When a child or teen is anxious, the whole family feels it, and often the most powerful change comes from working with the parents, not only the child. Some anxiety in kids is healthy and developmentally normal. It becomes a problem when it interferes with school, friendships, sleep, or family life, or when a child's distress affects the whole family.
What we treat
If selective eating or ARFID is also a concern, see our ARFID and selective eating page.
SPACE: Parent-based treatment for childhood anxiety
SPACE (Supportive Parenting for Anxious Childhood Emotions) is a research-supported treatment for children and adolescents with anxiety, OCD, and related challenges. Developed by Dr. Eli Lebowitz at the Yale Child Study Center, SPACE works directly with parents rather than requiring the child to participate in treatment.
Why work with parents?
Parents are an important part of a child's anxiety system. When a child is distressed, parents naturally respond in ways that help them feel safer. Over time, some of these responses can unintentionally maintain anxiety.
SPACE focuses on what parents can change: their own responses. By becoming more supportive while gradually reducing accommodations, parents can help children become more confident in their ability to cope.
What happens in SPACE?
Parents learn to acknowledge their child's distress while communicating confidence in their ability to handle difficult feelings and situations.
Parents gradually change the things they do that maintain anxiety, while continuing to support their child through the discomfort that comes with change.
Does my child need to participate?
Usually, no. SPACE is designed to work directly with parents. This can make it especially useful when a child doesn't want therapy, isn't ready to participate, or when previous attempts at child-focused treatment haven't been enough.
Some children also benefit from direct treatment using approaches such as ERP, CBT, or ACT. When appropriate, parent-based and child-based treatment can be used together.
What to expect
We start by understanding your child's anxiety and how it has affected your family's routines and responses. From there, we develop an individualized plan for changing the patterns that may be keeping anxiety going. We'll work at a pace that makes sense for your family, see what's working, and adjust as we go.
SPACE workshops for parents
I also offer introductory SPACE workshops for parents and community organizations. These psychoeducational programs explain childhood anxiety, family accommodation, and supportive ways parents can respond.