Mental health challenges among teenagers have reached crisis levels. Anxiety disorders and depression are now the two most common mental health conditions in the United States, with 20% of adolescents ages 12-17 reporting symptoms of anxiety in the last two weeks, and 18% reporting symptoms of depression during the same timeframe (Centers for Disease Control and Prevention, 2025).
As parents, educators, and youth-serving professionals, you witness firsthand how these challenges impact the young people in your care. While coaches are not therapists and coaching is not a substitute for therapy, mental health and behavioral health coaches can provide essential ongoing support around lifestyle changes for clients with mild to moderate symptoms.
This article explores how coaching approaches can support teenagers struggling with anxiety, offering practical insights into evidence-based techniques that can make a meaningful difference in their lives.
The American Psychological Association (2023) defines anxiety disorders as “any of a group of disorders that have as their central organizing theme the emotional state of fear, worry, or excessive apprehension” (para. 1). Understanding the specific types of anxiety helps coaches tailor their approach effectively.
Generalized anxiety disorder is characterized by persistent, excessive, and unrealistic worry about everyday things (Munir & Takov, 2022, para 1). For a diagnosis, this occurs more days than not for at least six months and involves three or more of the following symptoms:
Social anxiety disorder involves marked fear or anxiety about social situations where the individual faces possible scrutiny by others. Examples include social interactions like having conversations or meeting unfamiliar people, being observed while eating or drinking, and performing in front of others (NIH, 2016, para. 2).
Teens with social anxiety may experience physical symptoms such as blushing, sweating, trembling, rapid heart rate, or feeling their “mind going blank.” They often find it difficult to make eye contact, be around unfamiliar people, or speak in social situations, even when they want to engage.
Because our mind and body are interconnected, mental and physical health have a bidirectional relationship. Those with depression and anxiety are at significantly greater risk of developing chronic health conditions than those without these conditions. This happens because symptoms can interfere with engaging in wellness lifestyle activities that improve and sustain health.
Anxiety disorders may also result from physiological effects of medical conditions, including endocrine disorders like hyperthyroidism, respiratory disorders such as chronic obstructive pulmonary disease, cardiovascular disorders, metabolic disorders, and neurological conditions (APA, 2023a, para. 1).
For clients with mild to moderate anxiety symptoms who are functional enough to engage in the coaching experience, several evidence-based approaches can be adapted for coaching contexts.
Cognitive Behavioral Coaching draws from cognitive behavioral therapy principles, helping teens identify and modify thought patterns that contribute to anxiety. This approach focuses on building awareness of the connection between thoughts, feelings, and behaviors.
Acceptance and Commitment Coaching helps teens approach values-based goals while taking difficult feelings with them rather than remaining in avoidance patterns. This approach teaches clients to pursue what matters to them despite experiencing anxiety, preventing avoidance behaviors that often make anxiety stronger over time.
Exposure coaching involves gradually and systematically facing feared situations in a supportive environment. This approach helps teens build confidence and reduce avoidance behaviors that maintain anxiety.
Several large behavioral health organizations including Lyra Health, Bend Health, Brightline Health, InStride Health, and Charlie Health offer mental health coaching services for young people and families. These organizations assess clients and match them with coaches and/or therapists according to symptom severity.
Health and Wellness Coaching supports teens in achieving higher levels of wellness by fostering awareness, education, and growth. This approach focuses on building health and protective factors that contribute to holistic resilience, such as promoting regular exercise, good nutrition, and optimal nervous system functioning. By encouraging teens to adopt a wellness lifestyle, coaches help them become active participants in their care. Physical health and mental health are connected. Improving physical health improves mental health.
The National Institutes of Health (2022) defines emotional wellness as “the ability to successfully handle life’s stresses and adapt to change and difficult times” (para. 1). Coaches can support emotional wellness through evidence-based lifestyle modifications that address root causes of anxiety symptoms. We turn to the lifestyle medicine literature for guidance on the six pillars proven to treat root causes of chronic health conditions, including mental health health conditions like anxiety and depression. Those six pillars are optimal nutrition, physical activity, stress management, restorative sleep, connectedness, and avoiding risky substances (ACLM, 2025).
For coaches serving clients in private practice or organizations without a full continuum of care available, recognizing when symptoms require a higher level of intervention is crucial. When indicators suggest that a person’s symptoms require professional therapeutic intervention, coaches should share resources and recommend that clients seek care from qualified therapists.
If the client is not engaging over time, seems hesitant when working with you, appears triggered by the coaching process, or shows little to no progress during and/or between sessions, it may be appropriate to share resources for alternative support and conclude the coaching relationship. Sometimes the mismatch between coach and client is clear from the outset, but other times, it requires a direct and open conversation to identify what is working, what is not, and how adjustments to the approach might improve the working relationship. Seeking support from a coach supervisor or mentor can also offer valuable insights and assist in the decision-making process. The need to refer clients to external support will vary depending on the professional qualifications of each coach.
When navigating the boundaries between coaching and therapy, coaches must be mindful of their scope of practice. A fundamental consideration is the client’s level of functioning. Coaching is most effective for clients who are functional enough to actively engage in the coaching process, bear most of the cognitive load during sessions, and act independently on their goals between sessions. Clients presenting with severe dysfunction or serious mental illnesses are better served by qualified mental health clinicians who possess the specialized training to manage such cases effectively.
Here are key points for a coach who is not operating within an organization providing wraparound care or clinical supervision:
Since most coaches rely on client self-disclosure, it is essential to maintain a thorough intake process and ongoing dialogue about the client’s well-being. If severe issues emerge, coaches must act responsibly by referring these clients to appropriate clinical care.
Supporting teenagers through anxiety requires a comprehensive understanding of both evidence-based coaching techniques, lifestyle medicine principles, and recognizing when to refer to higher levels of support. By integrating cognitive behavioral coaching or acceptance and commitment coaching approaches with lifestyle modifications, you can provide meaningful support that addresses both symptoms and root causes.
The research is clear: nutrition, physical activity, sleep quality, social connection, stress management, and avoiding risky substances all play crucial roles in mental health outcomes. As coaches working with teens experiencing mild to moderate anxiety, you have the opportunity to guide them toward sustainable wellness practices that can transform their lives.
Want to learn more about supporting young people through our current mental health crisis? Learn more about our certification programs and develop the skills and knowledge needed to make a lasting impact on the teens in your care.
