Richardson Anxiety Therapy

Everyone experiences worry from time to time—that's a normal part of life. Anxiety disorders are different because the worries become more persistent, more intense, and begin to interfere with daily functioning. Some people experience a constant stream of worries about everyday situations, while others may struggle with intense fears related to social interactions, separation from loved ones, specific situations or objects, or sudden episodes of panic that seem to come out of nowhere.

No matter the type, anxiety often affects more than just thoughts. It can also show up in the body through headaches, stomachaches, muscle tension, restlessness, difficulty sleeping, or feeling constantly on edge. For children especially, physical symptoms are often one of the first signs of anxiety because they often understand how to talk about physical sensations, not big feelings.

Young children may not have the language to say, "I'm feeling anxious." so parents often hear phrases like "My stomach hurts," "I don't feel good," or "I don't want to go," instead. These physical complaints are very real and can be important clues that a child is struggling with anxiety.

Whether anxiety appears as generalized worry, social anxiety, separation anxiety, specific phobias, panic attacks, or another anxiety-related concern, effective treatment can help children, teens, and adults feel more confident, capable, and at ease in their daily lives.

Separation Anxiety Disorder

Often people think of separation anxiety as only a childhood thing, and that kids will grow out of it. While this is true for developmentally appropriate separation anxiety, it isn't true for separation anxiety disorder. And separation anxiety disorder doesn't just affect children, but adults too.

So what is developmentally appropriate? According to Stanford Medicine, children under the age of three years old are likely to experience separation anxiety. Infants are still developing important cognitive skills to understand that when you leave the room, you aren't gone forever. By about three years old, children typically begin to understand that separations are temporary and adjust to periods without primary caregivers more readily. That doesn't mean that there won't be tears on day one of daycare, but by the end of the week, it should be a lot easier.

For children with separation anxiety disorder, they know that being away from home or loved ones is supposed to be temporary, but they can't stop worrying that something will happen to make it permanent. They might worry about a caregiver being sick or getting into an accident, or. that they will get lost and never find their way home again. Some even worry about being taken if they are alone in a room in their own house for more than a few seconds. Because they might not know how to talk about worries, these kids might also endorse headaches or stomachaches.

In adults, separation anxiety disorder often occurs alongside another anxiety disorder. Symptoms in adults is similar to that in children, but the focus might be different. Rather than worrying about being separated from caregivers, adults with separation anxiety may worry about being away from partners or spouses or even their own children.

Selective Mutism

Selective mutism typically begins before children are 5 years old, but may not be recognized until a child enters daycare or school. People with selective mutism have developmentally appropriate language skills and readily speak in certain environments, but not in others. You might have heard of "fight or flight," but there are actually more stress responses. While there are times that we may be able to run away or fight back, there are other times where neither are options. If you have nowhere to go and there's nothing to fight, then people can "freeze." In selective mutism, the anxiety associated with speaking becomes so great that they often freeze and literally can't. Some children with selective mutism can communicate in other ways, such as shaking their head or using thumbs up and thumbs down, but for others, any form of communication, verbal or nonverbal, are impacted.

There are also some mental health conditions that may be associated with anxiety, but aren't actually anxiety disorders. Obsessive compulsive disorder and post-traumatic stress disorder (PTSD) used to be classified as an anxiety disorders in previous versions of the DSM, but the DSM-5 separated them into their own categories. People with obsessive compulsive disorder also experience intense anxiety related to certain thoughts or actions, but the difference is that they are compelled to do something in response. For example, those who are worried about germs or illness may wash their hands after they touch anything, regardless whether or not it's dirty. Similarly, people who have experienced trauma might have post-traumatic stress disorder (PTSD) and experience symptoms of anxiety when reminded of the trauma. However, there usually isn't a specific memory that causes anxiety, but rather a broader situation that triggers worry.

Social anxiety disorder is an intense, ongoing fear of being judged, watched, or negatively evaluated by others. While it’s completely natural to care about what others think, social anxiety goes beyond typical nerves and can feel overwhelming or even debilitating in everyday situations.

People with social anxiety often want connection and friendships, but social interactions can trigger strong physical and emotional reactions such as a racing heart, sweating, shaking, or difficulty speaking. These symptoms can create a cycle where the fear of being noticed for feeling anxious only increases the anxiety itself.

It’s important to note that social anxiety is different from shyness. Many people feel shy or hesitant in new situations, but this usually eases with time and familiarity. Social anxiety, on the other hand, tends to persist before, during, and after social situations and can significantly impact daily life if left untreated.

Panic attacks are relatively common. In fact, the Cleveland Clinic reports that about 1 in 10 people in the United States experience a panic attack each year. Although panic attacks are not physically dangerous, they can be emotionally exhausting and disruptive.

Panic attacks can feel extremely frightening, often with symptoms such as a racing or irregular heartbeat, shortness of breath, dizziness, or chest tightness. Because of how intense these sensations can be, panic attacks are even sometimes mistaken for serious medical emergencies like a heart attack.

Panic attacks become concerning when they are more frequent or when worrying about them prevents you from engaging in activities or daily life. Many people begin to worry about having an attack in public or in situations where escape feels difficult. In some cases, this fear can contribute to agoraphobia, which involves avoiding places or situations where a panic attack might occur or where help may feel hard to access.

While some people begin to avoid these situations altogether, others may push through them while still experiencing significant distress. The good news is that panic disorder is treatable, and effective therapy can help reduce both the frequency and intensity of panic symptoms.

Separation anxiety is often thought of as something only children experience and eventually grow out of. While mild, developmentally appropriate separation anxiety is a normal part of early childhood, separation anxiety disorder is different—and it can affect both children and adults.

In early development, some separation anxiety is expected. According to Stanford Medicine, it is common for children under age three to become distressed when separated from a primary caregiver. At this stage, children are still learning that when a caregiver leaves, they will return. By around age three, most children begin to understand that separations are temporary, and they typically adjust more easily to time away from parents or caregivers.

Separation anxiety disorder goes beyond this developmental stage. Children with this condition may understand, on a logical level, that separation is temporary, but they still experience intense and persistent fear that something bad will happen while they are apart. This can include worries that a caregiver will be injured or lost, or that they themselves will become lost or unable to return home. These fears are often accompanied by physical symptoms such as stomachaches, headaches, or nausea.

In adults, separation anxiety disorder can also occur and is often seen alongside other anxiety conditions. Rather than focusing on caregivers, adults may experience intense distress about being away from partners, spouses, children, or other important attachment figures. This can lead to avoidance of time apart or significant emotional distress when separation is unavoidable.

Separation anxiety disorder is highly treatable, and therapy can help children, teens, and adults build a greater sense of safety, confidence, and independence.

The decision to start therapy is a personal one, and only you can decide what's best for you. Outcomes are never guaranteed, but some potential benefits from therapy include:Starting therapy is a personal decision, and there is no single right path for everyone. While outcomes can’t be guaranteed, research consistently shows that therapy can offer meaningful and lasting benefits for children, teens, and adults struggling with anxiety and other mental health concerns.

Improved Coping Skills

One of the primary goals of therapy is to build healthier, more effective coping strategies. Many unhelpful behaviors—such as avoidance or procrastination—are actually ways of coping with uncomfortable emotions like fear or self-doubt. For example, a child who feels anxious about a school assignment may avoid starting it, which temporarily reduces stress but often leads to greater pressure later. Therapy helps individuals recognize these patterns and develop more adaptive ways to manage anxiety and difficult emotions.

Better Physical Health

Mental and physical health are closely connected. Anxiety, in particular, can show up in the body through symptoms such as headaches, stomachaches, fatigue, and muscle tension. Research has shown that a significant number of children with anxiety report frequent stomach pain. When anxiety is effectively treated, physical symptoms often improve as well. Addressing mental health early can also reduce long-term risks associated with chronic stress and related health concerns.

Increased Life Satisfaction

As anxiety symptoms decrease and coping skills improve, many people notice an overall improvement in mood and quality of life. Feeling more emotionally balanced often leads to greater satisfaction in daily activities, relationships, and overall well-being.

Improved School and Work Performance

Therapy can also support success in academic and professional settings. Individuals in counseling often experience better concentration, attendance, and productivity. For children and teens, this can translate into improved academic performance in areas such as reading, language, and math, as well as increased confidence in the classroom.

Healthier Communication and Relationships

Therapy helps individuals develop stronger communication skills, which can improve relationships with family, friends, and peers. When a child learns to better understand and express their emotions, it often reduces family stress and improves overall home dynamics.

Long-Term Benefits

Research suggests that the benefits of therapy often continue to grow even after treatment ends. In many cases, therapy can be as effective as or more effective than medication alone for anxiety and related conditions, especially when focusing on skill-building and long-term coping strategies.

Overall, therapy offers support not just for symptom relief, but for long-term emotional growth, resilience, and improved quality of life.

Research suggests that no single therapy approach is universally “best” for anxiety. While different treatment methods can be helpful, one of the strongest predictors of progress is the quality of the therapeutic relationship itself.

A strong alliance between client and therapist—built on trust, collaboration, and empathy—often plays a larger role in outcomes than any specific technique. Because of this, I prioritize creating a supportive, connected, and collaborative relationship with each client as the foundation of treatment.

I also take a flexible, individualized approach to care. Rather than using a one-size-fits-all model, I draw from evidence-based methods that meet clients where they are developmentally and emotionally. Together with clients and their families, we identify the approach that best fits their unique needs, strengths, and goals.

The length of therapy varies from person to person and depends on factors such as symptom severity, goals, and individual needs. There is no set number of sessions that works for everyone.

Research from the American Psychological Association (APA) suggests that about half of individuals in therapy show significant improvement within 15–20 sessions. For children, the Association for Play Therapy reports that play therapy often averages around 20 sessions to support meaningful progress. When sessions are held weekly, this typically translates to about four to five months of treatment.

At the same time, both the APA and Consumer Reports note that longer-term therapy can lead to stronger or more sustained outcomes, especially when concerns are more complex. Individuals experiencing co-occurring conditions—such as anxiety alongside depression—or those with a history of trauma may benefit from longer treatment lasting 12–18 months or more.

Ultimately, the duration of therapy is flexible. I work closely with each client and their family to develop a treatment plan that reflects their needs and goals, and we regularly revisit progress together. Some children may make significant gains in a relatively short period of time, while others benefit from a longer-term supportive process. Either way, the focus is always on providing care that feels appropriate, effective, and collaborative.