Using Social Stories to Overcome Childhood Situational Anxiety

Using Social Stories to Overcome Childhood Situational Anxiety

As an elementary school social worker, I often encounter children with a range of mental health challenges. While some are struggling with more severe difficulties, many have relatively “low-level” social-emotional concerns that involve strong emotional responses to a situation that is effectively solved with a brief, impactful intervention rather than requiring intensive assessment and weekly counseling sessions. Oftentimes, these issues seem to pop up out of nowhere and can be quite debilitating to the child and the family until it is properly addressed.

Social challenges are particularly common during the elementary-school years because children are introduced to a lot of “firsts” during this time. For example, unexpected anxiety attacks may occur on the first day of school, during fire drills, when eating at the lunch tables, while participating in a school performance, when visiting the dentist or doctor, or on the playground. Sometimes, anxiety and trepidation are experienced by children who are facing a situation they have encountered many times in the past, such as while working on a group project, playing on the playground, or reading aloud in front of the class.

Frequently, children in socially uncomfortable situations will experience some degree of apprehension while they consider how to react. Ideally, they will learn from the situation and will have the insight and skills to effectively manage it when they are faced with it for a second time; this knowledge leads to confidence and mastery and reduces the degree of stress associated it. For other children, certain social situations can cause a great deal of anxiety and may lead the child to refuse to participate in that event.

As you might imagine, these situations leave the parent to figure out how to support the child in facing their fears and limiting the amount of distress associated with it. Parents often worry that if they allow their child to avoid participation, they may encourage avoidance and reinforce their fear to the extent that they will be even less likely to want to participate in the future; on the other hand, parents worry about traumatizing their children and struggle to watch their child’s pained face when pushed to participate.

As a professional, I have always tried to be sensitive to both the child and the parent. I have used my academic and clinical experiences to guide my responses and support the family in addressing these issues. Recently, the tables have turned and I’ve found myself in the role of the parent with a 4-year-old child who adamantly refuses to visit the dentist. While I could sympathize with parents in the past, I can now truly empathize with the feeling of being totally at a loss as to how to react in those moments. After dragging her to the dentist and watching her refuse every request the dentist asked of her, I realized we needed an intervention to support her. Thankfully, I knew just the intervention, so we went home and began writing a Social Story!

Social Stories are used to familiarize children with anxiety-producing social situations and to encourage the use of self-calming and self-awareness strategies that can help the child manage their emotions during this event. The goal is to collaborate on a story that is specific to the child’s individual circumstances and that includes strategies they can use to help get them through the experience as calmly and confidently as possible. Social stories are not meant to change the child’s behavior, per se, but instead, are intended to provide the child with information, so they know what to expect and how best to handle it. Behavioral change often occurs as a consequence because children who know what to expect are naturally calmer and therefore generally better able to handle the emotions associated with that situation.

Another great aspect of Social Stories is that you do not need any specific in-depth training to write one with your child. The following are a few guidelines to help maximize the effectiveness of your Social Story. They can be used for nearly any stressful or uncomfortable social situations your child may feel worried about or have trouble managing! I’ve included pictures of my daughter’s Social Story as an example.

Rule 1: Social Stories should be written in the first person from the child’s perspective. I always start with “Hi, my name is…” and include a picture of them smiling and happy.

elousie child portrait

Rule 2: The child should write the story with you. Some professionals write the story for the child, but I personally feel that the child is much more willing to listen and learn from the story if they help make it. I always add pictures that they approve of and let them choose the format as well. My daughter wanted to choose a Halloween theme since we made this around that particular holiday.

Rule 3: The language should be positive and reassuring as well as answer the questions who, what, when, where, and why. It should also include the target behavior you would like to see.

childhood dentist experience

Rule 4: Use descriptive and directive sentences. Descriptive sentences state the facts, include thoughts and feelings, identify what others can do to help, and are aimed at reassuring the child. Directive sentences identify possible responses and gently direct the behavior. Maintain a ratio of at least 2 descriptive sentences for every directive sentence. This will make the story more vivid and the child will feel more buy into the story (and less like they are being told what to do).

Descriptive sentence:


Directive sentence:

Rule 5: Include what will likely happen if the child correctly performs the target behavior (e.g., making a friend, having healthy teeth, having fun at school). You may have to be creative about the benefits in the case that your child is not particularly motivated or interested in the outcome. In my daughter’s case, having healthy teeth didn’t matter to her because she doesn’t understand the value of it, but she does think it’s very cool to be brave and strong, so we added this:

Rule 6: Read the story as frequently as needed. New stories should be read frequently and prior to the challenging experience. As the child begins to show less anxiety and more mastery over the situation, you don’t need to read it as often. You should keep it in case the same or a similar circumstance arises in the future. In my situation, I had Elouise bring it to the dentist and the dentist even read it with her! That was exciting to see and worked quite well!

Rule 7: For ease of printing, one last tip is to use a PowerPoint or Google Slide format and have each page of the document serve as one page to the story. I always print out Social Stories and make them into the child’s own personal book, so that they can carry it around with them and have it to look at when they need it.

It is important to periodically assess the effectiveness of the Social Story once it has been used. If the child is not responding well or showing more appropriate behaviors to the situation, the story may need to be rewritten or paired with visual supports to remind them of the desired behavior. For example, a student who misses their mom while at school might benefit from bringing a trinket to school that reminds them of their parent. This trinket should be written into the social story as a support for them when they need it. If your child is struggling with a social issue, give a Social Story a try. You never know what small change can lead to a huge difference in their lives!

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