Treatment for Anxiety

What will therapy with CAMHS involve?

Following your assessment, you and your assessment clinician agreed that treatment for Anxiety would be most helpful for you.

You will have been offered one of these therapies:

  • Cognitive Behavioural Therapy (CBT)
  • Child Psychotherapy
  • Family and Systemic Psychotherapy

Cognitive Behavioural Therapy (CBT) for anxiety

CBT (Cognitive Behavioural Therapy) is a talking therapy which helps you to understand how your thoughts, behaviour and feelings are connected. It will help you to learn how to think and act in ways that will improve how you feel, and reduce your anxiety.

How many sessions will I have?

  • You will have up to 18 sessions.
  • You might have one-to-one sessions or group sessions.
  • Sessions may be in-person or online.
  • CBT will be adapted to suit your age and needs.
  • Your parents and carers may join some or all sessions.

Working with your clinician

CBT involves working collaboratively with your clinician. You will talk about your difficulties and find solutions for these. This work may involve experiments to challenge your thinking and behaviours and testing these out both in sessions and between sessions. You will have regular reviews with your clinician to make sure this approach is working for you.

British Association for Behavioural and Cognitive Psychotherapies - What is CBT?

This video explains what CBT is and how it can help you. Older children, teenagers and parents and carers may find this helpful. This video is 1 minute.

Mental Health Center Kids - What is CBT? CBT Tools - Catch, Check, Change

This video explains what CBT is and how it can help you. Younger children may find this helpful. This video is 4 minutes 31 seconds.

Mental Health Center Kids - Cognitive Behavioural Therapy for Kids, Thoughts Feelings, Actions

This video explains what CBT is and how it can help you. Younger children may find this helpful. This video is 4 minutes 7 seconds.

What is Graded Exposure?

Your therapy may also involve Graded Exposure. This will help you to face the situation/object you are avoiding by gradually helping to break the cycle of anxiety. This may feel scary, but your therapy is collaborative so you won’t be forced to do something you don’t want to do or that you aren’t ready to do. It will be built up slowly at your pace.

The cycle of anxiety shows how your thoughts, feelings and behaviour are linked. There are examples below.

A diagram showing an anxiety cycle for Generalised Anxiety Disorder using school exams as an example. There are four yellow circles joined in a loop with black arrows. The first circle says “Thought: I am going to fail all my exams.” The second circle says “Feelings: worried, anxious, panicky.” The third circle says “Body: headaches, tired, stomach aches.” The fourth circle says “Behaviour: spending too much time studying or avoiding studying completely.” The arrows show how each circle leads to the next and keeps going round in a circle. At the bottom, an orange box says “Consequence: not getting enough sleep, not seeing your friends.”

 

A diagram showing an anxiety cycle for Panic Disorder using a busy train as an example. At the top, there is an orange box that says “Trigger: You get on a busy train.” Below it, there are five yellow circles joined in a loop with black arrows. The first circle says “Thought: I hate busy trains.” The second circle says “Feelings: worried, anxious, panicky.” The third circle says “Body: racing heart, feeling dizzy.” The fourth circle says “Thoughts: I am going to faint, I can’t breathe.” The fifth circle says “Behaviour: get off the train at the next stop.” The arrows show how each circle leads to the next and keeps going round in a circle. At the bottom, an orange box says “Consequence: late for school or college as you walked.”

 

A diagram showing an anxiety cycle about phobias using a phobia of dogs as an example. At the top, an orange box says “Trigger: A dog runs towards you and barks loudly.” Below it, there are four yellow circles joined in a loop with black arrows. The first circle says “Thought: The dog is going to bite and attack me.” The second circle says “Feelings: anxious, panicky.” The third circle says “Body: racing heart, feeling dizzy, feeling sweaty.” The fourth circle says “Behaviour: running away, hiding from the dog.” The arrows show how each circle leads to the next and keeps going round in a circle. At the bottom, an orange box says “Consequence: not going out anymore, not learning you can feel safe around dogs.”

 

A diagram showing an anxiety cycle for Separation Anxiety using an example of going to school. At the top, an orange box says “Trigger: You are getting ready for school in the morning.” Below it, there are four yellow circles joined in a loop with black arrows. The first circle says “Thought: My parent or carer might get hurt while I am at school. I can’t cope without my parent or carer.” The second circle says “Feelings: anxious, panicky, distressed.” The third circle says “Body: feeling sick, stomach ache, headaches.” The fourth circle says “Behaviour: refusing to go to school.” The arrows show how each circle leads to the next and keeps going round in a circle. At the bottom, an orange box says “Consequence: not seeing your friends and not doing well in school.”

 

A diagram showing an anxiety cycle for Social Anxiety using a party as an example. At the top, an orange box says “Trigger: You are at a friend’s party.” Below it, there are four yellow circles joined in a loop with black arrows. The first circle says “Thought: What if I am wearing the wrong thing? What if I make a fool of myself?” The second circle says “Feelings: anxious, panicky, scared.” The third circle says “Body: racing heart, feeling dizzy, feeling sick.” The fourth circle says “Behaviour: avoiding eye contact, staying quiet, and going on your phone to avoid talking to people.” The arrows show how each circle leads to the next and keeps going round in a circle. At the bottom, an orange box says “Consequence: not enjoying the party and feeling different and isolated.”

 

What are safety behaviours?

You will practice challenging your safety behaviours. Safety behaviours are things you do protect yourself from your anxiety triggers.

You might avoid certain things, seek reassurance or distract yourself. These help you feel less anxious, but can make your anxiety worse in the long term. Below are some examples of safety behaviours. You may do some, all or none of these, that is okay, everyone experiences anxiety differently.

Your parents, carers and anyone you trust can help you to practice challenging your safety behaviours.

Examples of safety behaviours

  • Not leaving the house
  • Going on your phone when socialising
  • Staying close to exits
  • Avoid certain objects or situations e.g. getting an injection or going on public transport
  • Repeatedly checking things
  • Repeatedly asking your parents, carers or friends for reassurance

The therapies we offer in CAMHS have been tested and proven to help. You have been offered CBT as this is the best way to know how to help children and young people feel less anxious.

You can read about a young person’s experience of CBT for anxiety here.

You can read about a young person’s experience of therapy for panic attacks here.

Child Psychotherapy for anxiety

Child Psychotherapy is a talking therapy that can help you to understand yourself and your anxious thoughts better.

You might explore your emotions and behaviours by looking at what has happened in your life and your relationships with family, friends and other important people.

How many sessions will I have?

  • You will have up to 30 sessions.
  • These will be one-to-one sessions.
  • Sessions may be in-person or online.
  • Sessions will be adapted to suit your age and needs.
  • Your parents and carers may join some or all sessions.

Working with your clinician

Working closely with your clinician, together, you might try to better understand patterns that you may have not been aware of and coping strategies you may have developed. This can help you to understand yourself better and help you to make better choices.

Your clinician may also work with your parents, carers and family members to support the work you are doing with your clinician

You will have regular check ins with your clinician to make sure the therapy is working for you.

  • Line about rationale for this over CBT
  • May have already tried CBT and not helped

What is Family and Systemic Psychotherapy for anxiety

Within family & systemic psychotherapy sessions you will be supported to explore your relationships within your family (who ever your family is to you, including friends) and the possible effects the anxiety is having within those relationships.

Some times patterns are created around anxiety and our family/friends can support us to notice and challenge patterns that no longer work for us. Exploring the family communication surrounding the anxiety is usually helpful for all the family members.

Looking at wider support networks and how to continue positive changes is also what your family & systemic psychotherapist can explore together.

How many sessions will I have?

  • You will have up to 12 sessions.
  • These will be sessions with your family and carers.
  • Your sessions may be in-person or online.
  • Sessions will be adapted to suit your age and needs. 

In Family and Systemic Psychotherapy, 'Family' refers to anyone you care about and who cares about you. It doesn't just mean someone who is biologically related to you, so 'Family' also refers to:

  • Step-parents
  • Step-siblings
  • Carers
  • Adopted & foster siblings.

Read more information about this on the Association for Family Therapy and Systemic Practice.

How is my therapy going?

You and your therapist will have regular conversations about how you are finding therapy. These are called review sessions, we will do a review session after every 6 therapy sessions.

If you feel it’s not working, you can tell your clinician in your review sessions. But you can also do this any other time that you would like to. We encourage you to be honest with your therapist. Hearing your feedback helps your therapist to understand what does and doesn't help you. 

Your parents and carers might join these sessions, if you and your clinician think that is a good idea. You can tell your clinician if you don't want your parents and carers in your review sessions.

During your review sessions, you and your clinician will think about:

  • How therapy is going
  • Your goals and if therapy is helping you work towards these goals
  • If you need support from other services. This could be services within CAMHS or outside of CAMHS.

Together you will:

  • Update your care and/or safety plans
  • Update your risk assessment
  • Complete questionnaires to track your progress, you can read more about this on our Tracking Your Progress page
  • Plan next steps e.g. for therapy, starting to a different therapy, moving on from CAMHS.

Sometimes reviewing how your therapy is going involves your clinician talking to other clinicians in their team. This will happen in Multi-Disciplinary Team (MDT) meetings.

MDT meetings help your clinician think about you and your difficulties in different ways and what your next step might be. Your clinician will always share what was discussed in MDT meetings with you and use this to plan your next steps with you.

Any discussions held about you in MDT meetings are respectful and confidential. 

Requesting reasonable adjustments

We encourage you or your parents and carers to talk to your clinician about adjustments you may need. We will make adaptations to support you to engage with the therapy we offer. Below are some examples of adjustments you could ask for:  

  • Information to be shared in different formats or languages

  • Breaks during the session so that you can move around 

  • Using fidget toys and turning off bright lights  

  • Using visuals or writing down your thoughts

More information about my therapy

Children and Young People

Mind - Cognitive Behavioural Therapy

This website explains:

  • What CBT is?
  • What CBT treats?
  • What CBT sessions are likes?
  • How can I get CBT?
  • Can I do CBT by myself?
  • What if CBT doesn't work for me?

Young Minds - Talking Therapies

This website explains:

  • What is talking therapy?
  • Common types of talking therapy
  • What happens during therapy sessions?
  • How to make the most of therapy sessions?
  • How to access talking therapy
  • Finding the right therapist for you
  • Get help now

Parents and Carers

Young Minds - Counselling and therapy

This website link may be helpful for parents and carers to understand:

  • How can I get counselling or therapy for my child?
  • Finding the right support for your child
  • Common types of talking therapies
  • Talking to your child about counselling and therapy
  • Supporting your child during counselling or therapy
  • Looking after yourself
  • Useful helplines and websites

Children and Young People

Association of Child Psychotherapists - Information for Young People

This website explains:

  • What is Child Psychotherapy is?
  • What you might need to know.

Association of Child Psychotherapists - How Child and Adolescent Psychotherapy Can Help

This website explains:

  • What is Child Psychotherapy is?
  • How can it help?
  • Why does it help?

Parents and Carers

Association of Child Psychotherapists

This website explains:

  • What is Child Psychotherapy?
  • What Child Psychotherapists can help with?

Children and Young People & Parents and Carers

Association for Family and Systemic Psychotherapy

This website explains:

  • What is Family and Systemic Psychotherapy?
  • Who is Family and Systemic Psychotherapy for?
  • What difficulties can Family and Systemic Psychotherapy help?
  • Frequently Asked Questions

UK Council for Psychotherapy

This website explains:

  • What is Psychotherapy?
  • Types of Psychotherapy
  • How does Psychotherapy work?
  • Frequently Asked Questions

Click the link below to find information about NICE guidelines and recommendations for recognition, assessment and treatment for Social Anxiety.

NICE Guideline - Social Anxiety

This document from Anna Freud explains why we offer the therapies we do and the evidence that supports their use. This document explains:

  • What is Anxiety?
  • How can I get help?
  • When and why you will be offered different therapies?
  • The evidence behind each type of therapy for treating Anxiety

Understanding treatment options - Anxiety

Link to website