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Here's NewYork-Presbyterian's Dr. Shannon M. Bennett with some advice from our Back-to-School Guide for how students can deal with stress and anxiety as they head back to school.

While some students embrace the end-of-summer return to the classroom, for others, heading back to school causes feelings of stress and anxiety.

“Back-to-school jitters are very common, and a mild to moderate amount of anxiety and excitement about going back to school is normal and should pass relatively quickly once the new school year becomes routine,” says Dr. Shannon M. Bennett, the site clinical director for NewYork-Presbyterian’s Youth Anxiety Center and the director of the psychology division of the Child Psychiatry Outpatient Department at Weill Cornell Medicine. “If the anxiety persists or becomes more interfering in the child’s or family’s life, that’s when we would recommend seeking out an assessment or additional support. For youth who have an anxiety disorder, going back to school can be challenging.”

“Common triggers for anxiety are transition, changes in routine, or starting something new, and back to school incorporates all three,” she adds. Dr. Bennett says anxiety disorders are the most common type of childhood mental health diagnosis, affecting 8 to 10% of school-age children (ages 5 to 12 years). Some studies suggest as many as 1 in 3 adolescents has an anxiety disorder before age 18.

How can parents help soothe first-day jitters in their school-age kids?
Touring the school before the school year begins and meeting your child’s teachers could help familiarize students with their surroundings once school starts. Talk to your kids about what the routine will be like. If there’s a new schedule, go over what’s involved and discuss what classes they will be taking, so they can have some sense of knowing what’s to come. Finally, focus on the things that can be exciting about going back to school and starting a new year. This might be learning new things, getting new school supplies, new clothes, new books, and making new friends.

What treatment is available to kids for whom these tactics don’t work well enough to offset their anxiety?
The type of therapy we recommend for youth with anxiety is called cognitive behavioral therapy, or CBT. It’s an evidence-based treatment that focuses on teaching youth strategies for managing anxiety and not avoiding situations that cause them to feel anxious. One strategy is deep breathing. Deep breathing can be done anytime, anywhere by taking a few slow deep breaths to help to calm one’s body down and regulate the nervous system. Kids can practice it in the evening, in the morning before school, and in the classroom.

The C, or the cognitive part of CBT, has to do with our thoughts and focusing on realistic thinking. This involves challenging the worries we might have and replacing them with more realistic thoughts and expectations. For example, if a child is worried about failing a test, being laughed at on the first day, or that something bad happened to their parent while they were at school, we ask them to estimate the actual probability of these events happening.

The most powerful method we encourage kids to do, the B, in behavior therapy, is what we call exposure therapy, which is not avoiding the people, places, or things that trigger anxiety. We teach kids that it’s OK to do something that makes you feel nervous, and that it is likely that the more times you try it, the easier it will get.

What else can kids do on their own to cope with their anxiety?
Youth and parents can put together a list of what we call positive coping statements or positive self-statements that are grounded in evidence or realistic thinking. This could be “I can do this, there are people there to support me,” or “I’ve tried new things before and it went OK.” These realistic coping statements can be helpful for kids to have in a list to keep in their pocket so they can look at that on the first day of school if they’re feeling nervous.

When should parents get their kids extra help in dealing with anxiety?
When anxiety is making life difficult for a child or for their family, or has persisted for several weeks, I recommend meeting with a psychologist, child psychiatrist, social worker, or other mental health professional for an assessment and potentially for treatment if recommended. If anxiety progresses to the point of panic attacks or is really impacting a child’s mood, I recommend seeking help sooner rather than later.

I’d also seek help quickly for a child who is refusing to go to school. The longer a child stays out of school, the harder it becomes to return. Similarly, if a child doesn’t want to go on play dates or is avoiding after-school activities or other positive social and academic activities, this can be a sign that additional help is needed. The avoidance caused by anxiety robs children of the opportunity to learn that they can handle a healthy dose of stress.

Shannon Bennett, Ph.D., is an assistant professor of psychology in clinical psychiatry at Weill Cornell Medicine and the director of psychology for the Division of Child and Adolescent Psychiatry outpatient department at NewYork-Presbyterian/Weill Cornell Medical Center. Dr. Bennett also serves as the Weill Cornell site clinical director of the NewYork-Presbyterian Youth Anxiety Center and as the director of the Weill Cornell Medicine Center of Excellence for Tourette Syndrome.

This was adapted from an article that first appeared on NewYork-Presbyterian’s Health Matters.