What We Treat
Anxiety
Children, adolescents, and young adults with anxiety disorders may have excessive worry, a specific phobia, difficulty separating from a parent, or struggle in social situations. They may struggle with perfectionism, show an intolerance for uncertainty, or have physical symptoms like stomachaches or headaches. Anxiety becomes a problem that benefits from treatment when it significantly interferes with daily life—such as school, relationships, or sleep—or causes distress and avoidance behaviors.
At Riverstone, we use Cognitive Behavioral Therapy (CBT) to help clients recognize and challenge anxious thoughts, gradually face feared situations through exposure exercises, and learn coping skills. For teens and young adults, we often incorporate Acceptance and Commitment Therapy (ACT) to help them accept difficult thoughts and feelings, stay grounded through mindfulness, and choose actions aligned with their values—even in the presence of anxiety.
For younger children with anxiety—or in situations where a child or teen does not want to engage in individual treatment—we can help by working with parents using Supportive Parenting for Anxious Childhood Emotions (SPACE). Through SPACE treatment, parents learn how to reduce accommodations of their child’s anxiety and respond in a supportive way that empowers their child to face fears and build coping skills.
OCD
Children, adolescents, and young adults with obsessive-compulsive disorder (OCD) experience intrusive unwanted thoughts (obsessions) and perform rituals (compulsions) to reduce the distress associated with those unwanted thoughts. Common obsessions include fears of contamination or harm, a need for order or a “just right” feeling, or taboo thoughts. Common compulsions include excessive washing, checking, ordering, or mental rituals.
At Riverstone, we use Exposure and Response Prevention (ERP)—the gold-standard treatment for OCD—to break the obsession-compulsion cycle and reduce symptoms. Treatment begins by identifying a client’s unique obsessions and compulsions. Through ERP, we then support clients as they gradually face feared thoughts or situations (exposure) while refraining from performing rituals or compulsive behaviors (response prevention). This process teaches that anxiety naturally decreases without compulsions and that feared outcomes are unlikely or manageable. Over time, clients reduce reliance on rituals, build tolerance for uncertainty, and develop skills that support long-term recovery.
In a well-intentioned effort to relieve their child’s distress, parents often accommodate their child’s OCD in ways that end up helping maintain OCD symptoms. This can happen when parents provide repeated reassurance, change family routines to avoid OCD triggers, or perform tasks for their child like touching doorknobs or rewashing dishes. Because accommodation from family members is the norm (not the exception) when youth have OCD, we work closely with families throughout treatment to provide support and guidance to gradually reduce accommodations that may be maintaining the cycle of OCD.
Depression
Children, adolescents, and young adults with mood disorders like depression may show persistent sadness or irritability, loss of interest in activities, changes in appetite or sleep, fatigue, difficulty concentrating, or feelings of worthlessness or hopelessness. Depression often leads to avoidance and isolation which is likely to worsen mood over time.
At Riverstone, we use Behavioral Activation (BA) and Cognitive Behavioral Therapy (CBT) to treat depression. BA works to break the cycle of isolation and depression by helping clients re-engage with routine, meaningful, and enjoyable activities that lead to improvements in mood. CBT complements this by helping clients identify and challenge negative thought patterns, develop healthier ways of thinking, and build coping skills to manage emotional distress.
For teens and young adults, we often incorporate Acceptance and Commitment Therapy (ACT) to help them accept difficult thoughts and feelings, stay grounded through mindfulness, and choose actions aligned with their values—even in the presence of negative mood.
Trauma & PTSD
Some youth who experience traumatic events—such as abuse, car accidents, natural disasters, or loss—have difficulty recovering. They may experience intrusive memories or nightmares and avoid places or things that remind them of the traumatic event. They may also have negative beliefs about themself or the world, difficulty sleeping, problems concentrating, and bad feelings such as anger, fear, or guilt.
At Riverstone, we use Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) to help youth learn healthy ways to cope with the effects of trauma, gradually work through difficult memories, and feel more in control of their emotions and behaviors. Through supportive therapy, they begin to make sense of what happened and build confidence to move forward in a safe, positive direction. Parents are actively involved throughout treatment to help strengthen family support and healing.
Behavior Challenges
Some children have personality traits or mental health challenges that make them more difficult to parent leading to cycles of parent-child conflict and low child self-esteem. For children with behavior challenges—including defiance, tantrums, negative attention-seeking behaviors, aggression, and ADHD—the most effective treatment involves working with caregivers instead of working directly with the child.
At Riverstone, we work with parents using Parent Behavioral Therapy (PBT) to teach you new ways of communicating and responding to your child that will increase positive behaviors like self-control, decrease problem behaviors, strengthen your connection with your child, and increase your child’s self-esteem. PBT helps you set your child up for success by responding consistently using positive reinforcement-based skills such as praise, positive attention, planned ignoring, rewards and privileges, rule-setting, and consequences.
Though the most successful treatment for behavior challenges involves working primarily with parents, children also benefit from learning skills to regulate their emotions. We use tools from Cognitive Behavioral Therapy (CBT) to help children recognize and name their feelings, learn coping and relaxation strategies to handle big emotions, and communicate their feelings more effectively.