Child anxiety and OCD treatment in St. Louis.

We typically work with ages 7 and older. If you have a child that is under 7 we often recommend meeting with us, without the child present for parent coaching sessions.

Refusal is common, and it's usually anxiety doing the talking. We recommend framing the first visit as a first meeting, not a commitment: "We're going to meet someone who has helped a lot of kids with exactly the kind of thing that's been hard for you. You don't have to talk about anything you don't want to. Afterward, we'll talk about how it went." Our offices are set up for kids and teens, and our therapists are skilled at earning buy-in from even the most reluctant ones. And if your child still won't come, we can start with you. Through SPACE, parents learn to change the patterns that keep anxiety going, and research shows kids improve even when they never attend a session.

Most kids who come to us have already seen a therapist, and most of those therapists were caring and skilled. The difference isn't effort or warmth. It's method. Anxiety and OCD don't respond well to talking about feelings, exploring where the worry came from, or learning coping strategies in the abstract. They respond to practice: facing the feared thing, in small steps, until the brain learns it's safe. That's Exposure and Response Prevention, and it's the treatment with the strongest evidence for both conditions. Every therapist here is trained in it and uses it from the start. You'll also notice a different structure. Sessions have a plan, your child has homework between them, you're involved rather than in the waiting room, and we track progress so you can see whether it's working. If you've been in therapy for months and can't point to what's changed, that's usually a sign the approach needs to change, not that your child can't get better.

Every child and family is different, so there's no single answer, but here's what to expect. We typically begin with about eight weekly sessions. During this time we get to know your child, understand what's driving the anxiety or OCD, and build a treatment plan together, one that includes specific steps for your child and for you as the parent. Anxiety and OCD are family conditions in the sense that they affect everyone in the home, and parents are often the most powerful part of treatment. After those first eight weeks, we'll check in and evaluate whether it makes sense to move to every-other-week sessions. Factors like the severity of symptoms, how long they've been present, and how consistently the plan is practiced at home all shape how quickly a child progresses. Our goal is always to work ourselves out of a job: we want your child and your family to leave treatment with the tools to handle anxiety on your own.

It depends on where we are in treatment and what your child needs. The very first appointment is for parents only, and your child does not attend. This gives us a chance to hear the full picture from you and make a plan together before your child ever walks in the door.

For your child's first session, our general preference is to meet with them one on one. It's simply easier to build a relationship with a child when they aren't leaning on you to answer questions or wondering whether they should engage. On that first day, we'll come out to the waiting room, introduce ourselves, and say something like, "Hey, let me show you my office, and we can come back and get your parent in a little bit if we decide to." All of this is adjustable, and we'll talk through what feels right for your child during the parent-only appointment.

Beyond that, it varies. We often like to have parents present for large portions of sessions, because a big part of our work is helping you understand how to support your child at home. We'll plan this with you specifically rather than following a one-size-fits-all rule.

Almost every parent we work with asks this question, or wants to. So let's start here: no, this is not your fault.

From the moment you first noticed your child struggling, you've been trying to help. You've most likely been doing everything you can think of to reduce their suffering, adjusting, reassuring, problem-solving, searching for answers. The fact that you're reading this and considering an appointment says the same thing. You care, and you want to know what to do.

As we work together, we'll look at changes you can make in your role as a parent that help your child move forward. That's not blame. It's recognizing that you have real influence, and we're going to help you use it in the ways that work best.

We usually recommend keeping it simple and low pressure. You might say that you found a person who works with lots of kids just like them, kids who struggle with some of the exact same things, and that you've set up a time for them to meet. Something like: "I just want you to meet them and see what you think. We can talk about it afterward and decide what we want to do."

It also helps to let your child know that the first appointment is mostly just hanging out and getting to know each other. If it's in person, the therapist's office has a lot of cool things in it, and your child is never expected to share anything they don't want to share.

Many kids also feel relieved to hear that their parents have already met with the therapist, so the therapist already knows some of what's been going on. That takes the pressure off having to explain hard things themselves.

• We'll schedule a parent-only appointment.

• You'll receive an email with intake paperwork to complete through our secure client portal.

• You'll attend the parent-only session, where we will get more information to understand the problem.

• Your child will then attend their first session with their therapist.

• After this, we will work together to determine the structure of the sessions moving forward.

No. We are therapists, not medical doctors, so we don't prescribe medication. That said, if your child is working with a pediatrician or psychiatrist, or you're considering medication as part of treatment, we're happy to collaborate with them so that everyone caring for your child is on the same page.Item description

Possibly. All of our clinicians offer virtual sessions to families anywhere in Missouri, and several of us also hold licenses in Arizona, Illinois, Indiana, and Wisconsin. If your child lives in one of those states, we may be able to help. Licensing rules require that the child be physically located in a state where the therapist is licensed at the time of the session, so let us know where you're located when you reach out and we'll match you with a clinician who can work with you.