Cognitive Coping Cards

An important tool in your child or teen’s M.A.P. is the ability to change anxious, “tumble dryer” thoughts into more realistic, balanced thinking. However, when anxiety strikes, it can be difficult for youth to remember to challenge their fear thoughts. Fortunately, cognitive coping cards can remind your child to use his/her Balanced Thinking tools to reduce unwanted anxiety. With practice, your child can use cognitive coping cards independently as soon as anxiety strikes, which is helpful as you might not always be available to remind your child to use his/her tools.

Cognitive coping cards can include small index cards, handwritten notes, Apps on a mobile device, and even key chain or bracelet messages that contain phrases or short sentences for use when experiencing anxiety. The cards, notes and related items are portable reminders to boss back anxiety, stemming directly from the tools outlined in Balanced Thinking. Creating cognitive coping cards will make the most sense if done after you and your child have learned about Balanced Thinking.


What sorts of things are helpful to put onto a coping card?

  • A reminder that physical symptoms (e.g. sweaty palms, stomach-aches) are just anxiety and not a sign of something worse
  • The name your child has given to anxiety (e.g. “Mr. Worry”, “the pest”, “Meanie”)
  • A reminder that panic attacks, while unpleasant, aren’t dangerous and only last for a few minutes
  • Positive coaching statements (e.g. “I can get through this!”)
  • A reminder to use some coping skills (e.g. I can do relaxed breathing)
  • Some calming facts your child or teen has used before (e.g. Flying is safer than driving!)


Encourage your child to get involved

Who said fighting anxiety couldn’t be fun? Make this project an enjoyable one using whatever your child is passionate about. Generate visible reminders of how to boss back anxiety using items ranging from simple art and craft materials, to making a personal video or song, or designing jewelry. For teens who are into electronics, Apps like Mindshift enable the user to develop and store his/her own coping statements. Children and teens are more likely to use the coping cards if they’ve been involved in developing them. It’s not a good idea for you to simply write them up and hand them over.


Coping Cards to Beat Anxiety

Panic Disorder: Andrea has panic attacks and is afraid she is going to have a heart attack. She has started to boss back her panic by doing muscle relaxation and facing her fears about her panic attack symptoms. 

“Anxiety can’t hurt me! It’s just a bully! If my heart is racing, I get sweaty, and my stomach hurts it just means my anxiety is acting up. I’m not in danger.”

Remember: I do better when I float with the panic and try to stay calm. When I fight against the panic, it makes my sensations worse. Coping cards can calm the storm.


Social Anxiety Disorder: Chandra gets very anxious when she is at school. She is worried that the other kids don’t like her, and that if they knew she had anxiety, that they would laugh and make fun of her. She has been learning to capture, challenge and re-script her anxious thoughts.    

I can ask myself these helpful questions:

1. Has this ever happened before? If so, what happened and how did I cope?

2. What would I say to Min if she was worrying about what others think?

3. What would Nana tell me? She always knows what to say.

Remember: Most things that upset and worry me NOW will not bother me LATER!


Generalized Anxiety Disorder: Jasmine is 9 and worries about almost everything. She is a classic “worry wart.” The daily calendar has been helping her track her fears and see what comes trues. She puts a sticker on each day her worry makes a false prediction. So far anxiety is loosing!


1 2 3 4 5 6/7


Health Anxiety: Maya has asthma and is extremely anxious about having future attacks and being unable to cope. Until recently she would engage in complex safety measures to be “for sure certain,” that she had everything she needed in the event of an attack. But she is starting to see that this isn’t helpful and is using detective work to help assess her hunches and look for the facts.     

Fear: I’ll have an attack and won’t have an inhaler

Evidence for / Evidence against

1. I’ve had attacks / I’ve never forgotten an inhaler
2. Inhalers can seize up / But mine never have
3. My attacks are mild
4. I don’t always need an inhaler

Balanced Thought: Although I might have an attack I can use an inhaler or breathe my way through it.

Remember: Most of my past asthma incidents have been hassles not horrors!


Obsessive Compulsive Disorder: Jamal has OCD and is terrified of dirt and germs. He has started seeing his school counselor who taught him to use the Hassle or Horror tool to keep his fears from taking over. It seems to help at school.




I must wash my hands after lunch or else



Holding Samantha’s hand –ewww--- but I’ll do it



No time to change after going to the gym- stayed in sweaty clothes




Post Traumatic Stress Disorder: Lucy is 5 and has recently lost her parents in a car accident. Her grandma has been helping her to remember how much love is close at hand. She has done this by sewing messages into Lucy’s clothes so she can be reminded.  They even made a dream catcher with secret messages woven in.

 “Aunty JJ and Bill love me.”

“I have 15 friends at camp.”

“I’m safe with nana.”


Separation Anxiety Disorder: James is 13 and hates to be apart from his parents. However, he’s starting to realize that with some courage and his coping cards, he can handle more than his anxiety makes him believe. 

Situation: Mum went out to the store. I’m freakin out…

Questions to ask:

What is the worst thing that would happen? How would I handle it? Car breaking down. I’ll be home alone for over an hour, but at least I can watch all the TV I want.

What is the best thing that can happen? She bought stuff for ice-cream sundaes!

Think of 5 possibilities. Which is most probable (likely)?

  1. She’s being held at gunpoint
  2. Car broke down
  3. She’s been mugged
  4. She decide to get more stuff than she thought
  5. ****She stopped to talk to a friend**** most likely


Specific Phobia: Jacob is terrified of needles. He needs some dental work and will have to get 10 injections next week. He’s using detective reasoning to help him prepare for this challenge.

Fear: I cannot handle these injections

        Evidence for ------------- Evidence against

  1. I’ve never had 10 in a row --------------- 1. I’ve coped with past ones
  2. The mouth is sensitive ------------------ 2. I handled a broken arm
  3. I kinda freak out under stress ------------------ 3. I’ll have a sedative
  4. I’m older now than the last time

Although I can be sensitive to needles and no one likes getting shots, I’m older since the last dental work I had and I’ll have a sedative to help. Plus, it’ll be over in an hour! I can handle an hour!