Doernbecher Children's Hospital

Pediatric Anxiety Treatment Clinic

About our clinic

For children and teens with anxiety disorders, we provide full evaluation and the most up-to-date treatment options. Our main focus is on children (and their families) who haven't responded well to other treatment plans. We also specialize in cases where anxiety treatment is complex because of other factors, such as developmental or medical issues.

We are dedicated to providing the most advanced and proven anxiety treatments. We mainly use a specific Cognitive Behavioral Therapy (CBT) approach called Exposure and Response Prevention (ERP). This method is supported by the most up to date research. 

We work to develop a treatment plan that is customized to meet the unique needs of each child and family. We also work closely with pediatricians, primary care providers, psychiatrists and schools to coordinate the right care.

Clinic director

Anxiety

Some feelings of worry in life are normal, even for youth. If youth are nervous about a big test, that is normal. If they have so much anxiety that they feel like they can't breathe or can't leave the house, then this may mean there is a larger issue.

Anxiety can show in different ways, with symptoms ranging from mild to severe. When worry or fear begins to interfere in someone's ability to function in daily life, we call it an anxiety disorder. There are several types of anxiety disorders. If anxiety is severe, a person may have symptoms of more than one type.

Anxiety is common in youth. One national organization estimates that 25 percent of teens between the ages of 13-18 have an anxiety disorder.

We can help by evaluating and treating a variety of anxiety disorders and other related conditions. Some of these disorders are:

Youth with SPAD have feelings of extreme anxiety when separated from their parents. Children with this anxiety often have a fear that "bad things" will happen to them or their loved ones while separated. SPAD can also take the form of dread, a vague sense that something "terrible" will happen. SPAD can lead children to refuse to go to school. They may not want to leave home for sleepovers with friends or go to summer camp. Youth may demand that someone stay with them at bedtime or refuse to sleep in their own bed. They often have a fear of the dark and/or of being alone.

Youth with GAD are very worried about events outside of their control, such as natural disasters or the future. They often expect the worst for a variety of events for no clear reason. They may be overly concerned about school success, natural disasters, health of their families, personal safety, family finances and other things that are not their responsibility. Youth with GAD often have physical symptoms, such as headaches, stomachaches, muscle aches and restlessness.

A panic attack is a random feeling of terror. It can cause sweating, a rapid heartbeat, and chest pains. In youth with panic disorder, they have seemingly out-of-the-blue panic attacks. Then they are very worried about it happening again. They may fear the experience itself, but also worry about being judged by others (and themselves) as crazy or out of control.Because of this fear of a panic attack, some also develop a fear of leaving home (agoraphobia). Youth with agoraphobia have strong fear in places where escape seems difficult or they are unable to get help, such as an elevator or a plane. Youth with panic disorder often have other issues, which can make diagnosis harder. They may also have another anxiety disorder, depression, irritable bowel syndrome, asthma, drug or alcohol abuse.

Anyone can feel shy in social settings, but youth with SAD feel extreme fear. They are terrified of embarrassment or being negatively judged by others. Being called on in class for an answer can be an emotionally scary moment for kids with SAD. If symptoms are severe, youth may refuse to go to school and limit social relationships. They may say they feel powerless, alone or ashamed. SAD can interfere with daily life and prevent youth from forming important relationships.

If you've ever used the mute button on your TV remote to temporarily turn off the sound, then you have an idea of what children with selective mutism may do. Youth with this anxiety disorder are "selective," or careful, about when they speak. They may not speak in some social situations, such as at school, sports practice or at shops. However, they will talk comfortably in other situations. Often, youth with selective mutism also have social anxiety disorder. Selective mutism can interfere with school, making friends and having fun. It can also keep youth from being safe if they are unable to ask for help or basic needs.

Some fears are common and normal during childhood. However, if fears become more severe over time, they can develop into phobias for some youth.

A phobia is an extreme or unreasonable fear of something. Examples of specific phobias include a fear of animals, insects, darkness, heights, thunder, flying, needles (shots) and elevators. Youth with specific phobias may try hard to avoid the feared places or things.

Some youth develop a phobia after a scary event, such as having a fear of dogs after being bitten. For others, the fear has no cause, but is still very strong.

Older youth may recognize the fear does not make sense since there is little real danger, but may feel powerless and very anxious. In younger children, fears can show as crying, tantrums, clinging, headaches and stomachaches. Unlike adults or older youth, children often do not realize their fears are irrational.

Other related conditions

OCD can have a variety of symptoms, and not every person has the same combination of symptoms. Generally, youth with OCD experience unwanted thoughts that they can't easily stop (obsessions), which causes them to use a repetitive series of behaviors and routines (compulsions) to ease the distress.

Youth with OCD may not realize their obsessions and compulsions are extreme, though they may spend several hours each day with obsessive thoughts. They may engage in seemingly silly and lengthy rituals, such as counting or frequent handwashing. They use these methods to ward off unwelcome thoughts, feelings or images. Compulsions are often done in a very specific manner. For example, washing hands a certain number of times or in a very specific way. The symptoms of OCD can cause severe emotional distress and interfere with school, family or social activities.

PTSD is a serious condition that can occur in youth who have gone through a shocking experience or trauma. Youth can also develop PTSD by witnessing such an event. Examples of traumatic events include natural disasters, car accidents, war, rape, beatings and the sudden death of a loved one. Among these scary experiences, rape and/or beatings are more likely to cause PTSD than other types of traumas. Also, the more trauma events a youth experiences, the higher the risk of PTSD. Girls are more likely than boys to develop PTSD.

Youth can show symptoms of PTSD that includes extreme caution or watchfulness, nightmares, flashbacks and jumpiness around loud sounds. They may have negative reactions to reminders of the event, including certain sounds, places and more. They may want to pretend the event didn't happen. They may be anxious or sad. They may have trouble trusting others.

The emotional distress from PTSD can cause youth to have stomachaches, headaches, irritability, depression, poor concentration and feelings of hopelessness. It can also lead to impulsive or self-destructive behaviors, including anger, eating disorders, inappropriate sexual behavior and drug or alcohol abuse.

With PTSD, getting help soon after the event is very important before the symptoms or other behaviors start or worsen.

We also provide treatment other anxiety-related difficulties, such as vocal cord dysfunction or eating disorders due to fear of choking, vomiting or ingesting contaminates.

Associated difficulties

These anxiety disorders occur at much higher rates with other conditions, such as:

  • Depression
  • Attention-Deficit Hyperactivity Disorder
  • Tic and Tourette Disorders
  • The Body Focused Repetitive Behaviors (e.g., nail biting, hair pulling, skin picking)
  • Disruptive Behavior Disorder
  • Oppositional Defiant Disorder