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How to help your child with a needle phobia

Updated: Nov 30, 2022

needle phobia

One of the most common fears is needles and it’s particularly hard to see our kids struggle to deal with this one. Here are some strategies for helping your child deal with this phobia.

First, we’ll give your child some strategies for managing their stress and anxiety response. Practice one of these every day to give them the skills to draw upon when the situation gets more stressful.

Strategies for Managing Anxiety

Teach them diaphragmatic breathing.

This type of breathing activates the parasympathetic nervous system and this naturally calms the body. You can call it “belly breathing” and teach them to breathe in through their belly and have their stomach come out as they breathe. Then they can pause briefly. Then along with exhalation. Teach them to try not to move their chest and to make the exhalation nice and long.

Teach them to visualize a relaxing scene.

Have them choose a place where they feel totally relaxed and have them picture it vividly. They can describe it to you and then try picturing it every night before bed to practice. You can add music to their visualization practice if they find that relaxing as well. Have them pair this scene with a word of their choosing, like “relax” or “calm” or a descriptive word like “beach.” This pairs the word with the feeling through the power of classical conditioning.

Have a light and fun activity to do together.

Find funny, cute or relaxing pictures or memes online together and have a folder of these on your phone. Another option is have videos saved on Youtube that make him or her laugh. Watch them as a fun activity when there’s nothing stressful happening and also have them available the day of the needle.

Come up with a list of coping thoughts that help them.

Examples are, I can do this or I’ve done other hard things before. There’s a blank coping thought list here.

Applied Tension to Prevent Fainting

If your child faints in response to the needle, use applied tension to combat this response. This strategy combats the vasovagal response, which happens for a small percentage of people in response to needles or blood. Practice this method daily until they’ve got it down pat. When they go for the needle, have them use applied tension right before.

Applied tension:

  1. Have them sit and do a few belly breaths.

  2. Then have them tense their muscles in their legs, arms and torso as much as they can for 15 seconds. Ideally, they’ll feel some warmth on their face.

  3. Release the tension and take a break for 30 seconds.

  4. Do this 5 times.

  5. Now for dealing with the needle phobia itself. We will use exposure therapy to reduce the anxiety your child feels.

Exposure therapy for needle phobia

Teach your child to rate their anxiety from 0 (none at all) to 10 (the most they’ve ever experienced). This is called a SUDS scale.

Now write out all aspects of the needle situation that might be stressful and have them rate each situation on the SUDS scale. It’s good to have a variety of items on your list that range from 5-10 SUDS. You’ll be doing each of these items, if possible, but sometimes it’s difficult to actually do an item. For example, you won’t actually give your child a needle in most situations.

Often, it makes sense to add in items that are more realistic to do at home, but still activate your child’s stress response in response to needles. Examples are looking at pictures of people getting needles, watching videos of people getting needles, and seeing a picture of a needle. Other ideas are practicing the wipe of the alcohol, putting on a tourniquet, etc.

Make your fear ladder. The fear ladder is the list of all the situations related to needles that they fear ranked from least stressful (at the bottom) to most stressful (at the top). There’s a blank fear ladder here.




Getting the needle


​Waiting in the waiting room


​Driving to the health center


​Touching a needle


​Watching a video of someone getting a needle


Having a tourniquet and a wipe of the alcohol wipe


Seeing a picture of a needle


How to do exposure for needle phobia:

  1. Start with the lowest items on the fear ladder and have your child do this (this is called exposure). Let them do the exposure until the anxiety reduces by ½ or 20 minutes passes. Stop after 20 minutes even if there’s no change and try again the next day.

  2. Continue to do the exposure until the SUDS is ½ the starting point. When it reaches that point, move on to the next item on the fear ladder.

  3. Then continue until all items on the ladder are complete.

  4. Use the coping thoughts you came up with to encourage them. Be present with them and manage your own stress. They’ll be looking to you for the support!

  5. Praise praise praise! After you’re done the exposure, reward them with something small, like TV time, a small gift or a treat.

Rate the progress through the exposures on the Progress Tracking form here.

Try to do the exposures daily.

Other tips:

  1. Some of these items will be impossible (giving a needle for example). Sometimes you can have them visualize the situation. Other times, it’s just not something you can do an exposure with.

  2. Normalize for the child that they’ll feel anxious when they do these exercises and that’s a good thing, as it helps them get over the fear.

  3. Give them examples of how you’ve overcome fears through facing them.

  4. On the day of the needle, use the coping strategies that you’ve been practicing. The funny memes and videos are especially helpful here.

  5. Good luck with this and remember, if you need more help, reach out to a psychologist to guide you through the process.

If you would like to download the PDF version of this post, get it here.

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