Separation Anxiety in Children

Gentle, proven steps toward easier goodbyes and more independence.

What we treat

When goodbyes feel impossible

It is normal for young children to feel upset when a parent leaves. Separation anxiety disorder is when that fear is stronger and lasts longer than expected for a child's age. Kids may worry that something terrible will happen to a parent, or to themselves, whenever they are apart. With the right support, children can learn that they are safe and capable on their own.

How commonAbout 1 in 13 teens have had it at some point

Typical onsetOften in early and middle childhood

First-line treatmentCBT with gradual practice and parent coaching

FormatIn person or telehealth

Understanding separation anxiety

What separation anxiety looks like in kids

Separation anxiety often peaks at transitions: school drop-offs, bedtime, sleepovers, or a parent traveling. Children are not being manipulative. They are truly frightened, and their bodies react as if something dangerous is about to happen.

Common fears

A parent getting hurt, sick, or not coming back. Getting lost or being kidnapped. Something bad happening while apart. Being alone in a room or at night.

How it shows up

Crying, clinging, or tantrums at separations. Stomachaches or headaches on school mornings. Following a parent from room to room. Frequent calls or texts to check in.

What parents notice

Trouble sleeping alone. Refusing playdates, camps, or sleepovers. Difficulty staying at school. Parents limiting their own plans to avoid upsetting their child.

When to reach out

Distress at separation is intense or lasts for weeks
Your child's fears seem younger than their age
School attendance or drop-offs are becoming a battle
Your child can't sleep without a parent nearby
They miss out on activities they would otherwise enjoy
Family routines now revolve around avoiding separations

Why parents are central

With separation anxiety, parents are part of every situation that triggers fear. That makes them essential partners in treatment.

It is natural to stay close, cut plans short, or sleep beside an anxious child. We help parents replace these accommodations with calm, confident responses, an approach supported by research showing parent-based treatment can be as effective as child CBT^[4].

How we treat it

Our approach to separation anxiety

We use cognitive behavioral therapy (CBT), recommended as a first-line treatment for separation anxiety by the American Academy of Child and Adolescent Psychiatry^[3]. Treatment combines coping skills with gradual, planned practice being apart.

A thorough evaluation. We learn which separations are hardest, what your child fears will happen, and how the family currently responds.
Understanding worry. Children learn how anxiety works and why avoiding separations makes fear grow.
Brave tools. Coping statements, calm breathing, and transition routines help your child feel prepared.
Practice being apart. We build a step-by-step ladder, from short separations at home to school, sleepovers, and beyond.
Coaching parents. Parents learn to express confidence, keep goodbyes brief and warm, and reduce accommodation.
Keeping gains. We plan for transitions like new school years or travel so progress lasts.

Working with school: When separation anxiety affects school, we can coordinate with teachers and counselors to create a consistent drop-off and support plan.

The evidence

What the research says

Separation anxiety is one of the most common anxiety disorders in childhood, and CBT has strong evidence for helping children overcome it.

7.6%

of U.S. adolescents have experienced separation anxiety disorder at some point, in a national survey of more than 10,000 teens.

Merikangas et al., 2010 [2]

60% vs 24%

of children improved significantly with CBT alone, compared with pill placebo, in a trial of 488 children with separation, generalized, or social anxiety.

Walkup et al., 2008 [1]

Equal

benefit from a parent-only program (SPACE) and child CBT, in a randomized trial of 124 anxious children.

Lebowitz et al., 2020 [4]

The AACAP 2020 guideline recommends CBT for children and teens with separation anxiety disorder^[3].
In the CAMS study, CBT alone and medication alone each outperformed placebo, and combining them led to the best outcomes^[1].
Parent-focused approaches that reduce family accommodation offer an effective option, especially for younger children or kids reluctant to engage in therapy^[4].

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

Is this just a phase?

Some separation distress is normal, especially in toddlers and preschoolers. It becomes a concern when it is more intense than expected for your child's age, lasts for weeks, or keeps your child from school, sleep, or activities.

Should I sneak out to avoid a meltdown?

It is tempting, but sneaking away usually increases anxiety because children learn they can't predict when a parent will leave. We help you create short, warm, predictable goodbyes instead.

What if my child won't go to school?

School avoidance tends to grow the longer it continues, so it's best to act quickly. We work with your family and school on a gradual plan to get your child back in class.

How long does treatment take?

Many children make meaningful progress in about 12 to 20 weekly sessions, with parents involved throughout.

Can treatment be done over telehealth?

Yes. Telehealth works well, and it lets us coach parents and children through real separations at home.

References

Walkup, J. T., Albano, A. M., Piacentini, J., et al. (2008). Cognitive behavioral therapy, sertraline, or a combination in childhood anxiety. New England Journal of Medicine, 359(26), 2753–2766. View study
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
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 study
Lebowitz, E. R., Marin, C., Martino, A., Shimshoni, Y., & Silverman, W. K. (2020). Parent-based treatment as efficacious as cognitive-behavioral therapy for childhood anxiety: A randomized noninferiority study of Supportive Parenting for Anxious Childhood Emotions. Journal of the American Academy of Child & Adolescent Psychiatry, 59(3), 362–372. View study