Anxiety Problems

Anxiety is the most prevalent of mental health conditions in the United States.  When a family member is struggling with higher levels of anxiety it affects the whole family.  At Bryn Mawr Psychological Associates we use Cognitive Behavioral Therapy, Exposure and Response Prevention interventions, and other empirically-based behavioral interventions to help children and their parents to transcend these uncomfortable experiences.  And, we of course use good old-fashioned listening and talking to build a good working rapport and providing an opportunity to talk through and understand the pain that the child/adolescent is experiencing.  Sometimes we team up with a psychiatrist or internist who prescribes medication in conjunction with the therapy.


Separation anxiety:  For young children with Separation Anxiety we help parents learn strategies to help their child move toward independence with the least amount of stress on the child as possible.  Common examples we treat are fears of sleeping independently, fears of leaving a parent, and fears of separating at daycare or preschool.  For school age children this manifests in a fear of being in parts of the house where other family members are not present, fear of overnights away from parents such as at friends or a sleepaway camp.

Generalized Anxiety Disorder (GAD):  This is the catch-all category for anxiety that occurs in a general form in many settings and oven leaves the individual both physically and psychologically uncomfortable in work and social situations or even avoiding those situations.  We work with clients in helping them to explore their concerns and then how to reduce their overall anxiety through developing healthier thinking and coping patterns to increase their comfort.  This may include how to make difficult decisions or to improve assertiveness skills.

Obsessive Compulsive Disorder (OCD):  We treat mild to moderate levels of OCD at Bryn Mawr Psychological Associates.  Because OCD can manifest in many interfering and distressing ways, a careful assessment is the first order of business before establishing a specific treatment plan.  Often parents are unaware that OCD is the reason that their child/adolescent is experiencing peculiar thoughts and behaviors.  From there we utilize specific exposure and response based CBT interventions to help the individual gain control over the intrusive thoughts and problematic behaviors.

Social anxiety:  Social anxiety can manifest at a young age, but really can be a significant stressor at any point in grade school through high school and into college.  Children with social anxiety are uncomfortable in attending typical social experiences, feel that they miss out on friendships, and are at risk for being excluded or teased.  We teach anxiety reduction techniques and assertiveness skills as well as problem solving skills including learning to securing help from supportive school staff. 

Panic attacks:  It is difficult for friends and family who have never experienced a panic attack to understand just how debilitating and frightening these attacks can be.  Feeling like one could die from a panic attack or “lose one’s mind” is not unusual.  Fortunately, that is not what happens!  After determining the reasons for the attacks we teach techniques for staving off future panic attacks and reducing their intensity either with or without medication also being prescribed by a physician.

School refusal:  School refusal can result from a combination of anxiety factors that build to a point of the child refusing to go to school.  This of course greatly strains the family and can result in academic and legal problems, not to mention the stress that the child is experiencing.  This requires a team approach of the psychologist partnering with the parents and with supportive school personnel.

Specific phobias/fears:  Fear of specific things or situations such as dogs, bees, crowds, safety, weather events, and driving are sometimes a focus of treatment in which we utilize similar techniques as with other forms of anxiety to overcome these fears.

Post-Traumatic Stress Disorder (PTSD), Selective Mutism, and Agoraphobia are other anxiety disorders that we assess and treat at Bryn Mawr Psychological Associates. 

Comorbidity:  Other conditions that sometimes occur in conjunction with anxiety include depression, autism spectrum disorders, and substance use (in adolescence and adulthood).  Two forms of anxiety can also be comorbid; for example, GAD and social anxiety often co-occur.  In most instances where depression and substance use are comorbid with anxiety, it is anxiety that occurs first.  Once it worsens the risk of depression and substance use increases.  In the case of autism spectrum disorders and ADHD, the comorbidity is generally neurobiological in nature as they are co-occurring rather than one causing the other.

Medication:  Physicians and psychologists are generally in agreement that unless anxiety is severe that the favored course of intervention is to try therapy (often CBT-based therapies) first and then get a consultation for medication to go along with the therapy if therapy alone is not sufficient to bring relief.  We do not have prescribing professionals at Bryn Mawr Psychological, but are well-connected with local child psychiatrists/pediatricians and internists in the area if/when needed.