Anxiety and Occupational Therapy – Occupational Therapist Rabia Tuge Karaman

The role of occupational therapy in promoting, preventing and intervening in mental health with children and adolescents

Anxiety disorders

Children sometimes feel anxious as a defense against stress. Mild anxiety can help to turn that anxiety into positive behavior. For example, a student is researching this topic for debate; Being prepared can help you deal with challenges like speaking in public because individuals are aware that they will learn through research. However, when anxiety is constantly present and seems to be an unreasonable fear of familiar activities or situations, it is no longer a means of coping; Rather it is a disability condition (National Institute of Mental Health (NIMH)). Depending on the example, having knowledge does not comfort one. He may also feel weak socially and communicatively.

Anxiety disorders usually begin in childhood at 6 years of age or adolescence and significantly affect daily professional performance. The Diagnostic and Statistical Manual of Mental Disorders (DSM) defines 5 types of anxiety disorders: Obsessive Compulsive Disorder (OCD), Post-Traumatic Stress Disorder (PTSD), Social Or Specific Phobias, Panic Disorder And General Anxiety Disorder. Common symptoms are:

  • Excessive, unexplained anxiety
  • Difficulty managing anxiety
  • Instability or unexplained nervous energy
  • Easy fatigue,
  • Difficulty concentrating or loss of thinking (“mind becomes empty”)
  • Annoyance,
  • Muscle tension,
  • Sleep disorders

Occupational therapists play a vital role in addressing children’s anxiety disorders in a variety of settings, including at school, in the community and at home. In each setting, the intervention can focus on a number of areas, including routine and habit setting, pleasurable activity that provides optimal stimulation or relaxation, and techniques to manage symptoms to improve professional performance. These services help children develop self-esteem and build supportive relationships with family members, school staff and coworkers.

Occupational therapists play an important role in working with teachers and other school staff and family members to meet the performance demands of children with anxiety disorders.

How does anxiety disorder affect participation?

Anxiety symptoms can interfere with a child’s ability to participate in school activities, selected activities, and social opportunities. Fear of failure, anxiety about having a panic attack, or fear of embarrassment can lead to a lack of participation even if the child wants to take action. These experiences can lead to social isolation and the effectiveness of bad activity in the domain of all life skills.

How does anxiety disorder affect mental health?

Decreased participation in social situations and activities may increase feelings of low self-esteem; It can distort the child’s self-image and disrupt life habits, routines and roles. Wellness is affected by the overall quality of life and the underlying symptoms.

Activity performance

Children with anxiety disorders may have difficulty in the following performance areas:

Social participation

  • They may avoid social situations for fear of being in an unfamiliar environment, embarrassing themselves or for fear of panic attacks.
  • If annoyed they may flee.
  • They may appear irritable and unsuitable to other children.
  • They can be withdrawn as a way to manage symptoms.
  • The whole process interferes with the enjoyment of social activity.

Daily living activities

  • Excessive anxiety, poor concentration, slow data processing, and fatigue can disrupt the ability to perform daily routines and responsibilities in the bathroom, toilet, dressing, and eating.
  • They may start a weak, uninteresting day and show less motivation.


  • They show the possibility of social isolation in breaks and canteens.
  • Difficulties concentrating and processing information can hinder participation in activities, ability to understand and follow instructions, and completion of tasks.
  • They may lose their train of thought due to the intrusion of anxious thoughts.
  • They often avoid speaking out loud in class or drawing attention to themselves.


  • They can avoid work environments that require interaction with the environment and / or where the environment is intense and unpredictable.

Game / Free time

  • They are involved in routine business alone or with a trusted friend.
  • They may have trouble relaxing and having fun.

Sleep / rest

  • May be interrupted by anxiety; It can cause fatigue during the day.

In the process, parents / carers should be closely monitored; In light of these observations, occupational therapy interventions should be applied to improve well-being and develop independence.

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