Social Anxiety in Children and Teens

Step-by-step support to help kids speak up, join in, and feel at ease with others.

What we treat

When fear of judgment gets in the way

Most kids feel nervous before a class presentation or a party full of new faces. Social anxiety disorder is when the fear of being judged, embarrassed, or put on the spot is intense, lasts for months, and leads a child to avoid the situations that matter for school and friendships. It is not the same as being shy, and it responds well to treatment.

How commonAbout 1 in 11 teens have had it at some point

Typical onsetOften late childhood or early adolescence

First-line treatmentCBT with gradual, real-world practice

FormatIn person or telehealth

Understanding social anxiety

What social anxiety looks like in kids

Anxious kids often expect that others will notice their nerves and think badly of them. To stay safe, they hold back: they stay quiet, avoid eye contact, or skip events altogether. Avoidance brings quick relief, but it keeps the fear going and leaves fewer chances to build confidence.

Common fears

Saying something wrong. Being laughed at. Blushing or shaking in front of others. Being called on in class. Eating or performing while others watch.

How it shows up

Stomachaches or headaches before school or social events. Speaking very softly or not at all. Tears or tantrums in younger kids. Replaying conversations for hours afterward.

What parents notice

Few close friends. Avoiding parties, sports, or ordering food. Asking parents to speak for them. Falling behind on class participation or presentations.

When to reach out

Fear of judgment has lasted for several months
Your child avoids school events, parties, or activities
Class participation or presentations are a regular battle
Your child relies on you to speak for them
Worry before social events causes physical complaints
Your teen is becoming more isolated from peers

Shyness or social anxiety?

Shy children may warm up slowly, but they usually join in once they feel comfortable. With social anxiety, the fear does not fade with familiarity, and it starts to shrink a child's world.

Social anxiety tends to become more common with age during the teen years^[1]. Getting help early matters, because avoidance habits get harder to change the longer they last.

How we treat it

Our approach to social anxiety

We use cognitive behavioral therapy (CBT), the first-line treatment for childhood anxiety disorders recommended by the American Academy of Child and Adolescent Psychiatry^[4]. Treatment pairs practical skills with planned, gradual practice in real social situations.

A thorough evaluation. We learn which situations are hardest, what your child fears will happen, and how anxiety affects school and friendships.
Understanding anxiety. Kids learn how the cycle of avoidance keeps fear going, and why their body reacts the way it does.
Challenging anxious thoughts. Children learn to test predictions like “everyone will stare at me” against what actually happens.
Brave practice. Together we build a step-by-step ladder, from saying hello to a classmate to ordering food, asking questions in class, and joining activities.
Social skills and confidence. When helpful, we practice starting conversations, joining groups, and handling awkward moments.
Coaching parents. Parents learn to encourage brave behavior and gently step back from speaking or doing for their child.

Working with school: With your permission, we can coordinate with teachers on small, planned steps such as answering prepared questions in class before moving to presentations.

The evidence

What the research says

Social anxiety is one of the most common anxiety disorders in young people, and behavioral treatments have strong evidence for helping children overcome it.

9.1%

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

Merikangas et al., 2010 [1]

67% vs 5%

of children no longer met criteria for social phobia after a behavioral skills and exposure program, compared with an active comparison program.

Beidel et al., 2000 [2]

60% vs 24%

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

Walkup et al., 2008 [3]

The AACAP 2020 guideline recommends CBT for children and adolescents with social anxiety disorder^[4].
Gradual exposure to feared social situations, combined with skills practice, is a core ingredient of effective treatment^[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

Won't my child just grow out of it?

Some children outgrow shyness, but social anxiety disorder often continues or grows if it is left untreated, especially as social demands increase in middle and high school. Treatment can help your child build skills now.

Should I let my child skip things that make them anxious?

It is natural to want to protect your child from distress. Frequent avoidance, though, keeps the fear strong. We help you find the right balance of support and gentle encouragement.

Will my child have to do things that are too scary?

No. Practice is planned together, starts small, and moves at a pace your child agrees to. Children are never forced into situations.

Does telehealth work for social anxiety?

Yes. Telehealth works well, and it lets us practice real-world steps like phone calls, video chats, and ordering food with support in the moment.

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
Beidel, D. C., Turner, S. M., & Morris, T. L. (2000). Behavioral treatment of childhood social phobia. Journal of Consulting and Clinical Psychology, 68(6), 1072–1080. View study
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
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