How prevalent is anxiety in children and teens?

Data collected from 2021-2022 in Ohio determined that almost 12% of Ohio children, ages 3-17 had anxiety.¹ The Center for Disease Control (CDC) data from 2022-2023 found that an anxiety disorder was found in 2.3% of children ages 3-5, 9.2% of children 6-11, and 16% of children 12-17.²

What are the types of anxiety in children and teens?

Separation Anxiety Disorder: As referenced earlier, separation anxiety (not disorder) is a normal developmental phase. Separation Anxiety Disorder is extreme and continues beyond the typical developmental period. Kids may be worried about parents or other family members and have difficulty going to school or being away from home or may have difficulty falling asleep. If your child shows extreme distress with separations that is a sign to seek professional help.

Specific Phobias: Fear when in danger is good, fear helps us to survive. Specific phobias are extreme fears that are out of proportion with an actual threat of danger. A thunderstorm becomes a fear of a tornado, or any other circumstance that becomes catastrophized and blown out of proportion. For example, an intense fear of insects, a fear of elevators, escalators. Sometimes a child or teen will say “What if” this or that happens.

Social Anxiety: This is an intense fear of being judged or rejected in social situations. A child may avoid interacting with others at school or have a hard time speaking to people.

Generalized Anxiety Disorder: This is excessive worry or fear about a range of different things that happen in daily life. A child worries about the future more than other children.

Panic Disorder:  A panic disorder is a type of anxiety that also has intense physical symptoms like a racing heart, dizziness, feeling like they can’t breathe. A panic “attack” can come without warning and can go away within minutes to hours.

What can I look for if I think my child has anxiety?

• Some kids will say what they are afraid of: “I don’t want to go to school because the teacher might call on me in class?”
• Worry and/or cries more than other kids
• Complaints about being sick; upset stomach, headaches
• Trouble sleeping, nightmares, does not want to sleep alone
• Restless, jittery
• Anger easily
• Difficulty focusing
• Shaking
• Refusing to go to school
• Uses the bathroom a lot

What causes anxiety?

Some kids are just more sensitive and might have a hard time coping with change. These kids may have a biological or family tendency to be anxious. Anxiety can also develop after stressful life events such as:

• Death of someone close to them
• Moving to a new house or school
• Poverty: getting enough to eat, difficulty having a safe place to live
• Parents who fight and argue, or separation/divorce
• Abuse/neglect, bullying

Are there complications from anxiety?

Children with an anxiety disorder are at greater risk for depression and substance use disorders later life. There is also a higher risk for self-harm and suicide.

What can I do as a parent?

• The 3-3-3 Rule: Name 3 things you can see. Name 3 things you can hear. Move 3 body parts. This strategy incorporates multiple senses, distracts from the thoughts causing anxiety, and grounds the child in the present moment. Make this playful, practice when not anxious.
• Daily exercise
• A safe and supportive home and school environment
• Good sleep habits
• Well balanced meals
• Monitor screen time and social media
• Teach meditation and breathing techniques: Here are some free apps:

• Anxiety Free: iCan Hypnosis – Developed by hypnotherapist Donald MacKinnon, this app is designed to use self-hypnosis to help teach techniques for relaxation and altering subconscious thoughts.
• Sanvello* – Designed to be used in conjunction with therapy, this app teaches deep breathing and behavioral exercises. Users learn how to identify negative thinking patterns and replace them with positive ones. It focuses on the cause of anxiety and personalizes itself using voice recordings.
• Panic Relief*– This easy-to-use app uses evidence-based coping tools to help calm and safely move through a panic attack. Coping tools include muscle relaxation, rest, breathing and more.
• Self-Help Anxiety Management*– This app for older teenagers and adults focuses on mindfulness, or self-awareness. It helps users understand the causes of their anxiety and aids in monitoring them. It focuses on anxious thoughts and behaviors, and provides exercises to deal with them and private reflection.
• MindShift* – This app for adolescents and young adults teaches basic skills to manage anxiety disorders. It also helps manage performance anxiety, test anxiety and perfectionism. Users can choose among the coping strategies and “favorite” the methods that work for them. It also features a “Chill Out” tool, which uses breathing exercises, mental imagery and mindfulness. “Quick Tips” are included to assist with anxiety in the moment.
• Stop, Breathe & Think- Another mindfulness-driven app, Stop, Breathe & Think uses the foundational methods of meditations. This app allows users to track feelings before and after meditation and view yoga videos. The goal is to offer the chance and skills to breathe and think. Meditations are goal-oriented and constructed to help users calm down.
• Live OCD Free*– For children and adults with OCD, this app is designed to help aid cognitive behavioral treatment. It includes ERP (exposure response prevention) exercises and reminders, and offers personalization.
• Breathe2Relax*– This is an app, by the National Center for Telehealth & Technology, teaches breathing techniques to manage stress. The pace can be personalized for what is most relaxing to the user and includes a map to track personal progress. It helps manage fight-or-flight responses during panic attacks, aids in mood stabilization and anger control.
• Calm – Combining mindfulness and meditation to manage anxiety symptoms, this app is noted for its serene interface. It uses relaxing sounds and guided meditations to help the user stay calm.
• 7 Cups – This app functions as a confidential therapy chat room, allowing the user to talk about problems causing stress or panic, and connect with others dealing with anxiety disorders. It also has hundreds of mindfulness exercises and licensed therapists available.

What about professional help?

There are two main ways to treat child and teen anxiety: cognitive behavior therapy and medication therapy. Both of these treatments may work on their own, but they work better together; “pills don’t teach skills.”

The Behavioral Wellness Group has “one stop shopping” for help with your child or teen. We have therapists skilled in treating kids with anxiety, prescribers for medication, and if needed, an Intensive Outpatient Program (IOP) for Adolescents. Here is the link to our practice.

WEBSITE: https://behavioralwellnessgroup.com/

ADOLESCENT MENTAL HEALTH IOP: https://behavioralwellnessgroup.com/intensive-outpatient-programs/adolescent-iop/

____________________________________________________________________________________

¹ “Ohio Child Mental Health Project: Factors contributing to child and youth mental health struggles.” Health Policy Institute of Ohio, July 2025.

²Child and Adolescent Health Measurement Initiative. (2022-2023). National Survey of Children’s Health. Data Resource Center for Child and Adolescent Health supported by the U.S. Department of Health and Human Services, Health Resources and Services Administration (HRSA), Maternal and Child Health Bureau (MCHB).

Frank R. Ezzo, Ph.D., ABPP, LLC
The Behavioral Wellness Group
8224 Mentor Ave #208 Mentor OH 44060
P: 440 392 2222 #852 F: 440 565 2349
fezzo@behavioralwellnessgroup.com
www.behavioralwellnessgroup.com

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How prevalent is depression in children and teens?

While depression was often seen as an adult problem, according to the Centers for Disease Control (CDC) based on data from 2022-2023, an estimated 4% of children between 3 and 17 years old have been diagnosed with depression (3% of males and 6% of females). If teen years are only taken into consideration, according to the National Institute of Mental Health 20.1% of the U.S. population aged 12-17 have had at least one episode of major depression. Depressive episodes were higher in females (29.2%) compared to males (11.5%).

What to watch for:

• Behavior changes that last persistently for at least two weeks
• Mood changes like sadness, feeling “sluggish,” irritability, anger
• Loss of pleasure in previously enjoyed hobbies and activities
• Insomnia or sleeping too much, chronic lack of energy
• Excessive self-criticism or statements of worthlessness: “I can’t do anything right.”
• Persistent hopeless or helpless attitude
• Suicidal thoughts or self-harm (cutting)
• Dramatic changes in grooming
• Unusually erratic or impulsive behavior
• Appetite changes: weight loss or weight gain
• Preoccupation with song lyrics, books, poetry, or art that suggest that life is meaningless
• Physical, digestive complaints

Teenage blues vs. Depression

A good rule of thumb to determine whether a teen is suffering from typical teenage moodiness or something more is to look at how their moods are affecting daily functioning in school, with friends, and family relationships. If you notice a drop in grades, increased isolation-doesn’t want to hang out with friends, spends most of his/her time in their room away from family, there is a cause for concern. A teen who is sad or moody but not really depressed will still go out with friends or participate in activities. If your child is feeling down most of the day for more than 2 weeks and is withdrawing from social relationships and activities he/she once enjoyed, depression could be to blame.

Risk factors for childhood and teen depression

• Having issues that negatively impact self-esteem, such as obesity, peer problems, long-term bullying or academic problems
• Having been the victim or witness of violence, such as physical or sexual abuse
• Having other mental health conditions such as anxiety, attention-deficit hyperactivity disorder
• Having a learning disability
• Having certain personality traits such as low self-esteem. Or being overly dependent, self-critical or pessimistic
• Being gay, lesbian, bisexual, or transgender in an unsupportive environment
• Having a parent, grandparent or other blood relative with depression, or other behavioral health or substance use problems
• Having a family member or relative who died by suicide
• Having a family with major communication and relationship problems
• Having experienced recent stressful life events, such as parental divorce, parental military service, death of a loved one, break up of a romantic relationship

Need help?

The Behavioral Wellness Group can help with evidence based individual and family therapy as well as an Intensive Outpatient Program for Adolescents:

www.behavioralwellnessgroup.com/intensive-outpatient-programs/adolescent-iop/

Our practice also has medication management for child and teen depression if needed.

Call us for an Intake Consultation at 440-392-2222 to help determine how we can best help your child/teen and family. their financial sacrifices, even if you have student loans, family are making sacrifices for your future.

Frank R. Ezzo, Ph.D., ABPP, LLC
The Behavioral Wellness Group
8224 Mentor Ave #208 Mentor OH 44060
P: 440 392 2222 #852 F: 440 565 2349
fezzo@behavioralwellnessgroup.com
www.behavioralwellnessgroup.com

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Have you ever noticed thoughts like these when you consider taking a break?

As summer begins, many of us think about everything we want – or feel like we have to accomplish. But how often do we intentionally make space for rest?

For many people, rest is not as simple as taking a break. It can feel like a betrayal of expectations, productivity, or responsibility. Slowing down may bring feelings of guilt, shame, or anxiety. We may worry about disappointing others, falling behind, being judged, or somehow failing.

Sometimes our discomfort with rest has less to do with the present moment and more to do with cognitive distortions (mental biases) we’ve learned about worth, achievement, and what it means to be “good enough.” If we’ve been taught that our value comes from what we accomplish, resting can feel uncomfortable, even when our minds and bodies need it most.

Here are four ways to begin practicing intentional rest, even when uncomfortable emotions show up:

Start small, stay consistent, and expect some discomfort.
Rest doesn’t have to mean an entire day off. Start with something manageable, like taking 5–10 minutes of intentional downtime, going for a walk, sitting outside, listening to music, reading a few pages of a book, or working on a puzzle.

Remember that if rest feels unfamiliar, discomfort is normal. Like any new skill, it takes practice.

Schedule rest like you would any other commitment.
Put time for rest in your calendar or planner and treat it as an important appointment.
Rest is not the opposite of productivity, it supports it. Regular rest supports stress regulation, improves attention and concentration, and reduces the risk of burnout. This summer, consider making rest part of your plans instead of something you may fit in only if there’s time left over.

Practice self-compassion.
Your worth is not determined by your productivity.

Notice when your inner critic says things like:
• “I should be doing more.”
• “I’m just being lazy.”
• “I haven’t earned a break.”

Instead of accepting those thoughts as facts, acknowledge them and gently challenge them. Try replacing them with a more neutral thought, such as: “rest is needed, not earned” or “taking care of myself helps me show up in a more effective way.”

We don’t have to earn rest. Rest is a basic human need, not a reward.

Give yourself permission to truly rest.
When you choose to rest, allow yourself to be present with it rather than getting ‘stuck’ feeling guilty the entire time. Utilize mindfulness practice by noticing judgments without getting caught in what it might mean.

Rest can look different for everyone. It might include reading, watching your favorite Netflix series, spending time in nature, taking a nap, practicing mindfulness, or enjoying a low-stimulation hobby. There is no “right” way to rest if it leaves you feeling more restored.

Doing less does not mean you’re lazy, it means you’re human. Intentional rest creates the space our minds and bodies need to recover, grow, and reconnect with what matters most. This summer, consider not only what you hope to accomplish, but also how you’ll care for yourself along the way.

If making space for rest feels difficult, you’re not alone. Therapy can help explore unhelpful beliefs while building healthier ways to care for yourself. To get connected with a therapist, contact The Behavioral Wellness Group at 440-392-2222. We’d be happy to help you find a provider who feels like the right fit.

Genna Weinberg, LPCC
Therapist and In-Person DBT IOP Director
8224 Mentor Ave #208
Mentor OH 44060
P: 440-392-2222 #802 F: 440-565-2349
gweinberg@behavioralwellnessgroup.com
www.behavioralwellnessgroup.com
www.campustherapy.com

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The transition to college can be streamlined by categorizing your preparation into actionable, day-to-day strategies.

📚 Academic & Study Habits

• Treat study as a full-time job: In college, you may only be in class for about 15 hours a week, but you are expected to spend roughly 35 hours studying outside of class. Treat this out-of-class time as a scheduled job. Most college students report studying about 10 to 17 hours per week. However, professors and the U.S. Department of Education expect students to dedicate roughly 2 to 3 hours outside of class for every 1 credit hour, which translates to a recommended 30 to 45 hours per week of total out-of-class study time for a full-time, 15-credit schedule.
• Actual study time varies widely depending on your major, the nature of your classes, and whether you work.
• The Academic Rule of Thumb: According to the CollegiateParent guide, you should budget 2 hours of study time for every 1 unit of a humanities or non-science course, and 3 hours for every 1 unit of a science course.
• STEM vs. Humanities: Students in Engineering, Nursing, or Physics typically study longer—often 20 to 30+ hours a week—while those in certain Humanities or Education majors can average 10 hours or fewer.
• Community Consensus: On platforms like Reddit, students acknowledge a massive discrepancy between faculty expectations and real-world study habits. Many note that heavy-reading classes or STEM lab work drastically push up their hourly totals, while other lighter seminar classes barely require any outside studying at all.
• Always attend class & sit up front: Sitting in the first three rows keeps you engaged and helps your professors learn your face and name.
• Utilize office hours: Your professors’ office hours are the ultimate “cheat code”. Going to ask questions, even if you don’t need help, is how you build relationships that lead to recommendations, research opportunities, and internships.
• Avoid all-nighters: Cramming and pulling all-nighters are highly correlated with burnout and poor academic performance. Break large research papers and projects into smaller, manageable chunks.

🕒 Time Management & Organization

• Adopt a scheduling tool: Whether you prefer a paper planner, Google Calendar, or the Notion app, map out your syllabi, deadlines, and study blocks the first week of the semester.
• Prioritize active studying: Simply re-reading notes or highlighting your textbook is largely ineffective. Test your knowledge using Quizlet flashcards, summarize chapters in your own words, or explain difficult concepts to a classmate.

💳 Financial & Life Skills

• Learn the basics before you leave: Make sure you are comfortable doing your own laundry, maintaining a bank account, and preparing a few simple meals before moving to campus.
• Find student discounts: Shopping with an active university email can save you a significant amount on subscriptions, software, and gear.
• Review legal and medical paperwork: Talk to your family about getting a Healthcare Proxy/Medical Power of Attorney, a HIPAA release form, and FERPA Waiver to ensure they can help you if an emergency arises while you are away at school.

🤝 Social & Campus Life

• Go to the activities fair: The best way to make friends and build a community is by attending your school’s student organization or activities fair during orientation week. Join a few things, then narrow your focus to 1 or 2 core groups.
• Communicate with roommates: Address living and cleaning expectations early. Set ground rules so that your dorm remains a comfortable and safe study and sleep space.
•  Friends: Make new friends by being honest, helpful, and supportive. These friendships will last a lifetime. Take romantic relationships slowly, don’t lose sight of a balance between academic responsibilities and romantic relationships. If a relationship ends, try to end it in a friendly manner. I advise not jumping from one romantic relationship to another. Your reputation is important.
• Greek life: I favor fraternities and sororities that emphasize community service and not “partying.” Don’t follow the crowd; be an independent thinker and evaluate choices carefully.
• Need more support: If extra mental health support is needed contact the college counseling center. Also, The Behavioral Wellness Group has a College Wellness Intensive Outpatient Program. https://behavioralwellnessgroup.com/intensive-outpatient-programs/college-mental-health-iop/

Family Life

As a college student you are semi-independent, sort of a transition into adulthood. Be respectful to your family and have gratitude for their financial sacrifices, even if you have student loans, family are making sacrifices for your future.

Frank R. Ezzo, Ph.D., ABPP, LLC
The Behavioral Wellness Group
8224 Mentor Ave #208 Mentor OH 44060
P: 440 392 2222 #852 F: 440 565 2349
fezzo@behavioralwellnessgroup.com
www.behavioralwellnessgroup.com

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• Skills training works very well online– With DBTs structured approach-mindfulness, interpersonal effectiveness, emotion regulation and distress tolerance skill sets- all fit naturally into a video format.
• Group participation is often stronger– Many clients feel more comfortable speaking from their homes; this can help people open up sooner.
• Fewer missed sessions– No commute, fewer barriers to attending, easier scheduling that leads to better attendance, one of the strongest predictors of success.
• Privacy- For some people logging in from home reduces the anxiety of walking into a new building and sitting in a new waiting room.
• VIRTUAL DBT IOPs ARE NOT A ‘LIGHTER’ VERSION OF THE REAL THING. THEY ARE THE SAME TREATMENT DELIVERD IN A MORE ACCESSIBLE WAY.

Virtual IOPs Are Just as Effective as In-Person Care: What BWG Research Shows:

The research compared patient outcomes from BWG’s pre-COVID, in-person DBT-based IOP (2019) with outcomes from the rapidly adapted virtual IOP provided in 2021. The programs used the same core curriculum, facilitators, and interventions—only the delivery format changed. This research was conducted by Licensed Psychologist, Dr. Barbara Ballash, who specializes in CBT and DBT.  

• Key Finding: Virtual IOPs Are Equally Effective
• Using validated screening tools for depression and anxiety, the study found no significant differences in symptom improvement between the in-person and virtual groups. In other words:
• BWG’s virtual IOP produced the same clinical gains as the traditional in-person IOP, even among individuals with serious mental illness.

How This Study Fits into the Larger Evidence Base

                  –Recent research aligns strongly with BWG’s findings   

• Telehealth IOPs show comparable outcomes to in-person programs, including similar reductions in depression, anxiety, and substance-use symptoms (Contreras-Schwartz et al., 2024; Bulkes et al., 2021).
• Attendance and completion rates are often higher for virtual IOPs, likely due to fewer logistical barriers (Waite et al., 2022)
• Virtual IOPs show equal improvements in depression, anxiety, and emotion dysregulation compared to in-person programs.
• Studies report high retention and satisfaction with telehealth DBT groups.
• Telehealth DBT is effective for individuals with complex needs, including SMI and chronic emotion dysregulation.

Bottom line:
Virtual DBT IOPs deliver the same outcomes as in-person care — with added flexibility that helps more people stay engaged and get better.

Please contact me with any questions about the virtual DBT IOP.

Cathryn E. Knezevich, M.Ed., PCC
Therapist and DBT IOP Director
The Behavioral Wellness Group
8224 Mentor Ave #208     Mentor OH  44060
P:  440 392 2222 #304    F:  440 565 2349
cknezevich@behavioralwellnessgroup.com
www.behavioralwellnessgroup.com

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Email: scerula@behavioralwellnessgroup.com
Phone: 440-392-2222 opt. 1
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Instagram: @thebehavioralwellness

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