Anxiety can affect a young person's thoughts, emotions, physical well-being, and daily functioning. You might notice your teen:

• Avoiding school, social events, or activities 

• Spending more time alone or withdrawing from friends

• Overthinking decisions or seeking frequent reassurance

• Having trouble falling asleep or staying asleep

• Experiencing increased irritability 

• Reporting physical symptoms such as headaches or stomachaches

• Struggling with perfectionism or an intense fear of making mistakes

• Having difficulty starting assignments or completing tasks because of worry

• Worrying about how others perceive them

Anxiety exists on a spectrum, and not every young person experiences it in the same way. When anxiety becomes persistent, causes significant distress, or interferes with everyday life, therapy can help.

Anxiety often develops through a combination of genetic predisposition, temperament, life experiences, and environmental factors. During the preteen, teen, and young adult years, young people face a wave of changes and increased demands, making the adolescent period a common time for anxiety disorders to first develop.

The young people we work with may be navigating stressors such as:

• School transitions and academic pressure

• Friendship challenges and concerns about belonging

• Relationships beginning, changing, or ending

• Sports, extracurricular activities, and competing demands

• Family conflict or changes at home

• Identity development and questions about belonging

• Uncertainty about the future, college, or career decisions

At Sequoia Teen Counseling Center, our therapists specialize in working with preteens, adolescents, and young adults. We understand the unique developmental, social, and emotional challenges young people face, and we work collaboratively with them to help make life feel more manageable. When appropriate, we also involve parents and caregivers to help reinforce progress outside the therapy room.

Anxiety in preteens, teens, and young adults can take many forms! Our therapists work with a range of anxiety disorders, including:

• Generalized Anxiety Disorder (GAD): Persistent, difficult-to-control worry about multiple areas of life, such as school, relationships, health, or the future.

• Social Anxiety Disorder: Intense fear of being judged, embarrassed, or negatively evaluated in social or performance situations.

• Panic Disorder: Recurrent, unexpected panic attacks accompanied by ongoing worry about having another attack or changing behavior to avoid one.

• Separation Anxiety Disorder: Persistent distress about being away from caregivers or other attachment figures, beyond what is typical for a young person's developmental stage.

• Specific Phobias: Intense fear of a particular object or situation, such as spiders, vomiting (emetophobia), needles, or heights.

• Agoraphobia: Fear of situations in which escape might feel difficult or help might seem unavailable if panic-like or other distressing symptoms occur.

• Selective Mutism: Difficulty speaking in certain social situations, such as school, despite being able to speak in other settings.

Anxiety can also overlap with obsessive-compulsive disorder (OCD), body dysmorphic disorder (BDD), and other challenges. Our therapists take time to understand each young person's unique experiences rather than assuming that all anxiety looks the same.

At Sequoia Teen Counseling Center, we provide compassionate, evidence-based therapy tailored to each young person's needs, strengths, and developmental stage. Our goal is not simply to help teens feel less anxious in the moment, but to help them build skills that support greater confidence, flexibility, and autonomy over time. We utilize a variety of evidence-based practices implemented flexibly to meet the unique needs of the youth we serve.

Cognitive Behavioral Therapy (CBT)

Cognitive Behavioral Therapy (CBT) is an evidence-based approach that helps young people understand the connections between their thoughts, feelings, physical sensations, and behaviors.

Through Cognitive Behavioral Therapy, teens may learn to recognize patterns that contribute to anxiety, evaluate anxious predictions, develop practical coping strategies, and gradually approach situations they have been avoiding. CBT can also help young people build emotional awareness and respond to challenging thoughts with greater flexibility.

Exposure and Response Prevention (ERP)

Exposure and Response Prevention (ERP) is a specialized form of CBT that is particularly effective for OCD and is also used to treat many anxiety-related difficulties.

ERP involves gradually and collaboratively approaching feared situations, thoughts, or sensations while reducing avoidance, compulsions, or other behaviors used to obtain immediate relief. Over time, young people can learn that they are better able to tolerate discomfort and uncertainty without relying on anxiety-driven rituals or avoidance.

Exposure work is individualized and thoughtfully paced. Our aim is to help teens build confidence through manageable, meaningful steps, while keeping them in the driver’s seat of their treatment.

Additional approaches

Alongside CBT and Exposure, our team of therapists use a variety of additional techniques to support anxiety treatment in youth, including Somatic Therapy, Acceptance and Commitment Therapy (ACT), and Internal Family Systems (IFS). Some may also utilize art and movement in sessions. Additionally, we focus on rapport-building and Motivational Interviewing (MI) to increase a youth’s readiness for change and engagement in treatment. Our team of clinicians is prepared to meet preteens, teens, and young adults where they are at and build a customized, evidence-based treatment plan to lead them towards lives less controlled by anxiety.

We also recognize that anxiety rarely exists on its own. Many of the anxious teens that we work with are also struggling with depression or trauma. They also frequently identify as neurodivergent, gifted or twice-exceptional, highly sensitive, or LGBTQ+. 

These experiences can shape how anxiety develops, how it feels, and what kind of support is most helpful. For example, a neurodivergent teen may experience anxiety related to sensory overload, masking, executive functioning demands, or feeling misunderstood. A high-achieving teen may struggle with anxiety rooted in perfectionism or fear that making a mistake will disappoint others. A transgender teen may experience anxiety relating to “passing” or the sociopolitical climate.

At Sequoia Teen Counseling Center, we seek to understand each young person's strengths, challenges, identities, and environment so that treatment is relevant to their actual lives. We take an individualized, holistic approach to therapy which validates and empowers adolescents to build their own life worth living.

Watching your child struggle with anxiety can be difficult, particularly when avoidance, reassurance-seeking, or emotional overwhelm begins to affect family life. Parents and caregivers often want to help but may be unsure whether to offer reassurance, encourage a challenge, or give their teen space.

When appropriate, we collaborate with caregivers to help them better understand anxiety, support their teen's growing independence, and respond to anxiety-related behaviors in ways that reinforce therapeutic progress. Our aim is to help families become a source of support while empowering young people to develop the skills they need to navigate challenges more independently.

We also offer Caregiver Coaching and Individual Parent Psychotherapy for parents/guardians seeking additional support beyond occasional check-ins or sessions with their child’s individual therapist. These services are also a great option for families who want to help their anxious preteen or teen, even if the young person is resistant to engaging in individual therapy.

If anxiety is making everyday life harder for your child, support is available. At Sequoia Teen Counseling Center, we offer specialized therapy for preteens, adolescents, and young adults, with an affirming approach that respects each person's individuality and helps them build lasting skills.

We offer in-person counseling in the Eastlake neighborhood of Seattle and secure online therapy throughout Washington State.

Interested in learning more about anxiety therapy for your teen? Contact Sequoia Teen Counseling Center to explore whether our approach may be a good fit for your family.