What is Social Anxiety in Children and Teens?

Many children are shy or slow to warm up, and that’s a normal part of temperament. Social anxiety is different in its intensity, its persistence, and how much it gets in the way. A socially anxious child may avoid situations entirely, get through them with intense distress, or spend a lot of time worrying beforehand and replaying what happened afterward.

Social anxiety often first appears in childhood or early adolescence, and it can look different depending on age. Younger children may cry, cling, freeze, or have tantrums in social settings, and they often can’t explain what they’re afraid of. Some stop speaking altogether outside the home, a pattern known as selective mutism. Teens are usually more aware of their fears and may feel intensely self-conscious about how they look, sound, or come across, especially in the age of group chats and social media.

Because socially anxious kids are often quiet, well-behaved, and eager not to draw attention, their struggles are easy to overlook or mistake for shyness. Some children develop clever ways of avoiding the situations they fear, so adults may not realize how much they’re struggling. Social anxiety can also overlap with other conditions, such as generalized anxiety, depression, ADHD, autism, or learning differences, which is why a careful evaluation matters.

The good news is that social anxiety in young people responds well to treatment, and early support can keep it from narrowing a child’s world as they grow.

Signs and Symptoms

In social situations, your child may:

• Seem intensely afraid of being judged, laughed at, or embarrassed

• Worry that others will notice they’re nervous

• Freeze, go quiet, or have trouble getting words out

• Avoid eye contact or speak very softly

• Cry, cling to a parent, or have a meltdown (especially younger children)

• Blush, tremble, sweat, or feel their heart racing

• Complain of stomachaches, nausea, or headaches

Avoidance may look like:

• Not wanting to go to school, parties, sleepovers, or activities

• Refusing to raise their hand, read aloud, or present in class

• Asking a parent or sibling to speak for them, such as ordering at a restaurant

• Avoiding phone calls, eating in front of others, or using public bathrooms

• Sticking to one “safe” friend or staying on the edges of groups

• Spending most free time alone or online to avoid in-person interaction

• Quitting sports, music, or clubs they used to enjoy

Before and after social situations:

• Worrying for days or weeks before an event, test, or presentation

• Trouble sleeping the night before school or social plans

• Asking many “what if” questions or seeking reassurance

• Replaying conversations and focusing on what they “did wrong”

• Harsh self-criticism, such as “everyone thinks I’m weird”

Impact on daily life:

• Difficulty making or keeping friends

• Feeling lonely or left out, even while wanting connection

• Grades that don’t reflect their ability because of participation or attendance

• Missing out on activities, opportunities, and milestones

• Low self-esteem or a sense of being “different”

• Sadness or depression related to feeling isolated

My Approach to Treatment

I provide comprehensive, family-centered treatment for social anxiety in children and teens, helping young people feel less afraid, build confidence, and engage more fully in school, friendships, and activities.

Comprehensive Evaluation: I take time to understand the situations that trigger your child’s anxiety, how and when their symptoms developed, the ways they avoid or cope, and how anxiety is affecting home, school, and friendships. I also look carefully for co-occurring concerns such as generalized anxiety, depression, ADHD, autism, or learning differences that may be part of the picture.

Evidence-Based Therapy: Cognitive behavioral therapy (CBT) is the most well-studied treatment for social anxiety in young people. CBT-informed care helps children notice and challenge anxious thoughts, gradually face feared situations in small, manageable steps, and build social skills and confidence along the way. I often work alongside therapists who specialize in treating children and teens with this approach.

Parent Guidance: Parents play a powerful role in helping anxious kids. It’s natural to want to protect a child from distress, such as ordering for them, letting them skip the party, or answering for them when they freeze. Over time, though, these well-meaning accommodations can keep anxiety going. I’ll help you find ways to respond with warmth and confidence, supporting your child while encouraging them to take brave steps. Parent-focused approaches can be especially helpful when a child is reluctant to engage in therapy themselves.

Medication Management: When social anxiety is moderate to severe, or when therapy alone isn’t enough, medication can meaningfully reduce anxiety and make it easier for a child to engage in therapy and daily life. I’ll walk you through the options and the evidence for their use in young people, start carefully, and monitor closely.

Building Confidence and Self-Compassion: Socially anxious kids are often their own harshest critics. Treatment helps them learn that mistakes and awkward moments are a normal part of life, that they can handle discomfort, and that other people are usually far less critical than anxiety tells them.

School Coordination: Social anxiety often shows up most at school. When it affects participation, attendance, or performance, I can help you think through accommodations, such as alternatives to presenting in front of the class while skills are being built, and communicate with your child’s school when appropriate.

Contextual Care: I understand each child within the context of their family, culture, school, and community. Some social discomfort reflects temperament, neurodivergence, or real experiences like bullying or exclusion, and treatment is tailored to your child’s specific needs and your family’s goals.

What to Expect

The intake for children and adolescents is completed in three parts:

Part 1: Parent Session (60 minutes)
We’ll meet without your child to talk through your concerns, your child’s developmental, medical, and school history, and your family’s goals.

Part 2: Child Session (60 minutes)
I’ll meet with your child or teen to get to know them directly: how they see things, what feels hard, and what’s going well.

Part 3: Feedback Session (30 minutes)
About one week later, we’ll meet again to go over my impressions and talk through treatment options together.

Between sessions, I’ll review any records you share, such as report cards, prior testing, or treatment records, and, with your permission, speak with outside providers involved in your child’s care.

I know that meeting a new doctor can itself be hard for a socially anxious child. I’ll go at your child’s pace and work to make our sessions feel as comfortable as possible.

Getting Started

If social anxiety is keeping your child from friendships, activities, or feeling comfortable at school, I offer thoughtful evaluations and evidence-based treatment to help them build confidence and enjoy more of their lives. With the right support, most children and teens improve significantly.