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.
How we can help
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 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. In SPACE treatment, parents attend sessions without their child present, but the child remains the focus of care, with the goal of helping them feel less anxious and better able to face challenges.
OCD
People with obsessive-compulsive disorder (OCD) experience intrusive and unwanted thoughts, urges, or images (obsessions) that cause significant distress or anxiety, and perform rituals (compulsions) to reduce that distress. Common obsessions include fears of contamination or harming others, a need for order or a “just right” feeling, worries about morality, or taboo thoughts. Compulsions can be behaviors (e.g., excessive washing, checking, or ordering) or mental rituals (e.g., neutralizing a “bad” thought with a “good” one, reviewing memories, or silently counting) and vary greatly. Unfortunately, performing rituals only provides temporary relief, and maintains the obsession-compulsion cycle of OCD.
How we can help
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.
How we can help
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.
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 behavioral therapy involves working with caregivers instead of working directly with the child.
How we can help
At Riverstone, we work with parents using Parent Behavior Management Training (PBMT) 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. PBMT helps you set your child up for success by responding consistently using positive reinforcement-based skills such as praise, positive attention, planned ignoring, and rewards and consequences.
Although we work primarily with parents when treating behavior problems, 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.
It is brave to reach out for support. We are here to help you take the next step.
Want to learn more about how we can help you or your child? Get started by reaching out to schedule a free 15-minute consultation.
We look forward to hearing from you!
