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  • What Is Anxiety?What Is Anxiety?
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Anxiety Articles Anxiety Anxiety Treatment Anxiety Types Online Therapy for Anxiety

Anxiety in Children: Signs, Symptoms, & Treatments

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Author: Linda Kudla, Psy.D.

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Linda Kudla Psy.D.

Dr. Linda Kudla, licensed psychologist: expertise in tailored therapy, collaborative approach for progress.

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Medical Reviewer: Benjamin Troy, MD Licensed medical reviewer

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Benjamin Troy MD

Dr. Benjamin Troy is a child and adolescent psychiatrist with more than 10 years. Dr. Troy has significant experience in treating depression, bipolar disorder, schizophrenia, OCD, anxiety, PTSD, ADHD, and ASD.

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Published: April 5, 2025
  • What Is Anxiety?What Is Anxiety?
  • SignsSigns
  • Types of AnxietyTypes of Anxiety
  • Childhood Anxiety CausesChildhood Anxiety Causes
  • WhenWhen
  • Helping Your ChildHelping Your Child
  • Anxiety TreatmentAnxiety Treatment
  • Getting HelpGetting Help
  • PreventionPrevention
  • StatisticsStatistics
  • InfographicsInfographics
  • Additional ResourcesAdditional Resources

Anxiety in children and adolescents is one of the most commonly diagnosed mental health conditions, often affecting their ability to focus, socialize, and function day to day. While some anxiety is normal, excessive worry can be overwhelming and sometimes mistaken for behavior problems. Fortunately, there are many ways to manage childhood anxiety through therapy, parenting strategies, and lifestyle changes.

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What Is Anxiety?

While occasional anxiety is a normal part of life, anxiety disorders are defined by intense feelings of worry that persist and sometimes worsen over time. These feelings can significantly interfere with a person’s life, preventing them from engaging in their daily routines, work commitments, and relationships. Anxiety disorders include generalized anxiety disorder (GAD), panic disorder, social anxiety disorder, and specific phobias.1

How Many Kids Have Anxiety?

Millions of children are struggling with an anxiety disorder. According to the CDC, over 9% of all children ages 3-17 had diagnosed anxiety between 2016-2019.2 Rates of anxiety have also increased steadily over time. The NIMH found that nearly 32% of adolescents have an anxiety disorder.3 With anxiety so prevalent in children and teens, it is important to know what signs to look for.

Signs & Symptoms of Anxiety in Children

Anxiety in children can present in various ways, and the signs aren’t always easy to recognize. It’s often mistaken for behavior issues like defiance or inattention. Understanding the full range of symptoms can help identify when a child may be struggling with anxiety.

Below are common signs and symptoms:4, 5

Physical (Somatic) Symptoms

  • Headaches, stomachaches, gastrointestinal issues, chest pain, or dizziness with no known medical cause
  • Racing heart, clammy hands, sweating, dry mouth, shaky hands or body, warm or flushed face
  • Difficulty falling or staying asleep
  • Nightmares and/or night terrors

Emotional & Behavioral Symptoms

  • Avoidance or extreme panic/distress when encountering feared stimuli
  • Persistent and excessive panic or distress when anticipating or experiencing a feared situation
  • A persistent and unrelenting need for control and/or perfection
  • Unwillingness to be flexible when plans change, sometimes resulting in tantrum-like behavior
  • Crying spells or emotional outbursts
  • Extreme irritability, especially in unstructured settings
  • Recurrent avoidance of the object or experience that causes fear

Cognitive Symptoms

  • Worries and fears that feel impossible to control
  • Fear that is out of proportion to the actual threat posed
  • Need for constant comfort and reassurance
  • Difficulty focusing, not paying close attention to detail
  • Appearing not to follow directions or interrupting frequently to express worry

Duration & Impact

  • Symptoms persist for an extended period of time (often more than six months)
  • Experience causes significant distress or impairment in academic, social, or daily functioning
  • Symptoms are not better explained by a medical condition or another mental health disorder (e.g., ADHD or autism)6
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Types of Anxiety in Children

The most commonly diagnosed anxiety disorders include generalized anxiety disorder, social anxiety, and specific phobias. In younger children, separation anxiety is also very common.9

Additional types of anxiety in children include:

Generalized Anxiety Disorder

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Children with generalized anxiety disorder (GAD) are often described by others as general “worriers” and sometimes “perfectionists.” Their worry transcends across various situations, settings, and circumstances and occurs more often and with more intensity than same-aged peers. They also may not always understand that they are “anxious,” but may only be able to notice that they feel better when things are within their control (removing as much ambiguity as possible so they can be prepared).

Evenings and sleep are typically most difficult for children with GAD, as it’s the time of day where there are fewer distractions and their minds have the time and space to focus more directly on worries: Did I say/do the wrong thing earlier? What if things go horribly wrong tomorrow? They may look for excess comfort and reassurance and prefer co-sleeping with caregivers or siblings over sleeping alone, though the relief from these accommodations is usually only temporary.

Children with GAD also typically report more physical manifestations of anxiety, such as headaches or stomach issues.

Social Anxiety

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Social anxiety involves focused worry about social interactions. Rather than nervousness about a variety of topics like in GAD, the socially anxious child or adolescent attends exclusively to the judgments of others. They are typically terrified of embarrassing themselves in some way, resulting in others perceiving them negatively and/or ridiculing them. A child who is socially anxious will typically defer to others, refrain from having an opinion (lest it be “wrong”), and may potentially avoid social interaction altogether.

It is possible for someone who is socially anxious to engage with others, speak in front of groups, or perform among a crowd, but they often do so under extreme distress. They may sweat excessively, stutter when trying to speak or perform, experience dry mouth, or appear shaky. In younger children, social anxiety may present as selective mutism, which consists of a child’s failure to speak in certain situations despite the expectation for them to do so. They will, however, speak openly and fluently in more comfortable settings.

Specific Phobias

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When the idea of being near a feared stimulus (e.g., a bee, medical shot/needle, thunderstorm) is even so much as mentioned and the child reacts with significant distress or upset, they may be exhibiting signs of a specific phobia. They will often go to great lengths to avoid coming into contact with the feared stimulus, which inadvertently reinforces their fear: they are unable to experience any successful coping of exposure to the feared object. That, combined with a temporary feeling of relief from their avoidance of it, ultimately strengthens the phobia.

Children are expected to be afraid of things they first encounter or that are largely unfamiliar to them, especially those that we evolved as a species to fear naturally (e.g., dangerous animals, insects, heights, etc.). However, with an appropriate amount of reassurance and modeling from trusted caregiver(s), and with increased understanding, these fears typically subside. For some children, however, they do not. Further, when a child experiences a severe negative event (e.g., being bit by a dog), they are more likely to develop a fear related to the experience.

Other Less Common Anxiety Disorders

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Other anxiety disorders that children may experience include:6

  • Separation anxiety occurs when a child experiences the distress symptoms of anxiety (as listed above) in response to being apart from their caregiver(s)/attachment figures.
  • Selective mutism is a child’s refusal to speak in certain contexts, despite showing the ability to and freely doing so in more comfortable environments.
  • Panic disorder captures a purely physical manifestation of anxiety, when a child experiences panic attacks and becomes fearful of their continued occurrence.
  • Obsessive-compulsive disorder, post-traumatic stress disorder, and adjustment disorder include an anxiety component in their presentation, but are not, in fact, considered anxiety disorders. They are now viewed as “Trauma- and Stressor-Related Disorders.”

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What Causes Anxiety in Children?

The causes of anxiety disorders are considered a combination of both nature and nurture. One popular theory involves what’s called the “diathesis-stress” model, which suggests that there is an underlying genetic or developed irregularity (“diathesis”) that puts a child at risk. This, in combination with an inability to cope with an acute life event (“stress”), is what leads to the development of an anxiety disorder. Therefore, without the predisposition and/or with successful coping of aversive life stressors, there is less of a chance of acquiring an anxiety disorder.10

Genetics

Genetics and brain chemistry are considered two of the most common factors that contribute to a predisposition for anxiety. Anxiety’s genetic component means that children with close family members who also have an anxiety disorder are more likely to experience one themselves. Genes can also impact the production of certain neurotransmitters in the brain that, when in excess, short supply, or are not functioning properly, can also cause an extreme anxiety response. Children with a behaviorally inhibited temperament or who appear shy may also be at an increased risk.

Stressful Life Events

Significant life events and reinforcement of avoidance behavior can trigger and/or exacerbate existing anxiety.

Life events that can increase a child’s risk for developing an anxiety disorder include:

  • Loss of a loved one or attachment figure
  • Changes in familial structure
  • Witnessing or experiencing violence or abuse

These are typically more challenging to cope with and  therefore may place a child at an increased risk. However, even seemingly insignificant situations can trigger an anxiety response, such as experiencing pain when receiving a shot or being stung by an insect.11

Learned Behavior From Caregivers

In addition, caregivers often inadvertently reinforce their children’s avoidance of anxiety producing triggers. When a child is acting shy and their caregiver continually speaks for them, a pattern may develop that prevents them from building their confidence in managing their anxiety, perpetuating it instead.  Being overprotective, keeping excessive control over their children, and struggling to manage their own anxiety are a few other ways that caregivers can negatively impact their child’s experience of anxiety.

When Is Child Anxiety a Problem?

While everyone experiences some anxiety in life, children suffering from severe, persistent anxiety need help to heal their worries. Parents might wonder how to know if their child’s anxiety is a problem requiring action.

The most important sign to look for when a child is struggling with anxiety is disruption in their daily activities. If a child is unable to maintain their daily lifestyle – personal hygiene, school attendance and performance, social relationships, personal interests, etc. – then it is important to seek professional help.

Here are a few other signs to look for indicating that your child may need professional help to deal with their anxiety:2

  • Being very afraid to separate from parents
  • Having intense fear about a specific thing or situation (e.g., spiders, doctor visits)
  • Avoiding school, extracurricular activities, or playdates
  • Expressing worries about the future or bad things happening
  • Experiencing intense episodes of anxiety with somatic symptoms like heart pounding, chest pain, trouble breathing, dizziness, sweating or shaking
  • Increase in anger or irritability
  • Difficulty sleeping
  • Ongoing fatigue, headaches, or stomachaches

Managing Symptoms of Anxiety in Children

There are a number of methods to help an anxious child, including modeling healthy behaviors and helping them get to the bottom of what’s causing their anxiety. Children often learn and model directly from their caregivers, who have the opportunity to demonstrate and encourage effective coping strategies.

Free Coping Skills Worksheets for Kids

This collection of three worksheets is designed to introduce a variety of coping skills to kids and parents, so kids can better manage their feelings during times of stress. Find the one you need or download the full Coping Skills for Kids Workbook here.

Coping Skills for Kids Workbook
Complete Workbook Download
Thought Record for Kids Worksheet
Thought Record for Kids Download
Encouraging Emotional Expression for Kids Worksheet
Emotional Expression for Kids Download
Self-Care Checklist for Kids
Self-Care Checklist for Kids Download

Here are several ways to help a child cope with anxiety:

Identify Their Triggers & Don’t Minimize Them

The first step in helping a child cope with anxiety is to identify their triggers. Noticing what seems to trigger your child’s anxious feelings can empower them to better understand their anxiety, and begin to think through their worries and find coping strategies that work for them. When parents validate their child’s worries, rather than dismiss or minimize them, it offers children much-needed understanding and compassion for their emotional experience, which is very real for them.

Preview Any Anxiety-Provoking Situations When Possible

For children who struggle with social anxiety or specific phobias, talking through anxiety-provoking situations before they happen can give a child a sense of control and mastery, easing their fears. For a child who is anxious about starting school, for example, visiting the classroom and the teacher ahead of time can be helpful, as can talking through their daily routine and what to expect. Role-playing situations together can also support a child through an anxiety-inducing scenario, equipping them with language and coping tools to help them in the moment.

Communicate Positive (But Realistic) Expectations

Giving your child a “just right” challenge to build self-esteem can communicate your faith in them. Using positive praise and affirmation to acknowledge their efforts helps your child feel supported and seen, regardless of the outcome. When they run into a problem, you can problem-solve together, helping them to build valuable skills.

Try to Limit an Anticipation Period

Anticipatory anxiety can be debilitating for some children, so reducing the anticipation period for triggering tasks or situations can help ease your child’s worries. One way of doing this is to break down big, overwhelming tasks into smaller ones, giving the child a sense of accomplishment and mastery along the way.

Don’t Ask Leading Questions

When you talk with your child about their anxiety, try to stick to open-ended questions that don’t lead a child to a yes or no answer, but instead open up a child-led discussion. Leading questions, like “does [this situation] make you anxious?” might cause your child to feel pressured, embarrassed, or self-conscious. By keeping questions open-ended, your child feels empowered to take the lead on better understanding and sharing their experience of anxiety.

Help Them Relax

Anyone told to “calm down” isn’t likely to do so by command alone; they need to actually be calm before they can make sense of the world. The same is true for children. Sit with them and take deep breaths together. Use a grounding technique and ask them to name all of the things in the room that are one color. Or have them identify 5 things they can see, 4 things they can feel, 3 things they can hear, 2 things they can smell, and 1 thing they can taste. These techniques should be practiced regularly so that the child feels comfortable trying them when they are anxious.

Help Them Think Through the Entire Anxiety-Provoking Situation

Rather than providing logical responses to their fears, ask them to consider these themselves (e.g., what do you think is really likely to happen if you make a mistake when presenting in front of the class?).

Validate Their Worries and Concerns

Even if it’s difficult for you to understand their logic, find their truth. For example, “I know the loud sound of the thunder scares you. It’s a big boom, it really can be startling!” It’s much easier to tell a child why they don’t need to be afraid, but it can leave them feeling like they can’t trust themselves, which can have negative effects.12

Allow Children Control Whenever Possible

If they need to clean up a big mess, ask them which they’d like to clean up first, the crayons or the Legos. Instead of feeling like they have no control over having to clean, they focus on which choice they prefer, giving them a sense of control. When it’s difficult to find two options, resorting to, “Would you like to do it yourself, or would you rather I help you?” is an easy way to build in a choice (and often gets the job done faster!).

Help Children Approach (Not Avoid) Feared Stimuli

Provide them with support by letting them know you love them very much, acknowledging that what they have to do is difficult for them, reminding them that you have complete confidence in their ability to handle what they are faced with (within reason), and letting them know what you will do to support them (other than allow them to avoid it). Celebrate victory. Reward success.

Take Extra Care of Their Physical Health

Regular, moderate exercise has been shown to decrease current anxiety and to prevent future episodes. Anyone who has suffered from too little sleep knows the impact it can have on mood, concentration, and ability to tolerate everyday tasks and events; this is exacerbated in someone who also suffers from anxiety.

Model a Positive outlook and gratitude

Practicing gratitude can help shift a negative experience into at minimum a neutral one. When a child is encouraged to notice and appreciate little things on a regular basis, they develop resilience when faced with challenges.

Help Them Have a Predictable Home Life

The more predictable something is, the easier it is to prepare for, both literally and mentally. Having a regular schedule posted somewhere for all family members to see, keeping living and work spaces tidy with labeled places for items, and getting things ready in advance (e.g. packing a backpack the night before) are just a few ways to provide some relief at home.

Child Anxiety Treatment

There are a number of different approaches to treating anxiety in children and adolescents. For some, their anxiety may be so severe that only medication will reduce their symptoms enough to be able to engage in psychotherapy. Although medications show some effectiveness in treating anxiety, they often do not independently lead to the same long-term effects that psychotherapy and lifestyle changes can produce.

Therapy

The most common evidence-based form of psychotherapy for anxiety in children is CBT for kids. Although the exact structure of the therapy itself is tailored to the individual, manualized protocols for each anxiety disorder are often available to mental health providers.

Therapy is most successful when caregivers are involved because they can reinforce the coping skills for anxiety in kids that are being learned, encourage practice between therapy appointments, and model and support using the skills without compensating for the child’s efforts. Each child and their presentation will differ; however, CBT is generally intended to be a short-term therapy approach with initial results often seen between 3-6 months of weekly sessions.14 

Free CBT Worksheets for Kids

This collection of three worksheets is designed to introduce the core ideas behind CBT for children, and help kids and parents practice CBT techniques at home. Find the one you need or download the full CBT for Kids Workbook here.

CBT for Kids Workbook
Complete Workbook Download
Thought Record for Kids
Thought Record for Kids Download
Cognitive Distortions for Kids
Cognitive Distortions for Kids Download
Fear Hierarchy Worksheet
Fear Hierarchy Download

Medication

Medication is another intervention some caregivers might consider when attempting to alleviate their child’s anxiety. Anxiety medication is most often prescribed through a primary care pediatrician or psychiatrist. Although a few lesser-prescribed medications (e.g., stimulants, alpha-two agonists, antipsychotics) show some effectiveness in treating specific symptoms, they are less likely to address anxiety as a whole.

How to Get Help for Your Anxious Child

There are various ways to seek support for a child struggling with anxiety. Some families choose to start with their primary care provider or pediatrician to rule out medical causes and get referrals to local therapists or mental health agencies. Others may turn to trusted friends or family members for recommendations.

Increasingly, many caregivers are finding support through online therapy platforms, which offer flexible access to licensed child and adolescent therapists from the comfort of home. These platforms often allow you to filter providers by specialty, approach, and availability—making it easier to find someone who fits your child’s unique needs.

Regardless of how you find a therapist for your child, what matters most is the fit between the therapist and your child. A strong therapeutic relationship is key to effective treatment.

Don’t hesitate to:

  • Request consultations
  • Ask questions about the therapist’s experience with child anxiety
  • Arrange a brief meet-and-greet between your child and the therapist

It’s okay to “shop around” until you find the right match—one that makes both you and your child feel supported, comfortable, and hopeful.

School Support for Children With Anxiety

At times, a teacher will notice anxious behavior and reach out, either directly or through a school counselor. Some schools provide adjustment counselors for children who struggle with mental health challenges in the academic setting. Many schools promote social and emotional learning to help children build confidence and manage interpersonal relationships, which can result in decreased symptoms of anxiety. If they feel a child would benefit from additional interventions, they typically reach out to the caregiver(s) to discuss options.

Can Anxiety in Children Be Prevented?

While some factors that come to play in the development of childhood anxiety cannot be prevented, like biology and temperament, there are some things parents can do to help protect their children from anxiety. Research shows that children who are the victims of trauma, abuse, or chronic stress are more likely to experience anxiety. This includes children who experience bullying and social rejection from peers. Parental anxiety also puts children at risk of developing an anxiety disorder of their own. Protecting children from as many adverse childhood events as possible, while modeling healthy coping strategies when faced with stress or anxiety of their own, can empower parents to give their children the healthiest emotional advantage against anxiety.2

For children who are at risk, early intervention is key. Some parenting programs help those with young children to gain valuable insight and skills to prevent anxiety from developing later on.16 Seeking professional help right away for children who may be experiencing an anxiety disorder, and working together as a family to support them in identifying their anxiety triggers and practicing positive coping strategies in a supportive, nurturing home environment, will set any child up for success in managing their feelings of anxiety.

Childhood Anxiety Statistics

The National Institute of Mental Health (NIMH) estimates that close to 32% of adolescents (age 13-18) experience an anxiety disorder at one point during their adolescent years, with a higher rate for females (38%) than males (26.1%). Of all psychiatric diagnoses among this population, anxiety is the most common.3

Overall, research has shown that with children in the United States aged 3-17:8

  • 7.1% (approximately 4.4 million) experience an anxiety disorder
  • Of those with anxiety, more than 1 in 3 experience behavior issues (37.9%) or depression (32.3%)
  • Being diagnosed with an anxiety disorder has been increasing over time (5.5% in 2007; 6.4% in 2011-2012)
  • When broken down by age, only 1.5% are age 3-5, just over 6% are age 6-11, and more than 10% are between the ages of 12 and 17
  • Six out of ten (59.3%) receive treatment for their anxiety

Anxiety in Children Infographics

Symptoms of Anxiety in Children   Managing Symptoms of Anxiety in Children   Child Anxiety Treatment

Additional Resources

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How to Find & Choose the Right Therapist for Your Child

How to Find & Choose the Right Therapist for Your Child

Discovering and selecting the right therapist for your child often comes down to two things: research and persistence. Be willing to put in the time and effort to call around to different therapists or therapy organizations in your area. Read through therapist profiles to see if their style, approach, and expertise resonate with you and your child.

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Depression in Children Signs, Symptoms, & Treatments

Depression in Children: Signs, Symptoms, & Treatments

If you or someone you know is concerned about symptoms related to depression, seeking professional help from a mental health provider is highly recommended. Licensed professional counselors, social workers, psychologists, or psychiatric medication prescribers are able to determine whether a person is experiencing depression and the best methods of treatment.

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Sources Update History

ChoosingTherapy.com strives to provide our readers with mental health content that is accurate and actionable. We have high standards for what can be cited within our articles. Acceptable sources include government agencies, universities and colleges, scholarly journals, industry and professional associations, and other high-integrity sources of mental health journalism. Learn more by reviewing our full editorial policy.

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  • Centers for Disease Control and Prevention. (2019, May 1). Anxiety and depression in children: Get the facts. Centers for Disease Control and Prevention. https://www.cdc.gov/childrensmentalhealth/features/anxiety-depression-children.html

  • National Institute of Mental Health. (2017, November 1). NIMH » Any Anxiety Disorder. https://www.nimh.nih.gov/health/statistics/any-anxiety-disorder.shtml

  • Gelenberg A. J. (2000). Psychiatric and Somatic Markers of Anxiety: Identification and Pharmacologic Treatment. Primary care companion to the Journal of clinical psychiatry, 2(2), 49–54. https://doi.org/10.4088/pcc.v02n0204

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  • American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders (5th ed.). Washington, DC: Author.

  • Cherry, K., & Lehman, S. (2020, May 10). Why Optimal Arousal Levels Lead to Better Athletic Performance. Verywell Mind. https://www.verywellmind.com/what-is-the-yerkes-dodson-law-2796027

  • Centers for Disease Control and Prevention. (2020, June 15). Data and Statistics on Children’s Mental Health | CDC. https://www.cdc.gov/childrensmentalhealth/data.html

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  • The Children’s and Adult Center for OCD and Anxiety. (n.d.). WorryWiseKids.org | Cognitive Behavior Therapy and Medications. WorryWiseKids.Org. Retrieved September 11, 2020, from http://www.worrywisekids.org/node/22

  • Seligman, L. D., & Ollendick, T. H. (2011). Cognitive-behavioral therapy for anxiety disorders in youth. Child and adolescent psychiatric clinics of North America, 20(2), 217–238. https://doi.org/10.1016/j.chc.2011.01.003

  • Walkup, J. T. (n.d.). Best Medications for Kids With Anxiety. ChildMind.Org. Retrieved from https://childmind.org/article/best-medications-for-kids-anxiety/

  • Morgan, A. J., Rapee, R. M., & Bayer, J. K. (2016). Prevention and early intervention of anxiety problems in young children: A pilot evaluation of Cool Little Kids Online. Internet interventions, 4, 105–112. https://doi.org/10.1016/j.invent.2016.05.001

  • Guessoum, S. B., Lachal, J., Radjack, R., Carretier, E., Minassian, S., Benoit, L., & Moro, M. R. (2020). Adolescent psychiatric disorders during the COVID-19 pandemic and lockdown. Psychiatry research, 291, 113264. https://doi.org/10.1016/j.psychres.2020.113264‌

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We regularly update the articles on ChoosingTherapy.com to ensure we continue to reflect scientific consensus on the topics we cover, to incorporate new research into our articles, and to better answer our audience’s questions. When our content undergoes a significant revision, we summarize the changes that were made and the date on which they occurred. We also record the authors and medical reviewers who contributed to previous versions of the article. Read more about our editorial policies here.

April 9, 2025
Author: No Change
Reviewer: No Change
Primary Changes: Added Coping Skills for Kids worksheets.
April 5, 2025
Author: No Change
Reviewer: No Change
Primary Changes: Edited for readability and clarity. Added CBT for Kids worksheets.
October 4, 2023
Author: No Change
Reviewer: No Change
Primary Changes: Updated for readability and clarity. Reviewed and added relevant resources. Added “What Is Anxiety?”, “How Many Kids Have Anxiety?”, “When Is Child Anxiety a Problem?”, “Can Anxiety in Children Be Prevented?”. New material written by Heather Artushin, LISW-CP and reviewed by Kristen Fuller, MD.
September 18, 2020
Author: Linda Kudla, PhD
Reviewer: Benjamin Troy, MD
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