Anxiety Therapy for Children and Teens

ANXIETY IN CHILDREN AND TEENS

Anxiety in children and teens is a growing concern among parents. Our child focused therapies are collaborative and help families find calm.

Caring for a Child or Teen with Anxiety Can Be Challenging

All children experience fear and worry, some with great intensity. Anxiety in children is one of the most common struggles that youth face (along with depression [link]). Particular moments in childhood when serious anxieties develop in kids include when parents leave (separation anxiety) or anxiety around meeting with friends or going to school. While some kids develop a general anxiety without a particular cause.

If your child is experiencing fear or worry to a major degree they are showing some common signs of anxiety in children. Perhaps you have been suspecting it for a while, finding it strange that your child is more avoidant than your other children or your friend’s children. We know that it can feel overwhelming to care for and be responsible for a child that isn’t coping well with the world.

Many parents start noticing or addressing their child’s anxiety when they see grades slip. Students that are anxious tend to think of the school work as too overwhelming and so procrastinate in order to avoid the stress. They think “ this is too overwhelming, I better not try.”

Understand that many parents have been on this journey before you and we can help you and your child make sense of these difficult emotions.

Signs of Anxiety in Children

It can be difficult to determine whether your child has depression as many children lack the words to describe how they feel. Some children also don’t like to share their inner emotions for any number of reasons. Others try but end up frustrated. Even parents that are generally able to describe how their child behaves, and that can tell that something is wrong, may not be able to name it as anxiety themselves. 

If you are a parent of an anxious child, go ahead and list 2-3 traits about them, if “nervous”, “squirmy” or “avoidant” are used, those are often signs of anxiety. If any of these traits become the dominant emotion that your child displays then you would benefit from talking with one of our child therapists about anxiety.

Other common behaviors and signs that indicate anxiety in children

 

  • Becoming anxious when separated from parents – separation anxiety.
  • Extreme phobias such as fear of certain animals, foods, situations, etc.
  • Anxiety over social interactions – social anxiety.
  • General feelings of anxiety regardless of the situation (general anxiety). Some kids with general anxiety have physical symptoms associated with daily life. These can include general fatigue, headaches, stomachaches. 
  • Regular panic attacks – presenting as heavy breathing, shaking, or dizziness, etc.
  • Changes in sleep: too little or too much, or persistent nightmares.
  • Persistent “nervousness, “squirminess” or “avoidant behavior.”
  • Irritability, some quick tempers and mood swings can be caused by being agitated/anxious regularly. 
  • Changes in appetite – Our mind and gut are deeply connected, in fact a lot of stomach issues are psychological, so any changes in eating habits can be a sign of anxiety in children. 
  • Constantly seeking approval/reassurance.
  • Overly compliant/eager to please, constantly worrying about parental responses.
  • Intense fears about safety of themselves or their loved ones. 
  • Refusing to go to school.
  • Low self esteem and self confidence.

You should know:

In many children, anxiety can be very sensory. For example, if your child can’t sit still or is constantly in motion it may be due to any one of their five(ish) senses. Perhaps scratchy clothing or a food intolerance may be to blame. If children don’t move and exercise regularly, their sense of balance can get off, creating agitation as well. There are a number of sensory issues that we identify in children if we suspect that it may be a major contributor to their anxiety. You can investigate this yourself as well, if your child is acting anxious ask about each of their senses and see if one is irritating them. 

Also know that:

Depression has a strong overlap with anxiety. If your child has a mix of anxious behavior and depressed behavior, they may have some combination of the two. Read more on our depression in children page.

If you have seen any of these signs of anxiety in your child and are noticing changes in their attitudes towards separating from parents, making friends, attending school, changes in grades or notice a behavior that is causing a barrier to their development, schedule a consultation with our child therapists. Working on these emotions and behaviors as early as possible best prepares your child for proper emotional and social development as they progress through school.

 

 

Our Anxiety Treatment Plan for Children and Teens:

Our treatment plan is different for every child and every age. Younger children experience the world through play, so kids younger than 10 often see the best benefit from our play or art therapists. With younger kids we encourage them to conceptualize their anxiety in an understandable way. While teens are better able to sit and talk about their inner life on the couch.

Overall, we understand that many children are able to feel that something is wrong, but their coping methods tend to cause more harm than good. That’s why our focus is uniquely on developing emotional understanding, building coping skills and collaborating on practical steps in day to day life (and school). We help children by drawing from a variety of psychological methods to see which will best suit their needs. These methods include CBT, DBT, mindfulness and other evidence based approaches.

Anxiety in Children
(2-12 yrs old)

Anxiety in young children includes many behaviors common at this age, again the concern is if these behaviors are hindering the child’s development. For example, children with severe separation anxiety may cry and cling to a parent’s leg at every separation. A socially anxious child may ask to skip school or avoid friends at playtime. A child with phobias may avoid going outside to avoid a barking dog.

Major transitions at this age can also have an outsized effect on children at this age: divorce, moving, changing schools, skipping a grade. Anxiety is normal and healthy in such situations, but when it becomes paralyzing to a child, help should be sought.  

Bullying and Anxiety

This age (and especially the teenage years) is when many kids experience bullying. Notably, there is a significant connection between bullying and anxiety/depression. In many ways bullying is traumatic for children and leaves them on edge worrying that “something bad will happen to me soon.” We work with kids to conceptualize bullying and find healthier coping strategies. Often the self-esteem we develop during therapy helps empower children during bullying situations. Read more about bullying and children here.

Anxiety in Teens (13-18 years old)

Most people begin to show signs of anxiety before they turn 21, so the teenage years are where to keep an eye out for anxious behavior in order to treat it early. At this age the most common anxieties are general anxiety and social anxiety. Bullying too remains a major component of anxiety at this age. For all these struggles, rates of suicide among teens have increased over the past few years. Another reason why the teenage years are a critical time to take action.

When it comes to social anxiety, our therapists have seen that the number of teens that self- identify as being socially anxious has grown significantly over the past 10 years. It’s important for teens to work on social anxiety early on because the teenage years are when we learn most of our socialization skills. General anxiety is closely associated with stress, so as schoolwork and expectations for the future increase in intensity (especially in high school), general anxiety can begin to develop.

Teenage Anxiety and Social Media: A Growing Concern

A new concern that has been highly associated with anxiety rates in teens is the use of social media. We recommend watching “The Social Dilemma” on Netflix in order to see first hand the effects of social media on teens. The two teens shown in the docudrama are deeply impacted by their interactions on social media that cause a rollercoaster of emotions. 

With social media, too many likes leads to euphoria (a similar reaction in the brain as addictive substances). Too few likes and they fall into a deep sadness, often questioning their value and body image. We see such struggles in our work with teens almost universally. 

Note: The teenage years see a growing separation from parents as they lose importance in a kid’s life as friends take over that role. It can be difficult for teens to share with parents their inner struggles and feelings. This is why in our therapy sessions we make every effort for our therapists to create a non-judgemental space where teens can openly share their struggles without worrying about parental approval or shame. For many teens (especially those with few friends) it is the only place that they can truly talk and that can make all the difference.

What Can Parents Do About Anxiety in Children?

 

Personalize their anxiety. Talk with your child about what their anxiety feels or looks like. Ask them to give it a name. Many adults find benefit thinking of anxiety as a tiger that is always on the prowl. Some kids can find the same benefit in thinking of their anxiety as something outside of themselves that they can have a relationship with and be the boss of. Our therapists use this technique often, so if you find yourself at a loss for guiding your child through this conversation, meet with us first. 

Are you yourself anxious? Many kids model the anxieties that their parents project. Kids are like sponges and soak up all kinds of thoughts and behaviors without question. You may not even realize you are acting in an anxious way, if so read more about our approach to anxiety in adults.

Don’t encourage your kid to suppress their anxiety: “Stop thinking like that!” Saying this is like asking someone to not picture a purple elephant in their minds, everyone will do it and the more they try not to think of it, the more it pops in their head (try it yourself). 

Instead, help them understand it. Encourage them to “blow off their anxious energy.” Some kids shake their arms or go run outside, others might want to picture their anxiety for a moment to know that it can’t hurt them. There are many healthy ways that kids can build tolerance to their anxiety and cope with it in their lives. 

Exposure helps. If you have a socially anxious kid, weaning them off of being afraid to talk to strangers can start with small actions with people like waitstaff. It may start with saying what they would say to the waiter with you, then progressing to them ordering dessert directly, and eventually a full blown comfort with strangers over time. 

Exercise is important. Like we mentioned earlier, children are very sensitive to balance. If they haven’t been moving around a lot they can feel a slight disorientation that starts the cycle of anxiety. 

Parenting Suggestions – DON’Ts

DON’T criticise your child’s struggles. Focus on progress both in therapy sessions and in daily life. Criticism and contempt can shut down all the progress a child has made with one small poorly thought out statement. 

DON’T label your child’s social anxiety as shyness if you want them to overcome their anxiety. Oftentimes labelling shyness only makes children feel more comfortable in avoiding social situations. 

DON’T blame yourself or your teen for any mental health struggles. Too many parents think that they have total control over the development of their child. While parenting is an important part of development, many factors change what struggles a child will face (biological, situational, environmental). This blame game can continue in circles indefinitely so focus on solutions instead. Provide gentle support and guidance instead.

Frequently Asked Questions for Children/Teen Anxiety Counseling

Do you prescribe medication for children?

We typically suggest that parents start with talk therapy before jumping into medication. Once we have a good grasp on what the situation is, we connect parents with psychopharmacologists in the area who can prescribe appropriate medications. Generally, we listen to the cues of parents on this. Some parents avoid medicating their child and we can work with a more naturalistic approach (but we will advise what we think may be best as well).

Will you disagree with my parenting?

We won’t criticise your parenting, but will follow your lead. However, issues in families and in children typically are related to the family system.That means that the best results happen when there is significant parental involvement and buy-in. We will suggest certain actions you can take in terms of your parenting, but we understand that ultimately the responsibility lies in your methods

Do you work with divorced parents?

We do work with divorced parents. We will collaborate primarily with whatever parent is bringing the child to therapy. If you have joint custody that may mean we work with parents on alternatinating weeks. If the parents can be civil then they can both be included in group sessions when needed. In any case, we don’t take sides between parental conflicts, and prefer to have a parenting plan in place when it comes to implementation of therapy solutions. Please note that our therapists are mandated court reporters. We must report any instances of abuse, hurt, neglect, financial exploitation or serious threats children make to others or themselves.

Which therapist is right for us?

Let us help you find the right therapist. Many of our therapists specialize in anxiety, so view our profiles online to learn more about specific counselors specializing in anxiety treatment or speak with our Client Care Coordinator, who can help you with a personalized match to the right therapist for your needs. 

Finding the RIGHT therapist is the most important piece of reaching your goals.

How long does Therapy take?

Counseling works best within the framework of a safe and trusted therapeutic alliance. Since it takes time to build this relationship with your therapist, we recommend committing to weekly sessions for at least 8 weeks. Research shows that consistency adds to the positive outcomes of therapy. Once you reach your 8-week goal, you and your therapist can discuss a frequency of sessions that will support your continued success.

I’ve never done therapy before...What can I expect in my sessions?

The unknown of anything new can make it scary. Especially if you’ve never been to counseling before. Let us show you the “roadmap” so you know what to expect:

1st Session:
This first meeting is an introduction for both you and your counselor. Your therapist will explain the therapy process and go over the specifics of informed consent. From there, your therapist will gather additional information about your history, current circumstances, as well as struggles and personal strengths, which will help them to define a treatment plan that aligns with your goals. 

This is also the chance for you to learn more about your therapist. We encourage you to ask questions and get to know them; the relationship you build with your therapist will be the most important part of your work together. 

2nd Session and Future sessions:
In your weekly sessions, you and your therapist will use evidenced based therapies such as CBT, Mindfulness or ACT, to help you address your symptoms of worry, stress and anxiety. For anxiety rooted in trauma, or related to obsessive compulsive disorder (OCD), your therapist may recommend treatment with EMDR.

Closing Sessions:
Our goal is for you to find relief from your anxiety and be ready to “graduate” from therapy. In the last few sessions with your therapist, you will review your initial goals, the progress you have made, and solidify your new skills for managing anxiety in your life. At your last meeting together, you’ll have the time for the meaningful goodbye with your therapist.

How much does Counseling cost?

We strive to create access to high quality mental healthcare for everyone. Our therapists’ rates vary by experience and specialized training. We will make every effort to find the right therapist for you. 

Acuity Counseling also accepts health insurance and offers both in-network and out-of-network coverage. 

We are in-network partners with: 

Aetna

Cigna

First Choice

Premera Blue Cross

* We do not participate in EAP plans

Why don’t you only use Cognitive Behavioral Therapy (CBT)?

While we use CBT as an aspect of our therapeutic approaches, we know that every individual is different. No one responds to any method perfectly, so by employing many techniques we are able to provide the most personalized support. Cognitive Behavioral Therapy is talked about in relation to mental health so often because it has a large body of research behind it and is easy to replicate across all cases. This is why you may hear it called “evidence based,” which it certainly is. However, we use other evidence based therapies in conjunction with CBT in our therapies.

How can I evaluate whether therapy is working?

Acuity is unique because we use research backed questionnaires to assess your mood, goals and progress. From time to time we may share with you your progress on these reports, “you report being angry 30% less days than when you started therapy,” and then ask what your goals for the future may be. We have found that by having clients set their own goals and following up regularly we can achieve better results.

Is medication used in conjunction with your therapy?

Some conditions for some people are best treated with the help of medication. If we find it necessary after our initial assessments, we will discuss types of medication, your comfort with it, and the pros and cons of medication with you. If you so choose, we can refer you to the appropriate psychopharmacologist in the area. If you are already on medication, we will coordinate treatment with your primary provider.

How long does therapy take?

Counseling works best within the framework of a safe and trusted therapeutic alliance. Since it takes time to build this relationship with your therapist, we recommend committing to weekly sessions for at least 8 weeks. Research shows that consistency adds to the positive outcomes of therapy. Once you reach your 8-week goal, you and your therapist can discuss a frequency of sessions that will support your continued success.

Break-free and begin your journey to

Your best
YOU.

There is a future life where trauma does not control your day. Imagine yourself feeling calm, confident and ready to handle new situations with ease. The tools to living the life you have always envisioned are here, at your fingertips.

Acuity Counseling can help.

 

Schedule your therapy session online

Reach out directly to our Client Care Coordinator for questions, matching, and scheduling:

Online Counseling

Our services are also available online through Zoom. Telehealth/Online counseling gives you the opportunity to explore your challenges in life without complicating your daily schedule.

GET STARTED

If you have questions and would like to talk about any of our counseling services, please reach out for a complimentary phone consultation or send us an email.

First Session Within 72 Hours of Calling

We book you an appointment within 24 hours of contacting us (usually less) and make sure your first appointment is soon after.

Seattle: 206-922-2376

Bellevue: 425-549-3242

Bothell/Woodinville: 206-910-9476

info@acuitycounseling.net

for Billing questions call:
206-922-2298

SCHEDULING

Use our Online Scheduling Tool or call our office to schedule your appointment, or for any changes regarding scheduling.

Schedule by phone: 206-910-9476

INSURANCE

Counseling services are often covered in full or in part by your health insurance company. Acuity Counseling proudly accepts most major health insurance plans.

Aetna

First Choice

HMA

Lifewise

Meritain

Cigna

GEHA

Kaiser Core/PPO

Sound Health & Wellness

Premera Blue Cross

We do not participate
in EAP Plans

Acuity Counseling Locations

Seattle

Bellevue

Bothell/Woodinville

BELLEVUE, WA
Cascade Place II
12729 Northup Way, Suite 6
Bellevue WA 98005
(206) 910-9476

SEATTLE, WA
Plaza 600 Building
600 Stewart St, Suite 1228
Seattle WA 98101
(206) 910-9476

BOTHELL/WOODINVILLE
Falcon View
12900 NE 180th St, Suite 160
Bothell, WA 98011
(206) 910-9476

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