Phobias in Children and Teens
Safe, gradual steps that help kids face fears and get back to doing what they love.
What we treat
When a fear becomes too big
Many children go through fears of the dark, dogs, or storms. A specific phobia is an intense fear of a particular thing or situation that is out of proportion to the actual danger, lasts for months, and leads a child to avoid it. Phobias are among the most treatable anxiety problems in childhood.
Understanding phobias
What phobias look like in kids
When a child with a phobia sees or even thinks about what they fear, their body reacts as if they are in danger. Avoiding it brings relief, so the avoidance grows, and families often find themselves planning around the fear.
Common fears
Dogs or other animals. Vomiting or choking. Needles, blood, or doctors. The dark, storms, or loud noises. Elevators, heights, or flying.
How it shows up
Crying, freezing, or clinging. Tantrums or running away. Racing heart, shaking, or feeling faint. Constant questions about whether the feared thing will be there.
What parents notice
Avoiding parks, friends' homes with pets, or doctor visits. Picky eating from fear of choking or vomiting. Trouble sleeping. Family plans built around avoiding the fear.
When to reach out
- The fear has lasted six months or more
- Your child goes to great lengths to avoid the feared situation
- The fear limits school, friendships, or family activities
- Medical or dental care is becoming difficult
- Eating or sleeping is affected
- Reassurance no longer calms your child
Why phobias respond so well
Phobias are very common in young people[1], and they are highly treatable. Because the fear is focused on something specific, children can practice facing it directly in small, planned steps.
Some children make major progress in a short time with intensive, focused sessions[2].
How we treat it
Our approach to phobias
We use cognitive behavioral therapy (CBT) with gradual, guided exposure, the approach recommended for childhood anxiety disorders by the American Academy of Child and Adolescent Psychiatry[3]. For some children, we offer intensive sessions based on one-session treatment[2].
- A thorough evaluation. We learn exactly what your child fears, what they expect will happen, and how the fear affects daily life.
- Understanding fear. Kids learn how fear works in the body and brain, and why avoidance keeps it going.
- Building a fear ladder. Together we list steps from least to most scary, such as looking at pictures of a dog, watching one from a distance, and then petting a calm dog.
- Guided practice. With support and encouragement, your child climbs the ladder at their own pace and discovers they can handle it.
- Coaching parents. Parents learn to model calm, praise brave behavior, and gently reduce accommodation.
- Keeping gains. We plan for continued practice in everyday life so the fear does not return.
Intensive option: For fears like dogs, needles, or the dark, a longer, focused session of up to three hours can sometimes produce major gains. We discuss whether this fits your child.
The evidence
What the research says
Specific phobias are the most common anxiety disorder in young people, and exposure-based treatment has strong evidence for helping children overcome them.
of U.S. adolescents have experienced a specific phobia at some point, in a national survey of more than 10,000 teens.
Merikangas et al., 2010 [1]youth ages 7 to 16 took part in a trial of one-session exposure treatment in the U.S. and Sweden.
Ollendick et al., 2009 [2]of exposure treatment outperformed education and support on recovery rates and clinician ratings, with gains maintained six months later.
Ollendick et al., 2009 [2]- The AACAP 2020 guideline recommends CBT for children and adolescents with specific phobia[3].
- Exposure is the key ingredient: facing fears gradually and safely helps the brain learn that the feared situation is manageable[2].
Research results describe averages across groups of children. Every child is different, and we track your child's progress with standardized measures throughout treatment.
Common questions
Will my child be forced to face their fear?
No. Every step is planned together, and your child agrees to each one. We move at a pace that feels challenging but manageable.
Isn't this just a phase?
Many childhood fears fade on their own. A phobia is more intense, lasts for months, and leads to avoidance that limits your child's life. When that happens, treatment can help.
What about fear of vomiting or choking?
These fears are common and can affect eating, school, and travel. They respond well to the same gradual approach, adapted carefully to each child.
Can phobias be treated by telehealth?
Yes, for many fears. We use videos, images, and at-home practice with parent coaching. Some steps may work best in person.
References
- Merikangas, K. R., He, J. P., Burstein, M., et al. (2010). Lifetime prevalence of mental disorders in U.S. adolescents: Results from the National Comorbidity Survey Replication–Adolescent Supplement (NCS-A). Journal of the American Academy of Child & Adolescent Psychiatry, 49(10), 980–989. View study
- Ollendick, T. H., Öst, L.-G., Reuterskiöld, L., et al. (2009). One-session treatment of specific phobias in youth: A randomized clinical trial in the United States and Sweden. Journal of Consulting and Clinical Psychology, 77(3), 504–516. View study
- Walter, H. J., Bukstein, O. G., Abright, A. R., et al. (2020). Clinical practice guideline for the assessment and treatment of children and adolescents with anxiety disorders. Journal of the American Academy of Child & Adolescent Psychiatry, 59(10), 1107–1124. View guideline