Towards Evidence-Based Guidelines for Working with Climate-Anxious Youth: Insights from a Delphi Study of Mental Health Practitioners and Researchers

Abstract Background. Climate anxiety, defined as persistent worry and distress about climate change, is increasingly prevalent among young people, yet evidence-based guidelines for practitioners working with this population remain limited. This study aimed to develop and establish expert consensus on the helpfulness and feasibility of strategies for supporting young people experiencing climate anxiety. Method. A two-round modified internet-based Delphi study was conducted with researchers and practitioners with expertise in youth mental health. A total of 38 experts participated in Round 1 (R1) and 29 in Round 2 (R2). An initial set of 61 strategies, developed from focus groups, previous research conducted by the research team, and the broader literature, was rated for helpfulness and feasibility. Consensus was defined as at least 75% agreement on both helpfulness and feasibility. Results. Of the 61 candidate strategies, 53 (86.9%) reached consensus, with 37 reaching consensus in R1 and a further 16 in R2. Strongest support was found for strategies involving emotional processing and regulation, adaptive coping, cognitive-behavioral approaches, balanced climate-information consumption, manageable and collective action, social support, and psychoeducation. Consensus was lower or not reached for avoidance-based strategies, highly prescriptive pro-environmental behaviors, spirituality, pharmacological treatment, and some strategies requiring greater practical or organizational resources. Discussion. Experts showed substantial agreement regarding how young people experiencing climate anxiety should be supported. The findings suggest that support should primarily help young people understand and regulate climate-related emotions, strengthen coping and agency, engage with climate information in a balanced way, and draw on interpersonal support, while avoiding approaches that may reinforce avoidance, excessive individual responsibility, or unnecessary pathologization. The endorsed strategies provide an initial basis for informing practice, but their effectiveness should be evaluated in future intervention research.