• 1200 5th Avenue, Suite 800 Seattle, WA 98101
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Child Anxiety Center

Specialized, evidence-based care for anxiety, OCD, and related concerns in children and adolescents.

Anxiety in children is common — and it matters

Anxiety is now the most common mental health condition in children and adolescents. Recent national data show that 1 in 5 adolescents experienced anxiety or depression symptoms severe enough to interfere with daily life in the past year, and diagnoses of youth anxiety disorders have increased over 60% since 2016.
For many families, anxiety doesn’t appear suddenly. It grows quietly — showing up as avoidance, emotional distress, reassurance-seeking, school difficulties, sleep disruption, or increasing rigidity. When anxiety begins to shape daily life, waiting often allows these patterns to become more entrenched.

You don’t need to know what kind of treatment is right.

That’s our role.

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Cognitive-Behavioral Therapy (CBT): The Foundation of Our Care

What it is

Cognitive-Behavioral Therapy (CBT) is the most extensively researched and widely recommended treatment approach for anxiety and related conditions in children and adolescents. At its core, CBT is a framework for understanding how thoughts, emotions, physical sensations, and behaviors interact — and how certain patterns can keep anxiety and distress going over time.

Rather than being a single technique, CBT is a family of evidence-based treatments. Many of the approaches we use — including exposure therapy, ERP for OCD, CBT-I for insomnia, behavioral activation, habit reversal, and parent-based interventions — are grounded in CBT principles and supported by decades of research.

What treatment looks like

CBT-based treatment is active, structured, and goal-directed. Children and adolescents learn:

  • How anxiety and distress operate in the body and brain
  • Which behaviors (such as avoidance, reassurance-seeking, or rituals) unintentionally keep symptoms around
  • Practical skills for responding differently to anxious thoughts, physical sensations, and urges
  • How gradual, supported behavior change leads to lasting improvement
Depending on a child’s needs, treatment may emphasize different CBT-based strategies — such as exposure for fear and avoidance, behavioral activation for withdrawal and low mood, CBT-I for sleep difficulties, or habit-based interventions for repetitive behaviors.
Parents are often involved to help reinforce skills, reduce accommodations, and support progress outside of sessions.

Time-limited and focused on progress

CBT is designed to be time-limited rather than open-ended. Treatment is structured around clear goals, active skill-building, and measurable progress. As children gain confidence and mastery, the focus shifts toward independence and maintaining gains — not ongoing therapy for its own sake.

The goal of CBT is not to create long-term dependence on treatment, but to equip children and families with tools they can continue using well beyond the therapy room.

Why families pursue CBT-based care

CBT provides a clear, understandable roadmap for change. Rather than simply talking about feelings, it focuses on helping children do things differently in ways that lead to real improvement.

Families often appreciate that CBT:

  • Is grounded in strong scientific evidence
  • Offers concrete tools rather than vague guidance
  • Is tailored to the child’s specific presentation
  • Emphasizes progress, skill mastery, and independence

What outcomes look like

Decades of research show CBT-based treatments lead to significant reductions in anxiety and related symptoms for most children and adolescents. When delivered by clinicians with specialized training and supported by appropriate parent involvement, CBT helps children regain flexibility, confidence, and engagement in daily life — with skills that continue to be useful long after treatment ends.

Exposure Therapy / Exposure &
Response Prevention (ERP)

What it is
Exposure Therapy — and Exposure and Response Prevention (ERP) for OCD — is the most effective, research-supported treatment for anxiety disorders and obsessive-compulsive disorder. It directly targets the patterns that keep anxiety and OCD going: avoidance, reassurance-seeking, and rituals.
ERP is considered the gold-standard treatment for OCD and a core component of effective treatment for many anxiety disorders.
What treatment looks like
Treatment is structured, collaborative, and carefully paced. Children and adolescents:
  • Learn how anxiety and OCD work
  • Gradually face feared situations, thoughts, or sensations
  • Practice resisting avoidance and compulsive behaviors
  • Build confidence through repeated, supported experiences
Exposure is never about forcing or overwhelming a child. Each step is planned intentionally, matched to developmental level, and adjusted based on progress.
Why families pursue ERP
Avoidance and rituals provide short-term relief but strengthen anxiety over time. ERP helps children learn — through experience — that anxiety decreases on its own and that feared outcomes do not occur.
What outcomes look like
Decades of research show ERP leads to significant and lasting reductions in anxiety and OCD symptoms. Many children regain independence, school engagement, and daily functioning that anxiety or OCD had taken away.

Behavioral Activation

What it is
Behavioral Activation is a well-established, evidence-based treatment for depression and low motivation in children and adolescents. It is also commonly used when anxiety, withdrawal, or avoidance have led to reduced engagement in daily life.
Rather than focusing primarily on thoughts or feelings, Behavioral Activation targets patterns of avoidance and inactivity that maintain low mood and emotional shutdown.
What treatment looks like

Children and adolescents work with their clinician to:

  • Identify activities that have gradually fallen away due to anxiety, sadness, or overwhelm
  • Reintroduce meaningful, manageable activities in a structured and supportive way
  • Build routines that increase positive reinforcement and momentum
  • Learn how mood and motivation improve after action — not before
Parents are often involved to help support structure, consistency, and follow-through at home.
Why families pursue Behavioral Activation
When children are stuck, withdrawn, or “shut down,” waiting for motivation to return rarely works. Behavioral Activation provides a clear, practical path forward that helps children begin moving again — even when they don’t feel ready.
It is especially helpful when anxiety and depression overlap, or when low mood has led to disengagement from school, friends, or daily activities.
What outcomes look like
Research shows Behavioral Activation leads to meaningful improvements in mood, energy, and engagement. As activity increases, many children experience improved emotional regulation, confidence, and participation in daily life.

CBT-I & Evidence-Based Child Sleep Interventions

What they are
Sleep interventions for children and adolescents are evidence-based treatments designed to address insomnia, bedtime resistance, nighttime anxiety, and sleep disruptions linked to stress or anxiety.
CBT-I (Cognitive Behavioral Therapy for Insomnia) is the first-line treatment for chronic insomnia and is recommended over medication for long-term improvement.
What treatment looks like

Depending on a child’s age and needs, treatment may include:

  • Understanding how sleep patterns and anxiety interact

    Gradual changes to routines and sleep schedules

  • Reducing behaviors that interfere with child and parent sleep, including co-sleeping with parents

  • Strategies for managing nighttime worry or arousal

  • Parent coaching to support consistency and follow-through

Depending on a child’s age and needs, treatment may include:

  • Understanding how sleep patterns and anxiety interact

    Gradual changes to routines and sleep schedules

  • Reducing behaviors that interfere with child and parent sleep, including co-sleeping with parents

  • Strategies for managing nighttime worry or arousal

  • Parent coaching to support consistency and follow-through

Sleep treatment is practical, developmentally appropriate, and realistic for families.
Why families pursue sleep treatment
Poor sleep worsens anxiety, mood, attention, and emotional regulation. Addressing sleep directly often improves progress across all areas of treatment.
What outcomes look like
Research shows evidence-based sleep interventions lead to improvements in sleep onset, sleep quality, and nighttime awakenings, with positive effects on daytime mood, focus, and resilience.

Habit Reversal Training (HRT) & Comprehensive Behavioral Treatment (ComB)

What they are
HRT and ComB are the primary evidence-based treatments for body-focused repetitive behaviors (BFRBs) such as hair pulling, skin picking, nail biting, and for tic disorders.
HRT provides the foundation; ComB builds on it with a more individualized, comprehensive approach.
What treatment looks like

Children and adolescents learn to:

  • Increase awareness of urges and triggers
  • Implement competing responses that interrupt behaviors
  • Modify environments that make behaviors more likely
  • Address emotional, sensory, cognitive, and situational contributors
Treatment is practical, collaborative, and tailored to each child’s unique pattern.
Why families pursue HRT/ComB
These behaviors often feel uncontrollable and carry shame. HRT and ComB offer a clear, structured path forward that focuses on skill-building rather than willpower.
What outcomes look like
When delivered by trained specialists, these approaches lead to meaningful reductions in symptoms and improved confidence, comfort, and daily functioning.

Supportive Parenting for Anxious Childhood Emotions (SPACE)

What it is

SPACE is a research-supported, parent-based treatment for childhood anxiety. Rather than focusing primarily on the child, SPACE works directly with parents to reduce anxiety-maintaining accommodations while increasing supportive responses.

Children do not need to attend sessions for SPACE to be effective.

What treatment looks like

Parents learn:

  • How accommodation (such as reassurance or avoidance support) unintentionally maintains anxiety
  • How to respond with warmth and empathy while encouraging independence
  • How to make changes gradually and collaboratively

Treatment is structured, supportive, and focused on achievable steps.

Why families pursue SPACE

SPACE is especially helpful when:

  • Anxiety strongly affects family routines
  • Children resist or avoid therapy
  • Parents want clear, actionable guidance

What outcomes look like

Research shows SPACE leads to meaningful reductions in child anxiety and is as effective as child-focused CBT in many cases. Families often experience reduced stress and improved daily functioning.

Behavioral Parent Training (BPT)

What it is
Behavioral Parent Training is a well-established, evidence-based approach that works directly with parents to improve child behavior, emotional regulation, and family functioning.
BPT is especially effective when anxiety, emotional dysregulation, or avoidance have begun to shape family routines and interactions. It can also be helpful in managing situations around screen use problems.

What treatment looks like

Parents learn practical, research-supported strategies to:

  • Respond to challenging behaviors in ways that reduce escalation
  • Reinforce desired behaviors consistently
  • Set clear, predictable expectations
  • Support emotion regulation and independence

Treatment focuses on real-world situations and provides parents with tools they can use immediately.

Why families pursue BPT

When parents feel unsure how to respond, even well-intended efforts can inadvertently maintain problems. BPT helps parents feel confident, aligned, and effective.

What outcomes look like

Research shows Behavioral Parent Training improves child behavior, emotional regulation, and overall family functioning. Parents often report reduced stress and increased confidence, while children benefit from greater structure and support.

The Child Anxiety Center at EBTCS

The Child Anxiety Center at EBTCS is a multidisciplinary specialty center devoted exclusively to the diagnosis and treatment of anxiety, OCD, and related conditions in children and adolescents.
Our providers are all doctoral-level clinicians with advanced specialty training. Many members of our team also teach, supervise, conduct research, and collaborate with universities and medical institutions. We publish in peer-reviewed journals, present at national conferences, and train other professionals in evidence-based care. This truly is expert care.
We work as a fully integrated clinical team, not a collection of independent providers. This means your child’s care is coordinated, intentional, and guided by collective expertise. Families come to us when they want clarity, structure, and a plan grounded in science — not guesswork or generic therapy.
We provide therapy and medication services in person and via telehealth. Some services are available in Spanish.
When anxiety needs attention
Anxiety becomes a concern when it begins to limit daily life — not simply when a child worries.

Families often notice:

  • Avoidance of school, social situations, or independence
  • Difficulty separating from caregivers
  • Frequent reassurance-seeking or checking
  • Physical symptoms such as stomach aches, headaches, or fatigue
  • Intense emotional reactions to everyday expectations
Research shows that untreated childhood anxiety is associated with academic difficulties, higher risk for depression, and persistence into adulthood. Early, evidence-based treatment can interrupt these patterns and help children regain confidence and flexibility.
Treatment here is designed, not improvised. From the beginning, care is guided by careful assessment, clinical expertise, and decades of research on what actually helps children with anxiety and related concerns.
We take time to understand not only symptoms, but how anxiety is affecting your child’s life — at home, at school, and in relationships. Based on that understanding, we build a treatment plan that fits your child and family, rather than forcing them into a predetermined model.
Anxiety rarely affects only one child. It shapes family routines, decision-making, and daily interactions. Research consistently shows that thoughtful parent involvement improves outcomes, when treating childhood anxiety.

At EBTCS, parent involvement is intentional and grounded in science. Depending on your child’s needs, treatment may include:

  • Coaching parents on how to respond to anxiety without reinforcing avoidance
  • Structured, research-supported parent interventions, such as Supportive Parenting for Anxious Childhood Emotions (SPACE)
  • Behavioral parent training to support changes at home and school
  • Collaborative planning around routines, transitions, and independence
Parents are never blamed. Instead, they are supported with clear guidance and practical tools that help children make progress more quickly and sustainably.
There is no single “right” level of care for every child. What matters is selecting the right combination of services, at the right intensity, for the right amount of time.
Some children improve with standard outpatient therapy alone. Others benefit from additional supports. Families don’t have to decide what to add or when — that responsibility rests with our clinical team.
Our care may include:
  • Individual, evidence-based outpatient therapy
  • Parent-based interventions or family coaching
  • Coordination with a board-certified child and adolescent psychiatrist with anxiety expertise
  • Increased session frequency or structured treatment blocks
  • Step-up care to Intensive Outpatient (IOP) or Partial Hospitalization Program (PHP) levels when indicated
All services are coordinated within one system. Care is adjusted deliberately — based on progress, data, and consultation — without starting over or navigating multiple clinics.

Our Process

It never hurts to talk with a qualified professional. As often as we urge parents to come in, we also let them know when they don’t necessarily need to.

1.

Complete Your Screening

Provide your information by filling out a brief online form, or share your contact details so that we can schedule a phone screen. This allows us to better understand your concerns and determine the most appropriate next steps.

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2.

Book Your Initial Appointment

Our staff will help you find a convenient appointment time and connect your child with one of our clinicians who specializes in the treatment of anxiety and obsessive-compulsive disorder in children and adolescents.

3.

Begin Treatment

Begin treatment with an approach tailored to your child’s needs. Evidence-based treatment, including cognitive-behavioral approaches and, when indicated, exposure-based interventions, can help children and adolescents with anxiety and OCD work toward meaningful and lasting improvement.

Medication as Part of Treatment (When Appropriate)

What medication is — and what it isn’t

Medication can be a helpful component of treatment for some children and adolescents with moderate to severe anxiety or related concerns. It is not a stand-alone solution, and it is not the right choice for every child.
At the Child Anxiety Center, medication is used thoughtfully and selectively — always as part of a coordinated, evidence-based treatment plan.
*Currently, the psychiatrists at EBTCS only provide medication treatment services to those clients who are also receiving therapy services at our centers.
When medication is considered

Medication may be recommended when:

  • Anxiety symptoms are severe or persistent
  • Symptoms significantly interfere with daily functioning
  • Anxiety makes it difficult for a child to fully engage in therapy
  • There has been limited improvement with therapy alone
Decisions about medication are never automatic. They are made collaboratively, based on careful evaluation, clinical expertise, and family preferences.
What medication treatment looks like
Medication services at EBTCS are provided by board-certified child and adolescent psychiatrists with expertise in anxiety disorders. When medication is part of care:
  • A thorough evaluation is conducted
  • Options, risks, and benefits are explained clearly
  • Medication is started conservatively and monitored closely
  • Care is coordinated directly with the child’s therapist
This integrated approach ensures that medication supports therapy — rather than replacing it.
How medication fits with evidence-based therapy

Research shows that for some children, the combination of therapy and medication leads to greater improvement than either approach alone, particularly in more severe cases.

Medication can reduce symptom intensity, making it easier for children to participate in exposure, skill-building, and daily activities — allowing therapy to be more effective.
Time-limited and goal-directed
Like therapy, medication is not intended to continue indefinitely without purpose. Ongoing use is reviewed regularly, with attention to progress, side effects, and evolving needs. When symptoms are well managed and skills are in place, families and clinicians may consider tapering or discontinuation together.
The goal is always meaningful improvement and increasing independence — not long-term reliance on medication.
Will my child have to stay on medication long-term?
Not necessarily. Many children use medication for a period of time to support progress in therapy and daily functioning. Decisions about duration are made collaboratively and revisited over time, based on how the child is doing and what supports are still needed.

Telehealth: Expert anxiety care, available across PSYPACT states

We provide secure, evidence-based telehealth services for children and adolescents across Washington State and all PSYPACT states.
PSYPACT (the Psychology Interjurisdictional Compact) allows licensed psychologists with advanced credentials to provide care across participating states. This means families can access the same specialized, doctoral-level anxiety care offered at our center — even if they live outside our immediate geographic area.
The same care. The same clinicians. The same standards.
Telehealth at the Child Anxiety Center is not a simplified or reduced version of treatment. It is the same evidence-based care, delivered by the same expert clinicians, using the same structured treatment approaches.
Through telehealth, we provide:
  • Cognitive-behavioral therapy (CBT) for anxiety and related concerns
  • Exposure therapy and Exposure and Response Prevention (ERP) for anxiety and OCD
  • Parent-based treatments such SPACE as and Behavioral Parent Training
  • Treatment for sleep difficulties, including CBT-I and behavioral sleep interventions
  • Care for repetitive behaviors, tics, and related challenges
All sessions are conducted through secure, HIPAA-compliant platforms and are designed to be engaging, structured, and developmentally appropriate.

When telehealth is a strong option

Telehealth can be especially helpful for:
  • Families living outside major metropolitan areas
  • Children with anxiety that makes traveling difficult
  • Busy families balancing school, work, and extracurricular demands
  • Adolescents who engage more comfortably from their home environment

Research shows that telehealth-delivered CBT and exposure-based treatments are as effective as in-person care for childhood anxiety when delivered by trained specialists — making telehealth a powerful and flexible option for many families.

Thoughtful recommendations, not one-size-fits-all

While telehealth works well for many children and adolescents, it is not always the right fit for every situation. As part of our intake process, we help families determine whether telehealth, in-person care, or a combination of both is most appropriate based on clinical needs, age, and treatment goals.
Our priority is not convenience alone — it’s effectiveness.

Telehealth availability

We currently offer telehealth services to families located in:
  • Washington State
  • All PSYPACT-participating states
If you’re unsure whether your state is covered, our intake team is happy to help.

Getting started with telehealth care

You don’t need to find a provider in your state or navigate multiple systems. Our team will guide you through eligibility, scheduling, and next steps.

Taking the next step

Many families reach out wondering: “Is this serious enough?”, “Should we wait?”, “What if we choose the wrong treatment?”
You don’t need to answer those questions alone.

You don’t need a referral.

You don’t need a diagnosis.

You just need to reach out.

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Address

1200 5th Avenue,
Suite 800 Seattle, WA 98101

Email

info@ebtseattle.com