset, or acting out - at school or at home

withdrawing - seeming low, quiet or depressed

Finding out what's going on for your child

Sometimes it can be difficult to work out what's making your child feel anxious, and the first step is often helping them to identify exactly what's worrying them. Once you understand the problem, you'll be in a much better position to make changes that can help.

Young people can find it hard to explain what's causing their feelings, and might not be able to answer direct questions like 'what's going on?' Using an anxiety iceberg can help to open up the conversation - giving you a more relaxed way of exploring together what's causing their anxiety.

Watch our video to find out how to make an anxiety iceberg with your child.

If you're making an anxiety iceberg with younger children, you might want to draw images on the iceberg, or encourage them to write simple words. With older children and teenagers, you can ask them to write key words and phrases on the iceberg, or do this as a mind map, with 'school' in the middle and all the things they're finding difficult around the outside.

Through this exercise, you might identify worries such as arriving at school, finding the environment noisy or overwhelming, finding lessons confusing, feeling lonely through the day, or feeling uncomfortable during specific subjects.

Making changes at school

Once you understand what's going on for your child, you can use their anxiety iceberg or mind map to communicate with the school and ask for specific changes.

Follow these steps to start a conversation with the school:

Here are some examples of things you can ask the school for:

Remember that even though this situation can be really tough for you and your child, it's a good idea to maintain a positive relationship with the school. Recognise the support they're offering and any changes they're making. This will help you work together to make things better for your child.

Building a relationship with the attendance team at my son's school was hugely helpful, we were talking with them each day.

Strategies you can try at home

For more information and advice on managing anxiety, have a look at our guide for parents.

If your child isn't able to go to school at the moment

If your child isn't going to school at the moment, this can be incredibly stressful and exhausting for you - and really tough for your child. You might be worried about whether they will be able to get back to school or the impact on their education. Or, you might feel overwhelmed because you're juggling this alongside work and other family commitments.

If your child's anxiety about school has built up to the point where they can't go, it's a good idea to get them some professional mental health or SEN support - see our advice on this below.

Alongside requesting professional help, try to:

The school's SEN and attendance policies should be on their website. Knowing what these are can support you during meetings with the school.

This can help if your child is unable to go to school for a longer period of time and you need to ask for more support, including provision of alternative full-time education.

Encourage your child to get up, do some studying and stop for lunch at the same times they would if they were in school. This will make adapting back to school easier. Explain to your child that if they cannot go to school, they will need to study at home - at least until alternative arrangements are put in place. Ask the school to help you facilitate tasks and activities your child can do and use online resources such as BBC Bitesize.

Not going to school could leave your child feeling really isolated. Make sure they stay connected to the outside world by seeing friends and family, doing activities they enjoy and getting outside for walks and exercise.

Speaking to friends online can be really important if your child is feeling isolated at home. Sometimes, however, you might notice that your child is spending lots of time gaming or on their phone, and that this is getting in the way of important daily activities like spending quality time with family, learning, or sleeping and eating well. If this is becoming a problem, have a look at our guide to gaming or guide to social media for more information and advice.

Local authorities must provide alternative education if a child of compulsory school age is unable to attend school over a longer period of time. If your child cannot attend school because of a mental or physical health issue, the local authority should provide an alternative as soon as it is clear that they will be away from school for more than 15 days (either consecutively or over time). Find out how to request alternative education.

What will happen if my child doesn't go to school?

Parents often tell us they are worried about fines and prosecution, but schools generally consider this only if they feel there is no valid reason for the absence, or that parents aren't engaging with the problem.

If the absence is prolonged, the case may be referred to a local council Education Welfare Officer (EWO). They will arrange a home visit to find out more and discuss strategies. The school may also refer to other support, including from CAMHS.

Helping your child return to school after an absence

Getting back to school after weeks or months may feel extremely difficult for your child, but you and the school can help make it more manageable. Here are some things you can do to help:

Set small, achievable targets, such as visiting the building outside school hours or attending one lesson.

Request a home visit from a school staff member so your child can check in while feeling safe, see that the school cares and discuss any strategies that might help them.

Ask for a reduced timetable, with regular reviews to discuss building back up at a manageable rate.

Discuss changing classes or sets if your child thinks this would help.

Focus on qualifications needed for what your child wants to do next, perhaps dropping a less relevant GCSE to reduce stress.

My son wasn't questioned about his absence when he did feel able to pop in for favourite lessons, helping to ease him back into full days of education.

Getting mental health and SEN support

If your child is struggling with anxiety and it's affecting their day-to-day life, learning or relationships, it's a good idea to find some professional support. Speaking to the GP and finding them a counsellor or therapist are two good places to start. You can find more information about GPs, counsellors and other mental health services in our guide to getting help for your child.

If there is no other obvious reason for your child's inability to attend school, they may have an undiagnosed Special Educational Need (SEN) such as dyslexia, autism or ADHD.

If you think this is the case:

Speak to the school's SENCO or your GP to ask for a referral for an assessment.

While you are waiting for an assessment, you can also ask the SENCO to refer your child for support from other professionals, such as an Educational Psychologist or Speech and Language Therapist. These professionals can identify specific needs and make recommendations for additional support the school can put in place - even if your child hasn't had a formal diagnosis yet.

SEN support at school
If your child is diagnosed with SEN, extra support and adjustments should be put in place at school to help them attend and learn. This is called SEN support, and should be available within the school's existing resources. Speak to the school's SENCO in the first instance about how the school will support your child.
Education, Health and Care (EHC) plans
If you do not think your child's needs can be met by the school's existing resources, you can ask the local authority to carry out an Education, Health and Care needs assessment (EHC needs assessment). If the local authority decides your child needs additional support, they will then make an Education, Health and Care plan (EHC plan). This outlines how the extra support they need will be provided. Find out more about EHC plans.
Your Local Offer
Your Local Offer is the information, support and services available for young people with SEN, and for their parents and families. You can find out what support is available in your area by going to your local authority's website and searching for their Local Offer.

If you need more information and advice about getting the right education for your child when they have been diagnosed with a Special Educational Need (SEN), IPSEA can help.

If you need to talk through a problem, their Advice Line can provide support with any educational issue resulting from your child's SEN. You can also find lots of information, including information on assessments and diagnosis, as well as getting support from the school and local authority, on their website.

Finding more information and advice

Useful helplines and websites

While we take care to ensure that the organisations we signpost to provide high quality information and advice, we cannot take responsibility for any specific pieces of advice they may offer. We encourage parents and carers to always explore the website of a linked service or organisation to understand who they are and what support they offer before engaging with them.

You might also find this helpful

We have more tips and advice on supporting your child with school, and information about how you can get in touch with our Parents Helpline.

This page was reviewed in December 2022. It was created with parents and carers with lived experience of supporting their child or young person with school anxiety. We will next review the page in 2025. YoungMinds is a proud member of PIF TICK - the UK's quality mark for trusted health information.
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School Anxiety and Refusal | Parent Guide to Support

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If your child is anxious about school, or refusing to go to school at all, read our tips and advice on how you can support their mental health.

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A collection to encourage children to develop a positive mindset and to look for the positives in each day.

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Parenting and mental health - Beyond Blue

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Find parenting information and resources to support mental health and wellbeing for children, young people and families.

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When you are in the yellow or red zone, try some of these ways to help you calm down. Which one worked for you?

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We all feel angry sometimes, and that's okay. Try some of these activities to help you calm down and get back to the green zone.

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Mental health support for parents and carers – Place2Be

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Advice and resources for parents and carers to help support their child or young person’s wellbeing.

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Mental Health Resources For Children and Young People

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Free mental health resources, posters, lesson plans and activity sheets for primary and secondary school staff, and mental health professionals working with children and young people.

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Sarah Alleyn (The Blurt Foundation)

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This page contains affiliate links, read the disclosure statement Inside: Kid tested strategies used by child therapists for calming anxiety, including ideas to calm down, books to read and videos that can help
It's happening again. Your daughter is frustrated and stomping away down to her room, slamming the door and in general "has her cranky pants on". You say calm down, but she yells back "I don't know how to do that!!!"

We tend to tell our kids to "calm down" without ever giving them explicit directions on how to deal with stress and anxiety. Here's a collection of the best tools and tips I've found to teach children how to calm down and relax.

Sometimes you'll need a quick way to help your child calm down and you don't have much with you. Maybe it's when you're out at Target or stuck in traffic. These tips will come in handy at those times:

Imagine your favorite place - it's like taking a mini vacation wherever you are

Think of your favorite things

Name animals alphabetically (alligator, bear, cow, dog, etc...)

Squeeze Something (play dough, clay, silly putty, your fists, a stress ball)

Get a Cold Drink of Water

54321 Grounding - go through each of your 5 senses

Put your arms straight out in front of you, palms facing out.

Put one hand over the other at the wrists and interlace your fingers.

Swoop your hands and arms toward your body and then place your interlaced hands on your chest.

Cross your feet at the ankles and put your tongue on the roof of your mouth.

Stay still for one minute.

It's great to have a big list of coping skills to try when your child needs to calm down. Here are two more short lists of ideas for calming down at home or at school.

From Imperfect Families - Strategies to use at home

From Encourage Play - 10 Strategies to Help Kids Calm Down at school or home

People usually roll their eyes initially when they hear "breathing is important". But I will continue to say it and explain why. It's so simple, yet has such a big impact on your body's physiology.

When you and calm and relaxed, your body is in "rest and digest" mode. You breathe normally, your heart rate is lower and your muscles are relaxed. However, when stress or anxiety or anger occurs, your body automatically switches into "flight, fight or freeze" mode. Your muscles tense up, your heart rate increases and your breathing becomes more shallow.

Taking deep breaths, instead of shallow breaths, is one way to tell your body to get back to resting and digesting. That's why deep breathing is important!

Luckily, there are some fun ways to teach kids deep breathing techniques

Things to use

Things to say

Breathe in like you are smelling a flower, breathe out like you are blowing out birthday candles

Arms up and breathe in, arms down and breathe out

Pretend your belly is a balloon. Breathe in and make the balloon bigger, then breathe out and make the balloon shrink.

Videos to watch
4 - 7 - 8 Breathing by GoZen
Breathing at Sea Otter Cove from Stress Free Kids

A Coping Skills Toolbox is a kit that you create to help your child calm down when they are upset, anxious or worried. In order to get the most benefit from this, you should create this kit before an issue occurs. When your child experiences anxiety, then they can pick out an item from their Coping Skills Toolbox. This is one of my favorite ways to help kids learn to calm their anxiety.

Here are some other fantastic ideas for what to put in a coping skills toolbox/calm down kit from And Next Comes L

You can create a place specially designed to allow to calm down in a few steps

Find a spot and make it cozy (ask your child for help with that - maybe they can place a favorite blanket or stuffed animal inside)

Add calming tools

Explain how to use it and practice before

When they are starting to escalate, catch it early and give them a calm reminder about their calm down spot

Use the following phrases as a way to support your child, let them know that you're going to support them and help them in any way that you can.

"I'm here for you"

"Talk to me and tell me what's going on"

"How can I help?"

"Together, we can work on this. We're a great team"

"I love you"

"Do you want a hug?"

Here are some more ideas of what to say to calm an anxious child.

From Go Zen - 49 Phrases to Calm an Anxious Child

From Lemon Lime Adventures - What to Say to Calm an Anxious Child

Did you know there are podcasts with stories for children? Usually the hosts have a soothing voice and the stories tend to be pretty short. Your child can listen to these podcasts as a way to have some down time.

There are scripts you can read to your child to help them relax and calm down. Slowly and carefully read the words as your child listens and follows the instructions. Check out Inner Health Studios list of scripts you can use with your child. If you prefer not to read a script, there are ones that are pre-recorded.

There are also scripts to practice mindfulness with children. Eline Snel has written a great book on Mindfulness with Kids, Sitting Still Like a Frog. Here are the several scripts that can be used from that book!

Annaka Harris also has several pre-recorded scripts to help kids practice mindfulness

Confused about how to introduce mindfulness to kids? Check out these resources:
Simple Ways to Introduce Mindfulness and Meditation to Children 11 Simple But Effective Ways to Teach Mindfulness to Kids
What you need:

I've used empty soda bottles, empty water bottles, glass jars and plastic containers. Use whatever makes sense for you and your family. For instance, for the calming jars the kids have in their room, I used a heavy duty plastic bottle. I didn't want them to accidentally knock over a glass jar in the dark - that would be a huge mess!

I've had the best results when I've used warm water - it makes it easier for the water and paint to combine.
Glitter Paint
I prefer using glitter paint (or glitter glue) instead of glitter because then I'm not cleaning up glitter for weeks at my house after we make them :-)

To make your jar, add glitter paint to the bottom of the jar until it just covers the bottom of it. Add warm water. Put the cover on and shake to help the ingredients combine. Once you are satisfied with the look of your jar, then you can super glue the lid shut so it doesn't spill. In a pinch, I've also used duct tape to secure the lid.
Watch Make a Simple Calming Jar from Coping Skills for Kids on YouTube Wet Ingredients
Sometimes you want the glitter/other items to stay afloat longer or for a shorter amount of time. Here are some different ingredients you can use as the wet ingredients.
Dry Ingredients
To see several other ways to make calming jars, take a look at what Preschool Inspirations did.

One of the first things I always like to do with kids if they are struggling is to start using visuals. When you're stressed and anxious, it's harder to read and take in information. Visuals are easier.

I like to keep calming cue cards in my children's coping skills toolboxes so that they can make a decision about what coping skill they can use. Sometimes pulling out a list is too much in the moment. You can make your own cue cards.

Take several index cards or small pieces of cardstock

On each one, write or draw one coping skill

Hole punch the cards and place them on a keyring (to make them extra sturdy, you can laminate them)

Put them into the coping skills toolbox for easy access

Using visuals is a powerful way to help kids. When kids are overwhelmed, sometimes it's hard for them to figure out what to do. By having cue cards, your child can have a visual reminder of what calms and relaxes them.

To make things a little easier, I've created ready to use coping skills cue cardsfor you. There are four different sets: Calming, Physical, Distracting, and Processing. If you'd like all 4, I created a set where you can download them all together.

If your child is anxious, they may also be having a difficult time getting settled for bedtime. Here are some ideas to help your child get settled at bedtime.

PINPOINT WHAT THE FEAR IS

One of the most important things to do is to figure out exactly what is causing the anxiety. Is it fear of the dark? Is it a worry about something in the closet? Is it monsters? Is it spiders? Figuring out the cause of the fear will help you come up with ways you can help your child combat it.

REARRANGE THE ROOM

Are there particular spots of the room that seem to be darker or cause more fear at night than others? Go into the bedroom during the day with your child and talk about the spots that make your child nervous. Try moving night lights and furniture around for a more calming room arrangement.

TRANSITIONAL OBJECTS

If your child has a hard time separating from you, try a transitional object. This is a special item that helps your child feel comforted. It helps them feel like part of you is still present even when you're not there. It could be something like a stuffed animal or a special stone or necklace, or a sweatshirt of yours. The object isn't what matters, it's what the object represents. They can keep it and hold it all night long to help them relax and go to sleep.

Find more strategies here: 12 Kid Friendly Strategies to Calm Anxiety at Night

Looking for some calming guided meditation to help get to sleep at night? Try one of these: Best Guided Meditations for Sleep.

Whenever I sit down and talk with someone about their coping skills, one of the first
things I ask is if they have tried writing about it. Why do I always start with journaling as
a way of processing through difficult feelings?

It's easier to write about than talk about hard things

Journaling helps you process what's happening.

It's convenient.

It's not graded

It can help you solve a problem

It can help you re-frame your thinking

Looking for a journal for a child or teen? Check out Big Life Journals!

General Anxiety

The Coping Skills for Kids Workbook by Janine Halloran. This book has over 75 strategies for kids to try to help them manage their stress and worry. This book also includes colorful worksheets to help kids learn more about their anxiety and what they can do to manage their stress.

Wilma Jean the Worry Machine by Julia Cook I love that when Wilma Jean's physical reactions are described, they're also illustrated. When is says she has knots in her stomach and her knees lock, her stomach really looks like it's tied in a knot and there's a real lock around her knees. I love the activity she does with her teacher, going over worries she can control and worries she can't, it's a great way to help kids manage their anxiety.

David and the Worry Beast by Anne Marie Guanci David's anxiety is a beast, and the more anxious he gets, the bigger it grows. David learns to control his thoughts, and his beast shrinks. There's also a couple of pages for parents and kids in the back.

When My Worries Get Too Big by Kari Dunn Buron This book is wonderful! There are several pages where kids can add in their own thoughts, worries and what helps them relax. This book also uses the 5 point scale to talk about stress and different ways to manage it.

What To Do When You Worry Too Much by Dawn Huebner, PhD This book goes through several ways that can help kids manage anxiety, including setting a time for worries, thinking about things that make you happy and resetting your body with activity or relaxation. There are some interactive places in this book, where a child can write down their worries, draw some images of things that might help, etc.

What To Do When You're Scared and Worried by James J. Crist This is one of my favorite books for kids to help them deal with anxiety. Near the beginning of the book is a checklist that helps kids narrow down what they are anxious about. The beginning of the book covers the basics of what anxiety is and how to help manage with coping skills. The next section of the book goes into detail about different types of anxiety kids might experience, including Separation Anxiety, Phobias and Panic Attacks.

Separation Anxiety

The Kissing Hand by Audrey Penn Classic about managing separation anxiety when kids start school. My daughter's kindergarten teacher read this on our visit to school the first day.

When I miss you by Cornelia Maude Spelman This is perfect for little ones who have a hard time dealing with the fact that they are away from their parents during the day. It suggests a couple of things they can do to help and reassurance that parents will come back at the end of the day.

Wemberley Worried by Kevin Henkes Poor Wemberley worries about everything, and then she gets really worried when she is about to start school.

This E-Course offers you instant support from a Child Therapist.
You will get:
12 Videos that are quick and bite size

14 Exercises that will expand on the skills taught

6 Cheat Sheets that will serve as a reference
Along with the course you get:
Access to the instructor for ongoing support

Downloadable PDF versions of all lessons

Lifetime access to the course

More from Coping Skills for Kids about Anxiety in Children...

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Calming Anxiety - Coping Skills for Kids

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Inside: Kid tested strategies used by child therapists for calming anxiety, including ideas to calm down, books to read and videos that can help