Working with high-conflict couples: Best practices for therapists
Summary
Learn the best practices for eco-anxiety when supporting clients through climate distress to identify when environmental dread requires clinical intervention.
Master evidence-based climate anxiety treatment strategies, including somatic techniques and EMDR, to help clients regulate their nervous systems.
Use actionable validation tools to support younger generations navigating major life milestones amid environmental uncertainty.
Apply behavioral activation and values-based interventions to transform client paralysis into meaningful community agency.
Enhance your practice by managing countertransference and building resilience through supervision and intentional self-reflection.
Eco-anxiety may not be listed as a diagnosis in the DSM-5, but it's sitting across from therapists in sessions worldwide.
As more clients come to sessions struggling with eco-anxiety, supporting them through climate distress is becoming an essential skill for therapists.
Across the globe, Google searches for "eco-anxiety" or “climate anxiety” increased by 4,590% from 2018 to 2023, according to Google data. And 2025 data from the American Psychiatric Association (APA) suggests that more than half of adults (55%) believe climate change affects Americans’ mental health—and one-third of adults (35%) reported they worry about climate change on a weekly basis.
Behind each search is a person grappling with dread about our planet's future—and they're increasingly turning to mental health professionals for help.
The effects of climate change may feel like less of a distant idea and more of a reality for many. Whether it’s massive wildfires, record-breaking heatwaves, or extreme flooding, more people are seeking therapy with very real concerns about the future. As a therapist, you may be feeling this too.
So, how do you support your clients through climate distress and what climate anxiety treatment strategies actually help?
When does eco-anxiety become clinical?
Knowing when eco-anxiety warrants clinical care and how to support clients through climate distress is the first step in determining which climate anxiety treatment strategies are most appropriate for a given client.
“Eco-anxiety becomes clinical when distress over environmental threats begins to interfere with sleeping, relationships, and daily functioning,” says Kaila Hattis, MA, LMFT, and owner at Pacific Coast Therapy.
Climate anxiety is a rational fear and does not imply mental illness—but because the climate crisis does not have a clear solution, many people find it intense and overwhelming.
“Anxiety serves an evolutionary purpose of orienting us to danger and mobilizing our nervous system to respond, so it is absolutely healthy and normal to feel anxious when our existence is in question,” says Carson Brown, MD, integrative psychiatrist. “Anxiety, despair, and grief, when supported and shared, can clarify our values, improve focus, increase compassion, and drive informed behaviors.”
Unmanaged eco-anxiety can affect both mental and physical health in various ways:
Worry, fear, and anger
Grief and despair
Guilt and shame
Betrayal and abandonment (especially due to government inaction)
Chronic headaches
Gastrointestinal disruption
Fatigue that spikes with climate news cycles
“I start to conceptualize eco-anxiety as clinical when clients show persistent rumination about environmental catastrophe, difficulty concentrating on daily responsibilities, sleep disturbance, hopelessness about the future, or avoidance behaviors (for example, refusing to plan long-term life goals because they feel the future is ‘doomed’),” says Melissa Tract, LCSW, and owner of Mindful with Mel.
The climate crisis is a complex, massive issue to solve, and this can have real impacts on our nervous systems.
“Humans are not biologically equipped to process an existential, global-scale threat that they cannot physically fight or flee from,” says Joel Blackstock, LICSW and Clinical Director of Taproot Therapy Collective. “When a client’s amygdala is constantly firing threat signals about the climate, but their body cannot physically resolve that threat, the un-discharged survival energy gets trapped.”
This can lead the nervous system to “freeze”—turning clients numb, dissociated, and paralyzed by despair.
In contrast to eco-anxiety, psychiatric illnesses typically impair functioning, making it difficult to maintain relationships, day-to-day activities, and basic enjoyment of life.
“If someone exhibits cognitive distortions, emotional overwhelm and shutdown, social isolation, or cognitive problems, I consider psychiatric diagnoses,” Brown says. “A thorough mental health history around mood, anxiety, and trauma offers more differentiating clues, and I always pay attention to sleep, eating, and hygiene.”
If a client's distress is severely impairing their functioning or you suspect an underlying mood or anxiety disorder, a psychiatric consultation can help clarify the picture and determine whether medication or a higher level of care is warranted.
What age groups are most affected?
Data from the APA suggests that adults ages 18 to 34 are significantly more likely than those ages 65 or older to recognize the mental health impacts of climate change, feel personally affected, and report anxiety over the government’s response.
“In my experience, adolescents and young adults tend to experience the most intense eco-anxiety,” says Tract. “Developmentally, these groups are forming their worldview and imagining their future. When that future feels uncertain or threatened, it can create a sense of instability or existential distress.”
Younger people also tend to be more exposed to climate discussions through social media, which can amplify catastrophic messaging without providing emotional context or ways to cope.
Jenny Martin, PsyD, founder of Gemstone Wellness, sees it “most acutely in Millennials and Gen Z—particularly clients in their 20s and 30s who are making major life decisions (career, relationships, children, where to live) through the lens of an uncertain climate future.”
Parents are also more affected by these concerns. “Clinicians should not forget about new parents and perinatal clients who are dealing with eco-distress embedded in postpartum anxiety,” says Hattis.
Young kids can be affected too, and books and guides specifically exist for talking to kids about climate change.
“Looking your own child in the eye and talking about something so big and scary is awful,” Brown says. “I usually say, ‘I worry about the future sometimes, too, because some sad and scary things are happening. But the outcome isn't set in stone, and we can all work together to make things better.’”
How to validate environmental concerns
Knowing how to support clients through eco-anxiety and climate distress begins with validation rather than correction.
While many anxiety disorders focus on irrational fears, eco-anxiety is not irrational. The fact is that the planet is in crisis.
“Our job is not to talk clients out of their concern, but to help them metabolize it,” says Martin.
When considering how to validate environmental concerns, it may be helpful to frame eco-anxiety as a form of grief or anticipatory loss, rather than a cognitive distortion. Clients are simply responding to the reality around them, and treating their anxiety as something that needs to be corrected can do a disservice to the client.
According to Martin, “Validation sounds like: ‘Your nervous system is responding to a real threat. That makes sense. Let's figure out how to help you live well inside that truth.’”
What coping strategies are effective?
When it comes to eco-anxiety, supporting clients through climate distress requires a tailored approach since climate anxiety treatment strategies largely depend on the individual.
Cognitive restructuring
Cognitive restructuring is an effective coping strategy that helps clients identify catastrophic thinking patterns and reframe thoughts like “the future is hopeless” into more balanced perspectives.
While cognitive restructuring can be a helpful tool for managing the "all-or-nothing" thinking that leads to paralysis, it is often insufficient when used as a standalone solution for a systemic reality.
Effective treatment usually integrates these techniques to address specific spiraling thoughts while relying on more expansive, validation-heavy approaches to ensure the client’s core concerns about the planet are never dismissed as mere distortions.
As Blackstock puts it, “You cannot cognitive-reframe a burning planet.”
Distress tolerance skills
Distress tolerance skills are a part of dialectical behavior therapy (DBT) and focus on building resilience through painful emotions and situations.
Some examples of distress tolerance skills that clients can work on include grounding techniques, nervous system regulation through mindfulness and breathwork, and limiting doom scrolling—instead distracting the self with pleasurable activities.
Somatic techniques
Somatic therapy offers a powerful approach for supporting clients through eco-anxiety and climate distress. This climate anxiety treatment strategy focuses on more than just thoughts—it focuses on bodily sensations.
For clients that are stuck in fight or flight, or are experiencing overwhelming fear and worry, therapists can help them physically discharge the survival energy trapped in their bodies.
“I use somatic interventions and Brainspotting to help clients physically metabolize their grief and terror,” says Blackstock. “Once the nervous system is regulated back to a baseline of safety, building climate resilience means shifting the client from macro-paralysis to micro-action.”
Therapists can apply somatic therapy through orienting (scanning for safety), pendulating (shifting between activation and calm), titrating (gradual trauma exposure), and validating (normalizing physical responses).
EMDR
Another body-based approach to eco-anxiety is eye movement desensitization and reprocessing (EMDR) therapy. While somatic therapy focuses on bodily awareness to regulate the nervous system, EMDR addresses trauma by using bilateral stimulation, such as following hand movements or audio cues, to help the brain reprocess unresolved traumatic memories.
“EMDR can work effectively when a client has been through a direct climate event and the distress has been coded as trauma in the body,” says Hattis.
Behavioral activation
While body-based climate anxiety treatment strategies address trauma stored in the nervous system, behavioral approaches focus on restoring a sense of agency.
Behavioral activation is a form of cognitive behavioral therapy (CBT) typically used to treat depression and other mental health conditions. It helps individuals identify activities that align with their values and goals and take small steps to break the cycle of avoidance and withdrawal.
In the context of eco-anxiety, encouraging meaningful action such as community engagement and environmental volunteering can transform helplessness into agency.
Creating a schedule of activities and tracking effects on mood can be helpful to encourage clients to continue engaging in these behaviors.
Values-based work
Values-based work involves helping clients identify what matters to them in the present rather than becoming paralyzed by uncertainty about the future.
Helping clients identify what they care about and what actions align with those values can move them from feeling helpless to taking action.
Grief work
Naming climate distress as a form of grief legitimizes it, gives clients a framework for processing it, and can even serve as a catalyst for making productive and positive changes.
Peer support and group therapy can also be effective for clients to recognize that they are not alone in their grief.
Intentional media boundaries
There's a difference between staying informed and staying activated, so for clients wondering how to balance awareness and anxiety, setting intentional media boundaries and consciously curating social media feeds can be a helpful strategy.
For example, you might instruct clients to set a boundary by scheduling their news intake or social media scrolling to 20 or 30 minutes a day. Setting limits for media consumption, rather than avoiding it entirely, can be a helpful way to reduce overwhelm.
“I often recommend intentional boundaries around news consumption, particularly social media, where emotionally intense content spreads rapidly,” says Tract.
Community and collective action
Isolation often amplifies anxiety, and eco-anxiety is no different. Connecting with others who share environmental concerns and are doing something about it can be genuinely therapeutic.
“Joining a local conservation group or planting a community garden gives the nervous system a tangible, physical task that signals to the brain: ‘I am taking action, I am co-regulating with my community, and I am safe in this immediate moment,’” says Blackstock.
Research supports this—a study of adults ages 18 to 35 found that engaging in collective action, but not individual action alone, buffered the relationship between climate anxiety and depression symptoms specifically, suggesting collective approaches may offer particular protection against climate-related depression.
Brown also recommends more structured climate change discussions, such as Climate Cafes and Work That Reconnects (WTR) events.
“Every time I leave a Twin Cities Work That Reconnects meeting, I feel inspired, connected, and ready to work for the future we want,” says Brown. “Often people have difficulty identifying their role in climate activism, and I remind them that talking about climate change is in itself a form of activism.”
How to build climate resilience
Supporting clients through climate distress while building climate resilience involves clients strengthening support networks, becoming grounded in what matters, and fostering the psychological flexibility needed to sit with uncertainty. Encouraging small, meaningful actions can restore a sense of agency without overwhelming them.
And for clinicians, your eco-anxiety matters here, too.
“This is a topic where countertransference is real. If we haven't sat with our own climate grief, we may unconsciously minimize clients' distress or, conversely, over-identify with it,” Martin says. “Supervision and self-reflection on this topic are worth prioritizing.”
Ultimately, eco-anxiety and supporting clients through climate distress is an evolving area of practice—one that asks therapists to hold space for both the reality of the crisis and the possibility of resilience.
Sources
American Psychiatric Association. (2025). One-third of Americans Worry About Climate Change Weekly.
Baudon P, Jachens L. (2021). A Scoping Review of Interventions for the Treatment of Eco-Anxiety. Int J Environ Res Public Health.
Cunsolo A, Harper S, Minor K et al. (2020). Ecological grief and anxiety: the start of a healthy response to climate change? The Lancet Planetary Health.
Hickman C, Marks E, Pihkala P, et al. (2021). Climate anxiety in children and young people and their beliefs about government responses to climate change: a global survey. The Lancet Planetary Health.
Locker, M. (2023, November 22). Google searches for ‘climate anxiety’ are at an all-time high. TIME.
Schwartz SEO, Benoit L, Clayton S, Parnes MF, Swenson L, Lowe SR. (2022). Climate change anxiety and mental health: Environmental activism as buffer. Curr Psychol.
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