What is the best treatment for child anxiety?
Evidence shows Cognitive Behavioral Therapy (CBT) and, when appropriate, SSRI medication are first‑line treatments. For OCD, Exposure and Response Prevention (ERP) is the gold standard. In NYC, families can access therapy in schools and in the community, including Medicaid‑covered options.
NYC kids face big expectations, crowded classrooms, and long commutes. Anxiety can show up as school refusal, stomachaches before class, irritability, perfectionism, or sleepless nights. National data show youth anxiety is common and rising; local families need practical, evidence‑based steps that fit the city’s reality. This guide does exactly that.
Throughout this article, you’ll find source links to trusted organizations and NYC‑specific resources. You’ll also see natural references to Mount Behavioral Health services (no pushy CTAs) so you can move from information to action when you’re ready.
Elementary school: separation worries, stomachaches, tantrums before school, reassurance‑seeking.
Middle school: test anxiety, perfectionism, social worries, avoiding group projects.
High school: panic attacks, insomnia, procrastination/overwork cycles, burnout, substance experimentation to self‑soothe.
When symptoms persist for weeks, interfere with school or relationships, or cause significant distress, a professional evaluation is appropriate.
CBT helps kids notice anxious thoughts, test them against evidence, and practice new behaviors until anxiety loosens its grip. Skills include cognitive restructuring, behavioral activation, and stepwise exposures.
• Learn more or arrange CBT with a youth specialist in NYC: https://www.mountbh.org/treatments/cbt
• General overview of CBT for pediatric anxiety (research‑backed): https://pubmed.ncbi.nlm.nih.gov/32439401/
If anxiety takes the form of obsessions/compulsions (checking, cleaning, intrusive thoughts), ERP is the gold‑standard behavioral treatment. It teaches kids to face triggers without doing rituals so the anxiety system recalibrates.
• When Mount clinicians identify OCD, ERP is integrated into care plans; families can start with our treatments overview: https://www.mountbh.org/treatments
• NIMH overview of anxiety/OCD in youth: https://www.nimh.nih.gov/health/topics/anxiety-disorders
Anxiety often co‑travels with intense emotions. Skills from Dialectical Behavior Therapy (DBT)—distress tolerance, emotion regulation, and interpersonal effectiveness—help teens navigate school stress, friendship drama, and big feelings.
• Ask your clinician how we blend CBT + DBT skills within care plans: https://www.mountbh.org/treatments
For kids, therapy works best when caregivers learn reinforcement systems, morning‑routine fixes, and coordinated school supports. Family sessions reduce accommodation (well‑meaning behaviors that accidentally keep anxiety going) and boost consistent coping at home.
Child‑led and directive play approaches help younger kids name feelings, rehearse coping, and practice brave behaviors in a developmentally matched way—then generalize those gains at school and home.
For moderate to severe anxiety, SSRIs may be added to therapy. Medication decisions are individualized and monitored; the strongest long‑term outcomes are typically seen when CBT remains central.
Research snapshot: National and specialty guidelines support CBT as first‑line for pediatric anxiety, with SSRIs as an effective addition when needed. See a plain‑language overview of youth anxiety here: https://www.cdc.gov/children-mental-health/about/about-anxiety-and-depression-in-children.html and guideline details here: https://pubmed.ncbi.nlm.nih.gov/32439401/
Track frequency, intensity, and triggers for two weeks (school days vs. weekends, mornings vs. evenings). This becomes your starting data.
Families often begin with a therapist who sees children/teens weekly and coordinates with school staff as needed. If you prefer a clinic that’s set up for young people, start here: https://www.mountbh.org/faq and browse borough access here: https://www.mountbh.org/locations
NYC public schools offer mental health support and can collaborate on accommodations while treatment is underway (reduced‑stimulus testing rooms, modified deadlines, check‑ins). See the DOE mental health hub: https://www.schools.nyc.gov/school-life/health-and-wellness/mental-health
Create one daily exposure (e.g., ride one stop farther on the train, ask one question in class) and one soothing practice (paced breathing, short walk) that your child repeats every day.
Treatment should feel active and measurable. If progress stalls, your clinician may add ERP elements, DBT skills, or consider a medication consult while keeping CBT central.
Therapy should be accessible. Mount Behavioral Health participates in most major plans, including Medicaid—families routinely use Healthfirst, MetroPlus, Empire/Anthem, Molina, Fidelis and others. See current details any time: https://www.mountbh.org/insurance
If you’re navigating Medicaid and behavioral health in NYC, the city and state have helpful explainer pages:
• NYC Medicaid behavioral health overview: https://www.nyc.gov/site/doh/health/health-topics/medicaid-behavioral-health-services.page
• NYS Behavioral Health Managed Care (children’s services): https://omh.ny.gov/omhweb/bho/
Pro tip: when you call your plan, ask for “outpatient child and adolescent psychotherapy, CPT 90834/90837, place of service 11 (office) or 02 (telehealth)” to confirm coverage and copays.
If your child is refusing school, the solution is not days off; it’s graded exposure back to class with home + school coordination. NYC families often combine morning routine tweaks, attendance‑linked rewards, and a school plan for re‑entry. If this is you, share our school refusal overview with your team and consider CBT with exposure: https://www.mountbh.org/treatments/cbt
Two‑Minute Reset (ages 8–18)
Pro‑Student Study Loop (teens)
• 20 minutes focused work → 5 minutes movement → 20 minutes focused work → quick exposure (e.g., ask one clarifying question on Google Classroom).
Parents: Accommodation audit
List 3 ways you currently “rescue” your child from anxiety (emailing teachers, letting them skip presentations). Choose one to roll back this week with your clinician’s guidance.
Families use us across Brooklyn (Boro Park, Williamsburg, Bushwick, Bed‑Stuy, Crown Heights, Flatbush, Park Slope), Queens (Astoria, Long Island City, Forest Hills, Flushing), Manhattan (Upper West/East Side, Harlem, Washington Heights, Midtown), the Bronx, and Staten Island. Telehealth extends access across the five boroughs when in‑person visits are hard.
Find current location and access options: https://www.mountbh.org/locations
• CDC overview on child anxiety/depression: https://www.cdc.gov/children-mental-health/about/about-anxiety-and-depression-in-children.html
• National estimates show anxiety is common in adolescents; see NIMH stats: https://www.nimh.nih.gov/health/statistics/any-anxiety-disorder
• Guideline: CBT is first‑line; SSRIs are effective when indicated: https://pubmed.ncbi.nlm.nih.gov/32439401/
• NYC schools’ mental health supports: https://www.schools.nyc.gov/school-life/health-and-wellness/mental-health
• NY Medicaid behavioral health basics: https://www.nyc.gov/site/doh/health/health-topics/medicaid-behavioral-health-services.page and https://omh.ny.gov/omhweb/bho/
Is anxiety normal, or does my child need therapy?
Occasional worries are normal. If anxiety sticks around, escalates, or interferes with school, sleep, or friendships, an evaluation is a smart next step.
What’s the success rate of CBT for child anxiety?
Outcomes vary, but CBT is considered the most effective first‑line treatment for pediatric anxiety, especially when families practice skills between sessions.
Do you prescribe medication?
When appropriate, yes—after a careful assessment. Many youth do well with CBT alone; others benefit from CBT + SSRIs. Medication is monitored and time‑limited when possible.
Can we do therapy after school or via telehealth?
Yes. Evening, after‑school, and telehealth options help NYC families keep care consistent. Current access info: https://www.mountbh.org/faq
Is therapy covered by Medicaid?
Often yes. Mount participates with Medicaid plans commonly used by NYC families; see current details: https://www.mountbh.org/insurance
