Exploring Self-Soothing Behaviors in Children with Anxiety Disorders

This study aimed to explore the self-soothing behaviors of children with anxiety disorders, focusing on the strategies they employ to regulate distress and the meanings they attach to these practices. A qualitative research design with a descriptive–exploratory approach was employed. Twenty participants, including children diagnosed with anxiety disorders and their parents, were recruited from clinical and counseling centers in Tehran using purposive sampling. Data were collected through semi-structured interviews, which lasted between 45 and 60 minutes. Interviews were audio-recorded, transcribed verbatim, and analyzed using thematic analysis in NVivo 14. Data collection continued until theoretical saturation was reached. Credibility of the findings was ensured through peer debriefing and member checking. Analysis revealed four overarching themes of self-soothing behaviors: emotional regulation strategies, physical and sensory-based soothing, cognitive and imaginative coping, and social and relational soothing. Within emotional regulation strategies, children used breathing exercises, positive self-talk, distraction, comfort-seeking, and ritualized calming. Sensory-based soothing included movement activities, tactile comfort objects, oral soothing, grounding techniques, and protective postures. Cognitive and imaginative coping encompassed fantasy play, mental distraction, self-instruction, internalized parental coping, spiritual rituals, and thought-blocking. Relational soothing involved seeking parental and sibling support, peer and teacher assistance, nonverbal expression, withdrawal, and participation in group rituals. Both adaptive and maladaptive strategies were identified, reflecting the multidimensional nature of self-soothing in anxious children. The study highlights the centrality of self-soothing behaviors in the lived experiences of children with anxiety disorders, emphasizing their reliance on emotional, sensory, cognitive, and relational strategies. Findings demonstrate the importance of culturally relevant and developmentally appropriate interventions that strengthen adaptive self-soothing while addressing maladaptive patterns. The results contribute to clinical practice by informing the design of integrative, context-sensitive therapeutic approaches aimed at enhancing children’s resilience and emotional well-being.