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Does My Child’s Anxiety Need Therapy? 7 Signs for Long Island Parents
“Does my child’s anxiety need therapy, or is this just a phase?” It’s one of the questions I hear most from parents on Long Island. All kids worry. They worry about tests, the dark, a new teacher, a dog down the street. That’s normal, and most of it fades on its own. But sometimes worry gets bigger instead of smaller, and it starts running the family’s day. Here’s how to tell the difference, and what actually helps.
Normal worry vs. an anxiety problem
Normal worry is tied to a real situation, it’s in proportion to that situation, and it passes. A child who’s nervous before a piano recital, plays anyway, and is fine by dinner is doing exactly what kids are supposed to do.
An anxiety problem looks different. The fear is bigger than the situation calls for. It lasts for weeks or months. And, most important, it gets in the way of things the child needs or wants to do. That last part is the one I’d watch most closely.
7 signs it may be time to get help
1. Your child avoids things other kids their age handle. Skipping birthday parties, refusing sleepovers, not ordering their own food, staying out of the pool. One skipped party means nothing. A pattern of avoiding is worth paying attention to.
2. School mornings have become a battle. Stomachaches that show up on school days and disappear on weekends, tears at drop-off, calls to come home early. Missing school because of fear is one of the clearest signs that anxiety is in charge.
3. They need a lot of reassurance. “Are you sure the door is locked?” “What if you don’t come back?” “Is it going to rain?” Asked once, these are normal questions. Asked ten times, with the answer never quite good enough, they’re a sign of anxiety.
4. Bedtime takes forever. Many anxious kids can’t fall asleep without a parent in the room, or end up in the parents’ bed most nights well past the age when that usually stops.
5. Physical complaints keep coming back. Headaches, stomachaches, nausea, or feeling short of breath, especially before the same kinds of events. It’s smart to check with your pediatrician first. If nothing medical turns up, anxiety is a common reason.
6. Your family has started working around the fear. This one surprises parents. You leave the light on, skip the restaurant, answer for your child when someone asks a question, or drive them to school because the bus is “too much.” We all do this out of love. But when the whole family’s routine bends around a child’s anxiety, the anxiety usually grows.
7. It’s been going on for more than a few weeks. A rough patch after a move or a loss is expected. When the worry is still there, or getting worse, after a month or two, it’s time to talk to someone.
If you’re seeing one or two of these, keep an eye on it. If you’re seeing several, or the anxiety is keeping your child from school, friends or sleep, a consultation is a good idea.
Why “waiting it out” often backfires
Anxiety runs on avoidance. Every time a child avoids something scary, they feel relief right away. That relief teaches the brain that avoiding works, so next time the fear is a little bigger and the avoiding comes a little faster. Without help, many kids don’t outgrow it. They just get better at avoiding.
The good news is that this cycle can run the other way. When kids face their fears in small, manageable steps, the fear shrinks, and their confidence grows.
What helps
Cognitive behavioral therapy (CBT). CBT is the most researched treatment for anxiety in children. A trained therapist helps your child face feared situations gradually, one step at a time, and learn to handle worried thoughts. It’s active and practical, and kids usually do it with a lot of support and some humor. You can read more on our child therapy page and our anxiety treatment page.
Treatment that includes parents. Parents are a big part of the solution. You don’t need to become your child’s therapist. But learning when to step back, how to respond to reassurance-seeking, and how to stay calm while your child does something hard can make a real difference.
Independence Therapy. At CBA we also offer Independence Therapy, an approach I developed with Dr. Matthew Fastman. Kids take on fun and sometimes challenging tasks on their own, like walking to a store or making a meal, while parents work on loosening the reins. Doing things on their own gives anxious kids proof that they can handle more than they (or we) thought.
What you can do this week
- Notice the avoiding. Write down what your child skips or needs you for because of worry. This list is useful if you do talk to a therapist.
- Shrink the reassurance. Answer a worried question once, kindly, then say something like “I already answered that. I know you can handle it.”
- Praise brave behavior. When your child does something that was hard for them, notice it out loud, even if it was small.
- Give them a small job on their own. Paying at a counter, ordering for themselves, walking the dog around the block. Pick something just a little outside their comfort zone.
When to call us
If your child’s worry is getting in the way of school, friends, sleep, or family life, you don’t have to figure it out alone. Our team in Great Neck works with children, teens and parents from across Long Island and New York City, in person and by video.
Schedule a call to talk with us about whether therapy makes sense for your child.
This article is general information, not medical advice. If your child is in crisis or talking about hurting themselves, call or text 988 or go to the nearest emergency room.