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Dr. Carey Heller is a licensed psychologist and founding partner with The Heller Psychology Group LLC, which is a small private practice located in Bethesda, Maryland near Montgomery Mall. He specializes in working with children, adolescents, and their families. Dr. Heller conducts play, individual, and family psychotherapy for a variety... Read more

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Dr. Carey Heller: Psychologist with The Heller Psychology Group in Bethesda, Maryland

Adding More Structure to Reduce Anxiety

Dr. Carey Heller: Psychologist with The Heller Psychology Group in Bethesda, Maryland

Dr. Carey Heller: Psychologist with The Heller Psychology Group in Bethesda, Maryland

Children and adolescents experience anxiety for a variety of reasons. The exact causes largely impact which methods should be used to address the anxiety. One common reason for anxiety, especially in individuals with ADHD, executive functioning issues, or learning disabilities, is that they feel overwhelmed by daily and long-term homework assignments and other tasks. Instead of being able to focus on what they have to do in the moment or that evening, they focus on everything they have to do in general. As a result, the anxiety around this may become so overwhelming that they are unable to complete much if anything. A nice way to think about this feeling is to imagine a snow globe. When the globe is not shaken, the little snow flakes, which in this case represent the different tasks that have to be completed, float very nicely and seem calm. However, when the globe is shaken, the snow flakes swirl around. Similarly, children and adolescents often feel that there is so much swirling around in their head that they cannot mentally or sometimes physically organize everything, which leads to feeling overwhelmed and experiencing anxiety.

For children and adolescents who experience anxiety because of being overwhelmed by tasks that need to be completed or hectic schedules, implementing a lot of structure into their daily routine can make a huge difference. However, this has to be done carefully, because otherwise in some cases too much structure or the manner in which structure is implemented can lead to even more anxiety. That is why you need to really look at the cause of the anxiety and individual factors about your child’s or adolescent’s functioning.  If you have significant concerns about your child’s or adolescent’s anxiety and what interventions may be best, consulting a mental health professional who can assess the situation and provide appropriate interventions is important.

Here are a few strategies to incorporate more structure into your child’s or adolescent’s daily routine. Please use these suggestions with caution since they will need to be tailored to your individual child’s or adolescent’s needs:

1)      Have your child or adolescent create a task list. He or she should have one task list for homework tasks and one for non-school related items. For younger children, writing this on a white board, paper on a bulletin board, or other place may be helpful. For older children and adolescents, many find using apps such as MyHomework, Reminders, and Wunderlist to be helpful. In addition to these main task lists, children and adolescents should have a daily task list, which lists out all tasks that need to be done that day (i.e., homework assignments due the next day, daily chores, etc.).

2)      For older children and adolescents who have more long-term assignments and tasks (i.e., English paper, college application process), they should break down tasks into parts and include the daily part of the project in their daily task list. For example, if writing an English paper, on Monday, they could list create outline. On Tuesday, begin research could be included. For Wednesday, summarize research could be included. The idea is to plan out assignments by scheduling a specific day to do each part of the assignment. For non school tasks such as applying to college, an adolescent could schedule tasks on given days such as: make a list of 20 potential colleges, create spreadsheet with due dates for each application, etc.

3)      Create a visual schedule for each day of the week. Some children and adolescents get overwhelmed going from one after school activity to the next and devoting time to complete homework. For some individuals, simply having a clear visual schedule to refer to helps them to mentally prepare themselves for each activity in a given day. The visual schedule can be color coded based on type of activity and hung in their room, study area, etc. For older children and adolescents, using a calendar app for this may be helpful.

4)      For younger children, prompting them orally and sometimes visually when getting ready to transition to the next activity after school can be very helpful. Using pictures to represent each activity can also be beneficial.

By implementing more structure, it often helps children and adolescents to feel like there are less things swirling around in their head that they have to do. The use of a visual schedule also helps children and adolescents to learn to mentally prepare themselves to transition from one activity to the next.  Adding more structure is only one component of addressing anxiety. While this can greatly help children and adolescents who experience anxiety from feeling overwhelmed, incorporating other preventative and in the moment interventions is crucial to properly treating anxiety symptoms.

Copyright 2014 Carey A Heller, Psy.D.

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*Disclaimer: The previous information is intended as general guidance based on my professional opinion, does not constitute an established professional relationship,  and should not replace the recommendations of a psychologist or other licensed professional with whom you initiate or maintain a professional relationship*

Carey Heller, Psy.D.

About Carey Heller, Psy.D.

Dr. Carey Heller is a licensed psychologist with The Heller Psychology Group LLC in Bethesda, Maryland. He works with children, adolescents, and young adults, providing psychological/psychoeducational evaluations and individual psychotherapy. Dr. Heller specializes in ADHD, executive functioning issues, and Autism Spectrum Disorder and is happy to answer questions and provide consultations for individuals who are considering pursuing treatment or an evaluation for their child, adolescent, or themselves. Dr. Heller can be reached directly at 301.385.2610 or For appointments, please call the office at (301) 385-2610 or email The Heller Psychology Group at with your contact information and availability for appointment times.


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