Children with chronic illnesses may experience anxiety related to medical procedures and hospitalization, and they may lack coping strategies for managing this anxiety. The objectives of the current study were to implement a new anxiety management manual for children and use qualitative methods to examine how children personalized strategies from the manual. Parent perceptions of child coping also were examined. Twenty-six children with chronic illnesses and twenty-five parents reviewed an anxiety coping manual focused on cognitive behavioral strategies of distraction, imagination, relaxation, and positive self-talk/thinking. Children reviewed the manuals with an interviewer and then they developed coping menus to reflect how they would use the cognitive and behavioral strategies from the manual. Parents also completed a survey to provide information about their child’s current coping and the strategies from the manual they thought their child was most likely to implement. Qualitative techniques were used to analyze data. Findings indicated that children had the ability to personalize coping strategies taught in the anxiety coping manual. Parents felt their children were most likely to use relaxation and distraction strategies. Parents reported that children had some pre-existing coping strategies, similar to those presented in the manual. Children were developing personalized strategies for managing their anxiety, including distraction, imagery, relaxation, and positive self-talk. Parents, family members and pets were key support figures. Future research should explore whether children use the strategies over time, as they undergo repeated procedures and hospitalizations.