By Camilo Ortiz, PhD, 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 did not used to be this way. A generation ago, 6- to 8-year-old kids would routinely meet friends for fun and adults barely noticed. Something has changed, and there are reasons to think the results of vanishing child independence have been bad for kids and parents.
In an era where childhood anxiety rates are rising, parents and mental health professionals are seeking effective solutions. We know exposure and parent accommodation-based approaches work, but they are 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. This approach challenges traditional methods by empowering anxious kids through large doses of independence, proving that sometimes the best therapy is 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 ages 8-13 in pilot studies.
Why independence matters
Over the past few decades, childhood independence has plummeted. Kids once roamed neighborhoods freely, playing unsupervised for hours. Today, they are 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.
Overprotection can prevent children from developing resilience, leading to a cycle where kids feel incapable and parents hover more. Traditional treatments like CBT or medication help many, but they are time-intensive and not always accessible. Dr. Fastman and I saw an opportunity for a transdiagnostic approach that addresses anxiety broadly without delving into specific fears.
How Independence Therapy works
Independence Therapy flips the script. Instead of avoiding discomfort, it encourages kids to embrace challenges independently, building confidence organically.
The premise is simple: anxious children often believe the world is too dangerous or that they are too incompetent to handle it. By proving otherwise through real experiences, the therapy rewires their mindset.
Unlike traditional exposure therapy, which targets specific phobias, 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 while exposing themselves to discomfort, disappointment, distress, and even some danger.
Sessions involve both children and parents, focusing on planning, executing, and reflecting on activities. It is 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 the approach widely accessible.
The phases of treatment
Independence Therapy unfolds in structured phases, emphasizing collaboration between therapist, child, and parents.
Planning independence activities: The child brainstorms fun, challenging tasks that involve mild risk or discomfort. These must be unstructured, involve no adult help, and be appealing to the child. Examples include walking the dog alone, cooking a simple meal, or biking to a friend’s house. The goal is one independence activity per day, starting small and scaling up.
Refining and problem-solving: After trying activities, sessions review what worked and what did not. Parents learn to step back and manage 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 is not just treatment. It is 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.
Learn more at cbtreatment.com/independence-therapy.