Discovering Independence Therapy: A Novel Approach to Treating Child and Adolescent Anxiety
Discovering Independence Therapy: A Novel Approach to Treating Child and Adolescent Anxiety
By Camilo Ortiz, Ph.D., ABPP
At what age would you allow a child to walk half a mile, alone, to a pizza shop to meet friends? This is a question I start most of my talks with. Audience answers vary widely, from seven to “never!” It didn’t used to be this way. A generation ago, 6–8-year-old kids would routinely meet friends for fun and adults barely noticed. Something has changed and there are reasons to think that the results of vanishing child independence has been pretty bad for kids (and parents).
In an era where childhood anxiety rates are skyrocketing, parents and mental health professionals are desperately seeking effective solutions. We know exposure and parent accommodation-based approaches work, but they are also not easy to scale, and this problem is getting bigger by the day.
Enter Independence Therapy, a novel treatment developed by me, Dr. Camilo Ortiz, a clinical psychologist and associate professor at Long Island University and my colleague, Dr. Matthew Fastman, a postdoctoral fellow at Cognitive Behavioral Associates, a group practice on Long Island. This approach challenges traditional methods by empowering anxious kids through “mega-doses” of independence, proving that sometimes, the best therapy is simply letting children spread their wings. Featured in The New York Times and The Free Press, Independence Therapy offers hope for families struggling with anxiety disorders, showing promising results in kids 8-13 years old in pilot studies.
To understand why Independence Therapy could be an important addition to the evidence-based tools CBT clinicians already have, consider the context. Over the past few decades, childhood independence has plummeted. Kids once roamed neighborhoods freely, playing unsupervised for hours. Today, they’re often confined to structured activities, screens, or constant adult supervision. This shift, fueled by parental fears amplified by media, has coincided with a surge in anxiety diagnoses. According to experts, overprotection prevents children from developing resilience, leading to a vicious cycle where kids feel incapable and parents hover more. Traditional treatments like CBT or medication help many, but they’re time-intensive and not always accessible. Dr. Fastman and I saw an opportunity for a transdiagnostic approach—one that addresses anxiety broadly without delving into specific fears.
Independence Therapy flips the script: instead of avoiding discomfort, it encourages kids to embrace challenges independently, building confidence organically. The premise is simple yet profound: anxious children often believe the world is too dangerous or they’re too incompetent to handle it. By proving otherwise through real experiences, the therapy rewires their mindset. Unlike traditional exposure therapy, which targets specific phobias (e.g., facing dogs for a dog-fearful child), Independence Therapy is broader. It uses everyday independence as the exposure tool, making it versatile for various anxieties. We call it an exposure “Trojan Horse.” Kids are happily enjoying fun activities with friends yet are exposing themselves to what we call the “4 D’s” (discomfort, disappointment, distress and yes, even danger. Sessions involve both child and parents, focusing on planning, executing, and reflecting on activities. It’s short- term—often just a few weeks—and can be adapted for home, school, or clinical settings. LetGrow.org offers free manuals for therapists, parents, and educators, making it widely accessible.
Independence Therapy unfolds in structured phases, emphasizing collaboration between therapist, child, and parents. It’s divided into key components: Planning Independence Activities (IAs): The child brainstorms fun, challenging tasks that involve mild risk or discomfort. These must be unstructured—no adult help—and appealing to the kid. Examples include walking the dog alone, cooking a simple meal, or biking to a friend’s house. The goal is one IA per day, starting small and scaling up. Refining and Problem-Solving: After trying IAs, sessions review what worked and what didn’t. Parents learn to step back, managing their own anxieties about safety or judgment from others. Obstacles like logistics or fear are addressed collaboratively. Managing the Future: As therapy wraps up, families plan for sustained independence. This might involve school projects or home routines that embed autonomy. Addressing Parental Barriers: A crucial element is helping parents overcome hurdles like societal pressure or exaggerated fears.
The therapy’s rationale is developmental: kids naturally crave independence and denying it stunts growth. By letting go, parents signal trust, boosting the child’s self-esteem. A study published in the Journal of Anxiety Disorders supported its efficacy, with kids reporting reduced anxiety and increased confidence and parents reporting increased confidence in their kids. Independence Therapy isn’t just treatment—it’s a philosophy shift. By trusting kids with responsibility, we unlock their potential and heal their worries. In a world that overprotects, a mega-dose of freedom might be the cure we need.