Benched by anxiety: Rethinking coaching, confidence, and childhood potential

This article addresses a call for understanding anxiety in youth sports from the perspective of an occupational therapist, academic researcher, and parent.

As both an OTP and academic researcher, I have studied the neurobiology of stress, human performance, and occupational engagement. However, nothing could have prepared me for the anguish of watching my own son be consumed by anxiety. His anxiety was not simply an internal condition, but a response that was amplified by external voices of authority. Recently, his coach told him he was not trusted on the floor because of his anxiety. This statement was not a neutral observation; it was a projection of negative self-worth that pierced his developing identity. Witnessing the light in his eyes dim and his belief in himself fracture compels me to ask: When will we stand up? When will we collectively reject stigmatizing practices in youth sports and instead cultivate environments where children are nurtured and supported?

Anxiety is not a personal weakness, but a neurobiological response rooted in the brain. The frontal lobe, particularly the prefrontal cortex, plays a central role in higher-order executive functions, including emotional regulation, problem-solving, and decision-making (Arnsten, 2009). During optimal conditions, the prefrontal cortex moderates amygdala activation, dampening excessive fear responses. However, when people, especially children, experience stress, rejection, or criticism, the balance between the prefrontal cortex and amygdala is disrupted, leading to heightened anxiety (McEwen & Morrison, 2013). In young athletes, whose brains are still developing, this vulnerability is particularly pronounced. Comments from coaches that undermine confidence can activate the amygdala in ways that override rational processing and trigger the body’s survival instincts.

Anxiety is further characterized by the activation of the fight, flight, or freeze response, mediated by the sympathetic nervous system. This physiological process prepares the body to confront or escape perceived threats through increased heart rate, shallow breathing, and muscle tension (Chand & Marwaha, 2022). Although adaptive in the presence of real danger, this response becomes maladaptive in performance settings. When children are told they are untrustworthy due to anxiety, their brain interprets the remark as social rejection, which activates neural pathways associated with physical pain (Eisenberger, 2012). This compromises their ability to engage cognitively and emotionally in sport, redirecting attention away from learning, skill execution, and teamwork. Such states reinforce a cycle in which anxiety impairs performance, and poor performance reinforces further anxiety (Beesdo et al., 2009).

From an occupational therapy perspective, sports are not just recreational pursuits but meaningful occupations that support social participation, self-identity, and developmental growth (AOTA, 2020). Negative experiences in these contexts can create occupational imbalance and even occupational deprivation. Stigmatizing comments, such as those my son endured, often result in avoidance behaviors, decreased participation, and withdrawal from both athletic and social opportunities. This cycle not only diminishes immediate performance but also undermines long-term resilience and self-esteem (Fraser-Thomas et al., 2008). In contrast, research demonstrates that supportive coaching, which emphasizes encouragement and growth, fosters resilience, grit, and sustained engagement in valued occupations (Côté & Gilbert, 2009). Occupational justice, which emphasizes the right to meaningful participation free from stigma, highlights how damaging exclusionary or critical practices can be to children’s developmental trajectories (Wilcock & Townsend, 2019).

To address this challenge, OTPs can play a critical role in implementing a community-based model of practice in school districts. Such a model positions coaches not merely as sport instructors but as key developmental figures. The model begins with education, where coaches receive structured workshops on child development, trauma-informed practices, and the neuroscience of anxiety. These trainings, facilitated by OTPs and other allied health professionals, help coaches understand the profound impact their words and behaviors have on children’s neurological and emotional states (Substance Abuse and Mental Health Services Administration, 2014). Strength-based coaching is the second pillar, reframing athletes’ experiences around potential rather than deficits. By recognizing effort, creativity, and persistence, coaches can reinforce adaptive coping and resilience (O’Brien & Kuhaneck, 2020). A third element is embedding safe and supportive environments in athletic programming, ensuring that inclusion, positive reinforcement, and belonging are consistently prioritized. Such strategies have been linked to better psychosocial outcomes and improved athletic performance (World Health Organization [WHO], 2020). Lastly, sustainable partnerships between occupational therapy programs and school districts institutionalize accountability and reflective practice, ensuring that the psychosocial dimensions of sports participation are valued alongside physical skills.

Significantly, this model benefits not only children experiencing anxiety but also the broader youth sports culture. By fostering encouragement, safety, and growth, sports environments align with global recommendations for promoting healthy participation in physical activity (WHO, 2020). Beyond physical outcomes, these environments support mental health, social connection, and lifelong engagement in leisure and play, which are central to human occupation.

As professionals, educators, and parents, we must advocate for systemic change in youth sports. Coaches occupy positions of immense influence on children’s identities and developmental pathways. They must be equipped with strategies that align with developmental science, trauma-informed care, and occupational justice. Anxiety should not be stigmatized but understood as a natural human response requiring compassion and support. Occupational therapy has historically championed inclusion, dignity, and the right to meaningful participation. These principles are urgently needed in youth sports.

Conclusion

We must stand up for children like my son, whose potential should be nurtured rather than constrained by the projections of others. When will we stand up? The answer must be: now.

References

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Sean Weir, EdD (ABD) MS/OTR, CBIS, is an Assistant Professor of Occupational Therapy and Program Chair of the Occupational Therapy Assistant Program at the University of Southern Indiana. He earned his Master of Science in Occupational Therapy from USI in 2012 and is currently completing his Ed.D. in Educational Leadership. As a Certified Brain Injury Specialist, his clinical background reflects advanced experience in inpatient rehabilitation, with a focus on neurological injury and functional recovery. His scholarly work advances occupational therapy and health professions education by examining adverse childhood experiences (ACEs), retraumatization in experiential and fieldwork education, and the application of multisource feedback to strengthen equity, learner development, and assessment practices.