Fear & Phobias in Teens & Pre-Teens

Parent Q&A

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  • Hello, My 10 year old daughter is dealing with anxiety issues--some disturbing thoughts that make it hard for her to fall asleep at night, worries, scared of certain situations (like doesn't want to read about a hosptial scene becasue she saw our neighbor being carried out to an ambulance when she was younger and it really scared her) some phobias, sometimes some school refusal, some sensory issues around clothes.  She is also delightful, friendly, loves school, does lots of different things :) Anyways, we are working with a pyschiatrist and trying a new med., so hopefully that will help soon but I also want to figure out a good therapist and trying to figure what type of therapy--family therapy (my husband and I are both on the more high strung end of things, i feel overwhelmed alot and have a tendency to worry, my mom is very anxious and she lives in our in law unit)  or CBT or  CBT and exposure therapy.  I've heard different things--what matters most is the relationship and connection the child has with the therapist, it's a family systems issue so we should do family therapy but also that at the end of the day talk/art/play therapy don't help much as much as the CBT/exposure therapy.    so trying to figure out what will be the most helpful and then of course there is the challenge of finding someone and the cost.  so also curious to hear specific recommendations of therapists. Thanks!!

    We, too, have anxious tendencies, and our child started having anxiety issues around 9 / 10 years old. They were having issues with sleep, self esteem, depression. We tried CBT exposure therapy and it wasn’t for us. It is not meant to be for a long term and we do think the few sessions did have immediate improvement in child’s fear but the process was very intense. I do not doubt the effectiveness but we wanted a more warm and supportive / relationship based therapy. The work involved was so hard that the child refused to do the exposure therapy. Also, CBT / exposure therapy tends to be more expensive. I think it’s because it is meant to be a short term, targeted work? When we began exposure therapy, the therapist said she thought it would take about 10-12 sessions to address the  2 main issues. 

    We switched to a play based therapy at www.thechildrensinstitute.com and it has been working out well. Child enjoys the warmth, validation and gentle guidance from the therapist. We also meet with the same therapist and she does coaching for us. the improvement may take more time but the process is less painful for us and the child. The coaching sessions are helping us understand our child better.

    The cost is a burden. Our child’s current therapist is $200/hr which is less than any CBT therapist we worked with or looked into. I think play based therapists charge anywhere from $175-$225 based on our recent research. Most don’t take insurance. We have Kaiser so we have no options but when we had Cigna PPO, we submitted for reimbursement and we found Cigna to issue reimbursements pretty quickly. 
     

    I am sorry you are dealing with this. Hope you find the help you need ASAP. 

    Hi, I am a therapist and would recommend talking with a few therapists. I think Cognitive Behavioral Therapy (CBT) or Exposure Response Prevention (ERP) would be a good place to start. But most therapists will assess if the type of treatment is appropriate for your child. And most ERP therapists are also trained in CBT, not always the other way around.

    For parents there is also SPACE treatment (Supportive Parenting for Anxious Childhood Emotions) which is a way of treating the child’s anxiety through working with the parents only. It’s a great treatment for school refusal due to anxiety and childhood anxiety in general.

    Unless you are scared for their safety I would not go the med route at age 10. You may end up on a non stop road of meds that are not really made for children. I have a lot of experience in this having gone through it with my own child. DBT therapy would be very appropriate. It has groups, parent training, individual therapy all as a part of it. Another option is Equine therapy. Both of these are helpful for anxiety and trauma. They helped my child immensely. 

    My child sounds similar to yours and we've had great success with CBT. It does take work in between sessions, but our therapist did an amazing job of getting my child's buy-in when suggesting new things to try. She always takes time at the beginning of the session to check in on general stuff - how things are going with friends, any new school drama, how the soccer game went, etc. And she must take amazing notes because she remembers everything! Which of course makes my child feel connected and heard. It's expensive, but short-term. We did a few months in the spring and successfully addressed panic attacks and some sleep issues. We are now back for some new stuff, but the expectation is that this will also be short-term. 

  • Hello I’m looking for a therapist for my 14 years old daughter for Emetophobia (phobia of vomit) she’s been suffering and struggling with her daily life and school .

    Our daughter started seeing a therapist at Kaiser Oakland for the same problem, same age. We're not aware of anyone specialized in it, it's lumped together with a number of other phobias and anxieties so it's likely most any therapist can talk about it, although there are people who seem more focused on cognitive behavioral therapy who might be appropriate. I looked at various posts on this list but landed on Kaiser for cost reasons. Her problem didn't seem debilitating and my impression is that the therapy helped a bit, but aging a couple of years and life experience seem to be helping more. If it were more of a problem we would have looked for someone to meet more regularly  who seemed more focused on this issue specifically, but at this level it's been ok. FWIW, she just had a bout of a real stomach flu with real vomiting, which was tough but in the end seemed to help - now she knows the difference between real and imagined illness...
     

    My daughter saw Emily Berner MFT on College Ave. for the same thing. She is amazing!!!! My daughter made a total comeback! She is expensive if you have to pay out of pocket but worth every penny! Your child's mental health and well-being is worth it. You can reach her at (510) 652-4455, ext. 5.

    I would highly recommend Dr Kim at the Wright Institute for childhood anxiety and phobias. She has helped pretty much cure my daughter of her blood/injury/injection phobia. Here's her email: anatasiakim [at] gmail.com

    Good luck!

    If she is still in practice and taking new patients, Dr. Amy Jenks helped my daughter with this exact issue. Good luck, I know this can be very difficult.

Archived Q&A and Reviews


Questions

12 year old's intense fears triggered by movies

Nov 2008

Our 12 year old daughter has been experiencing veryintense, paralyzing fears for about a year. These fears are always triggered by a scary movie (the latest one was one she had to watch in English class, as the new genre they are studying is ''science fiction and mysteries''). The result for her is that she is unable to go in the bathroom by herself, must have someone with her when she brushes her teeth, she cannot sleep in her own room, she cannot do her homework alone (must be surrounded by other family members), and so on. Mostly, these fears occur at night, when it is dark outside. She gradually gets back to normal and then, WHAM, she will see a scary movie at a slumber party, school, or something like that and the whole things starts over again!

I did take her to see a therapist, which seemed to help in the moment, but now what? It is not getting better overall. She feels awful about this condition (she is embarrassed and ashamed to feel this way), is tired from lack of sleep, and feels frustrated that she is powerless to say no to friends and teachers who ''make'' her watch this stuff. Even as she is watching the movie, she is afraid of being afraid and what the consequence will be later. We do encourage her to speak up to her friends, which she tries to do. But, for example, at the last party, she was over-ruled and her choice was to leave the room (which she was afraid to do, because it was night time and she did not want to be alone), or watch the movie with everyone else. From now on, I will warn the parents at sleep-overs, but I cannot monitor every interaction (as in the case of what happened at school).

For the record, nothing has happened to her, outside of her movie fears (both I and the therapist confirmed this), and she does not have any other OCD type of behaviors that would go along with these seemingly irrational fears she is experiencing.

We are at our wit's end, and my husband and I are starting to fight about this (he thinks we should ignore it and I think we should help her). It is not going away, and is not getting better. HELP! Will she grow out of it?


My 15 year old daughter had a very similar experience when she was 11. She was left in the car with her brother, then 8, in front of a cheese shop on Hopkins while I picked up cheese for pizza for dinner. When I came back, my children told me some of the middle school kids were talking to them through the closed window. After this experience my daughter couldn't be alone while my son was totally unaffected by the incident. She had to be escorted to the bathroom and everywhere else. Of course, as a parent you don't know how long her fear would last. So the normal thing to do seems to be take her to a therapist or seek for professional help. But I didn't grow up in the US, and taking her to a therapist felt against my instinct, even though my friends recommended therapy. My daughter wanted to be with me all the time. So I decided to be with her all the time. It was a bit tiring after a week, and more importantly worrisome. At night it got worse. She slept with me and my husband. But I felt her fear when I was with her, whatever the cause was. So my heart goes out for your daughter. But it doesn't last forever. I don't remember exactly how long. But it wasn't long. Now my daughter is perfectly 'normal.' She is a sensitive person who gets scared of violent movies. But who doesn't? It's only so natural to feel this way. I cannot understand why more children aren't paralyzed by the kind of movies they watch. Hang in there. She will be fine sooner or later. Best wishes and thoughts. Hia


Stop stepping in for your daughter. At this point, she definitely knows she can't handle scary movies. She has to learn to say ''no, I don't want to watch it.'' If she doesn't, then she has to live with the consequences. I am 50, and was exactly like your daughter. I never outgrew it. I still sleep with a hall light on when no one else is home and have not seen a ''scary'' movie since Silence of the Lambs, which tortured me for years. I never grew out of it, but I have to deal with it. she needs to deal with it.


When my son was 7-8, he saw a PeeWee Herman movie that featured a character called Large Marge. That person took off a mask in the movie to reveal a monster behind the mask. This so scared my son that he had to be wrapped in a blanket and held for a day. He told us he was worried we were all wearing masks that hid our true faces. He then slept in our bedroom for a month, then his little brother's bedroom for a year. He also became very worried over certain books. It was problematic for him to watch movies with friends. Here's the good news--he did indeed grow out of his intense reaction to external stimuli. But it took a while. I kept telling him that he could watch his fear and see that nothing bad was going to happen to him just because he had this feeling in him. This seemed to help, but it took years. So I don't think ignoring the matter is helpful, but trying to take the intensity out of the child's response might offer relief. And by the way, he has an extremely vivid imagination which he's learned to channel in amazing ways. mom of formerly frightened kid


Wow! That sounds very intense and very hard. I also had a very vivid imagination when young, and still do, so that even scary (Agatha Christie etc.) stories had me up at night, and even stories of the devil became very real for me. Being very imaginative is a real gift, and my recommendations would be to really protect her and be there for her. How about telling the sleepover parents that she can only see movies there that you have previously approved (and, by the way, I find it extremely insesitive to have her fears re the movie 'overruled'; I will NEVER a allow that in my house), and a similar discussion with the teacher? There must be a non-punitive alternative for her (and, hopefully, some other students so she's not alone)instead of the fear-inducing movies. And, btw, why are so many movies watched in school??? I would defintely let her sleep with you and be with her at night when she's afraid without making a big deal out of it. I had scary dreams for years and wish my parents had been more comforting and present around those. Pro Support


The teachers even show scary movies in elementary school. So frustrating! Here are some ideas.

Get a scary movie or turn on a scary tv program and show your daughter how they use music to manipulate the viewers feelings. Turn the sound off and some of the terrifying scenes are actually funny without the music.

Get her transferred out of a class that uses scary movies.

I think it is the obligation of the hostess to create a party at which all the guests are comfortable. I know some people are very selfish and say ''this is my day and I can do what I want.'' But still I think you or your daughter can call ahead of time to find out what is planned. Then you or your daughter can put gentle pressure on the host to find a movie that all enjoy. If that doesn't work, your daughter can choose not to attend, or choose to attend the fun part of the party. Or, if she has an ipod or other such device, she could listen to music and read while the rest of the group watches the movie. I think it will be easier for her just knowing that she has choices. anon


http://www.a-levelpsychology.co.uk/common/supplementary/1841692514/675.pdf

''Systematic desensitisation'' is a therapy that you might want to check out. You mention ''you did see a therapist''. Did you know that often it takes a very long time to mend something that may have taken a very short time to initiate? Also there are many types of therapists, and many therapists of each variety. Sometimes it takes more than one course of visits or changing therapists to accomplish your goal.

I encourage you to be very persistent in finding what will work for your daughter. She does seem more sensitive about this issue than others, but in my experience she is not alone. Also as a society we may be unaware or minimally informed regarding how children are impressed by films and video games etc. There have just been recent studies that are linking anti social behavior to violent video games. To me it should be obvious, but as we know we are all different. We did not allow our daughter to see scary films until she was much older than her peers who were watching them. It turns out I scared her unexpectedly playing a make believe game when she was young and underestimated how ''real'' it might seem to her. We still talk about it. Lessons learned.

If you insist that your daughter has not accomplished her goals of well being usually insurance coverage can be extended. I would also really insist that you discuss with her doctor about providing a written release from watching further films for class. If your daughter was highly allergic to guinea pigs, what would you do if the class project was ''raise the newborn guinea pigs'' and ''bring the guinea pigs home for a week''? I am thinking if you could think of this as an allergy to scary films maybe you would have a better sense of what to ask for in terms of school or visiting peers.

At this age teens are really into the horror genre, so I would expect this is a real problem for her. It could really push her buttons to always be put in the situation of having to watch, or anticipating what might happen in a film, and lead to worse things. Adolescence as we all know is rife with peer pressure, and they can be quite cruel to each other. She at least needs to have permission to leave, go to the bathroom, call you, call her therapist, or refuse to watch something that she is not comfortable with. Teachers will not cut her any slack without a written medical note, and then you may still need to meet with her teachers. Teachers can be opinionated even when it flies in the face of heavy medical documentation, this is my first hand experience both as a working teacher, and a mom with a child with special needs.

Find her the right therapy, and also a way to control her ''fear'' reactions - breathing, yoga, meditation skills are helpful. Hypnosis might be helpful. There are certified medical hypnotists and self-hypnotism can be very useful it moving through fearful moments.

Regards and good luck. Sending my support


There is a treatment that could be very helpful for your daughter. It is called EMDR (Eye Movement Desensitization and Reprocessing. Check it out online.) I've worked with kids using this method and it has been very effective for diminishing fears. jan


Thank you for posting this and for all the thoughtful responses. My 13 year old son is quite fearful and I have been exploring the program I have seen recommended on the advice/recommendations letters. It is offered at Kaiser Vallejo, reducing fears in children, 8-14 years old, I believe. The MD who offered this class has provided his info for sale at: http://www.angelnet.com/fear.html caution vs fear?


12-year-old is constantly freaked out that she will die

Nov 2007

My 12 year old began experiencing what we consider to be severe anxiety in the past six months and particularly when she began middle school. We consulted with a psychiatrist who specializes in children and she diagnosed her with depression and signs of OCD yet that was not definitive. We have tried conservative treatment- psychotherapy and homopathic remedies but she is only able to control some of the anxiety during the day but at bedtime she is constantly freaked out that she will die from whatever she is focusing on that day. The doctor is now recommending an SSRI, Zoloft or or Lexapro. We see all the warnings on the web and are freaked out. Can anyone advise as to their experiences with either and let us know what they have found. We so do not want to get this wrong with our daughter but also do not want to see her continually struggle and suffer. Thank you. Anon.


Hi,

Our daughter had anxiety issues in the fifth grade but we were able to resolve them fairly quickly without the use of psychiatric medicine. She is now a high school student and thankfully has not had that level of anxiety since. We also used homeopathy and therapy to help reduce her anxiety. Although we did not get an official diagnosis from a psychiatrist for her condition I can tell you that for a time her anxiety was very intense and we were quite worried. Ultimately I credit her therapist with helping her the most in terms of teaching her to manage her anxiety. I am not against psychiatric approaches when absolutely necessary but I hope you will continue to seek alternative approaches to avoid drugs if at all possible.

Also, please check out a program called ''Phobease'' described by some parents who posted their comments on the Berkeley Parent's Network at the following link: liebgold.html . Phobease was developed by a doctor who has personal experience with anxiety disorders and developed a group therapy approach covered in a 10 week course. We went once but the drive was long and difficult through rush hour traffic and fortunately our daughter's condition improved without needing to continue. One thing my daughter remembers from the workshop that helps her control her anxious thought processes to this day is ''There are no what if's, only what is.'' For more information on Phobease and Dr. Howard Liebgold call (925) 335-9524; e- mail at Phobease@ aol.com; or click on the ''Cure Phobias'' section at www.angelnet.com. If you would like to seek help from our daughter's therapist please call Wendy Lucero at (510) 843-6587. I don't know if she is currently accepting new clients but if she is I would highly recommend her. She is a very gentle person and did a remarkable job helping our daughter. Good luck to you and your daughter. anon


In the past, I have suffered from severe anxiety and OCD, and have found Paxil to be very helpful. I can also recommend a very good therapist I am currently seeing, if you think that would be useful. His name is Kenneth Pound, he has an office in Rockridge near the Rockridge BART. His number is 510 496-6072. I hope this helps. Jim


Your daughter sounds like she is having some of the same difficulties that both of our children (ages 14 and 11) have - anxiety, some OCD, depression. We had them evaluated a few years ago and several recommendations were made including using counseling and medication. Like you, we were also concerned about using SSRIs and tried all other options first. Counseling in particular was very helpful for the depression, but it was never quite enough for the anxiety. After a year or more of the counseling route, we seemed to reach a plateau in their treatment. At that point, we began to seriously investigate the use of SSRIs. We asked their practioners many questions about the safety of SSRIs in children and had our fears addressed.

The children have now both been on SSRIs for almost 1 1/2 years. We were fortunate that they each had a good fit the first time (son is on Celexa, daughter on Prozac) and have had very few and minimal side effects. They feel so much better. Our very anxious son is still anxious, but can cope with many more situations than before and has a much more normal social life. Our daughter was doing so much better this past summer that we decided to try doing without the SSRI, so we weaned her off of it (under her doctor's supervision). What a mistake! She went back to being extremely moody and anxious, having lots of concerns about dying - thinking about dying was keeping her awake at night. Within three weeks, we were back at her doctor's office. That was a couple of months ago and now she is back on the Prozac and feels normal again.

I know that SSRIs are not for everyone and not the only solution to these issues - counseling has also been an important component for their well-being. Unfortunately, my children seem to have inherited the chemical imbalance that runs in my family, and will probably need to treat that imbalance with SSRIs for the rest of their lives. I'm very happy that they have had access to this option as it has made such a difference for them. Best Wishes. Another parent


My daughter exhibited similar symptoms starting at about the same time. I am convinced that they were related to hormonal changes. She also did talk and group therapy which helped, but this was in combination with drug therapy. The medication made a huge difference. But it was not easy. First, because of her paranoia, my daughter was convinced that we and the doctor were trying to drug her into submission. Then she was concerned that the drugs would alter her personality. It was only after she agreed to take the medication and began to feel better, that she realized the drugs were helping her find some sort of normalcy. If you decide to use the medication, be prepared to have to alter it as your daughter's body chemistry changes. Our daughter also suffered from severe migraines, and we found that the anti-depression medication, coupled with birth control pills to even out the hormonal balance has made all the difference. Our daughter is happy and functional. She has been able to move past the depression and has learned to convert her OCD into a very useful tool to organize her school work, her job, etc. The bottom line is that for us, medication has been an extremely successful therapy. I wish you the very best of luck in what is surely a stressful time for the entire family. Moving Out of the Darkness


To the parent with teen with OCD and depression OCD is shown to respond well to cognitive behavioral therapy. This also helps depression. Check the anxiety disorders of America website for further information(www.adaa.org ). I treat this issue as do a few others in the community. Feel free to contact me to discuss treatment. Melinda


Oh! My daughter experienced terrible, dramatic (I've been poisened and am going to die) anxiety attacks on the approach to middle school. We did talk therapy, but really, cognitive behavioral therapy, offered through Kaiser Valleo was a life changer! Very cook-bookey, with homework - do a google search! ''Dr. Fear'' - you do not need to be a Kaiser patient to attend. There is a home program, which you can order on-line, which we did. In addition though, the class is great! All of these kids attend - it's very liberating to know that you aren't the only one with these intense feelings. It saved us from a very terribly hard and scarey place. Good luck! anon.


My pre-teen (now teenager) suffered from panic attacks and worry thinking, too, as did I (Panic Disorder runs in my family). I strongly, strongly suggest you consult with a cognitive behavioral therapist--it is the best and most effective way to deal with anxiety issues--it has worked wonderfully for both me and my daughter and we're both drug free. You can contact the San Francisco/Bay Area Center for Cognitive Therapy on College Ave. in Rockridge, or Melinda White on Solano Ave. Also see: nacbt.org for information on cbt. Good Luck. A fellow parent


Our son was diagnosed with depression and anxiety issues when he was 11. He has been on Zoloft ever since and it is a Godsend.

He's turning 18 in two weeks. Without it, I'm not sure if we'd be celebrating his birthday or planning a memorial.

It changed all our lives.

When his life gets over-stressed and he falls behind in school, he still has bouts of depression, but never as severe as when he was 11; these have been very rare.

We have always gone through family and individual therapy as well as seeing the prescribing psychiatrist regularly.

I feel that without anti-depressants there would be way more teen suicides than because of the medications. The media wants to focus on the small percentage of those who react negatively to medication.

I recommend trying the medication along with talk therapy for the whole family. Watch your child carefully for any worsening signs, but I bet he/she will feel better soon.

As an 11 year old, our son didn't know that the medication takes several days to kick in. Two days after taking it, he said that something happened at school that would usually bother him, but it didn't. Even just a confidence boost can help. Good luck. Anon


Anxious 11-year-old can't get fears out of his head

April 2006

Hi, My 11 year old son has recently asked me to see a therapist. He is insecure and and has learning difficulties. He is quite talkative but has had anxiety issues in the past. He is now complaining about fears he can't get out of his head when he is going to sleep and feels he needs ''to get alot talking out of hisself''. I am looking for a therapist in the oakland or south berkeley area who has experience with kids and anxiety issues. I am pretty anti medication and am looking for a wholistic approach as I do not trust giving SSRI's to children. Please don't debate me on this one. I just want recommendations for therapists.Thanks for any help. worried mom


Be very grateful that your 11 year old is telling you his feelings and not acting out or self-harming in order to get his fears out. I have a daughter who did just that. I was totally against medicating her and when she was 15, she attempted suicide. She was hospitalized in Berkeley and through others advice, I finally authorized medication. She is like a different person now. If you don't want to medicate (after you find a therapist) - consider giving him 1 1/2 teaspoons of fish oil a day (mix with juice). It is a natural form of Lithium - a highly effective anti- depressant


I wish you and your son the best. I have a daughter who also suffered from fear and anxiety. She was beginning to do some compulsive behaviors trying to eliminate it and was even more anxious at night than during the day. She saw Ellen Singer Phd at the reccomendation of a psychiatrist at Childrens. Ellen was able to help her (and us) feel much more secure. Her number is 525-1975. anonymous


Regarding your anxious 11 yr old son, I highly recommend the Cognitive Therapy group in Rockridge. Michael Tompkins would be terrific but if he is not available, you can trust the other members of the group. I know of several families who have successfully worked with a cognitive approach, It makes a lot of sense for teens and preteens. mom of teen boys


It's wonderful that your son is able to articulate his needs as you've described. That bodes well for him.

I strongly recommend Michelle Horton, Ph.D. (985-2958). She is a clinical psychologist who specializes in working with kids like yours, does great work in therapy with them and is an expert in learning and emotional issues -- which are often quite interconnected. She's located on College Ave. near Broadway, which fits your geographic desires. She also can recommend other options or therapists who may fit your needs.

Feel free to skip what follows, but I will offer four brief comments. First, 11 (middle school) is an age at which problems often rise to the surface, even if they've been present earlier.

Second, anxiety may originate in biology, experience or both, and may (or may not) be a symptom of a more involved psychiatric condition. That said, starting with a psychologist/therapist is the right course of action. Just don't assume this is necessarily as straightforward as it may first look.

Third, it's likely that you, and your son, will be misunderstood, objectified, criticized and dismissed -- by family, friends and/or especially the school system. ''Bad parenting'' is the usual script. Too many who should know better, or be more compassionate, are ignorant and judgmental. Don't accept that or let it make you crazy.

Finally, I respect your request for no debate on medications. I do encourage you to keep an open mind, and to make a decision after discussing the subject if it arises. A competent professional will be respectful of your views and will explain theirs objectively, leaving any decision to you.

I wish you well. Been there...


I recommend you call John Sprinson, he has an office in Oakland on Glen Eden (off Piedmont Ave.). His number is in the white pages. He is kind, smart, has a wonderful calm presence and will give you and your son an honest assessment of your son's needs and a course of treatment. been there