CHILD & ADOLESCENT TREATMENT
Anxiety during childhood happens in the context of development.
Children and adolescents are doing the ongoing work of growing up - learning to handle difficult emotions, navigate friendships, recover from mistakes and disappointments, become increasingly independent, and begin to discover who they are and what matters to them. Anxiety can become woven into these developmental experiences, shaping how a child moves through them.
Treating anxiety in children and adolescents requires more than simply adapting adult therapy for a younger client. The principles of effective anxiety treatment remain the same, but how they are applied changes considerably across development. Treatment must account for a child's developmental needs, the role of parents and other important adults, and the everyday environments in which anxiety takes hold.
Anxiety Presentations Treated
Anxiety is a normal part of childhood and adolescence. Treatment may be appropriate when anxiety causes significant distress or begins to interfere with school, friendships, family life, or everyday activities.
Generalized Anxiety
Frequent worry about school, family, health, or what might go wrong, sometimes accompanied by reassurance seeking, difficulty relaxing, sleep problems, headaches, or stomachaches.
Separation Anxiety
Difficulty separating from parents or caregivers, including distress around school, bedtime, being alone, sleeping away from home, or other situations that involve separation.
School Avoidance
Anxiety that makes getting to school, staying at school, or participating in the school day increasingly difficult, sometimes leading to frequent absences or requests to leave early.
Social Anxiety
Fear of judgment or embarrassment that may show up as avoiding peers, difficulty speaking up, worrying about how one is perceived, or avoiding social and performance situations.
Health Anxiety
Persistent worry about illness, physical sensations, or something being wrong with the body, often accompanied by checking, reassurance seeking, or repeated questions about health.
Specific Phobias & Emetophobia
Intense fears of particular situations or experiences—including vomiting—that may lead to significant distress, avoidance, reassurance seeking, or changes in everyday routines.
Obsessive-Compulsive Disorder
Intrusive thoughts, fears, or “not right” feelings accompanied by rituals, checking, reassurance seeking, repeating, avoidance, or other behaviors a child feels driven to do.
Selective Mutism
Consistent difficulty speaking in certain settings, such as school or social situations, despite speaking comfortably in other environments, often interfering with participation, friendships, or everyday activities.
Individual Treatment & Parent Involvement
Individual treatment draws on evidence-based approaches including cognitive behavioral therapy (CBT) and exposure and response prevention (ERP). Treatment helps children and adolescents recognize when anxiety is shaping their behavior and learn to respond differently, particularly by approaching situations they might otherwise avoid. Much of this work extends beyond sessions and into everyday life.
Parent involvement is tailored to the child's age and clinical needs. Parents may participate in sessions, help children practice new skills in everyday situations, or learn to respond more effectively to their child's anxiety and OCD symptoms.
For some children and adolescents, working directly with parents may be the primary approach to treatment.
Coordinated Care
For children and adolescents, effective treatment may include coordination with pediatricians, school personnel, psychiatrists, and other providers.
This may include addressing school avoidance, supporting treatment strategies in the school setting, or working with prescribing clinicians when medication is part of a child’s care.
Considering treatment for your child or adolescent?
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Telehealth in Maryland and participating PSYPACT states.