Child Therapy

When something is wrong, adults can usually put it into words. Children often cannot. Instead, they show it through meltdowns, clinginess, aggression, withdrawal, a sudden drop in grades, or a reluctance to go to school in the morning. These behaviors are not defiance or manipulation. They are communicating. And when you know how to listen, they point clearly toward a child who is struggling and needs support. 

At Old Town Psychology, we provide expert, compassionate therapy for children in Alexandria, VA, delivered by clinicians who specialize in working with kids. We have immediate openings, so your child does not have to wait months to be seen.

What Is Child Therapy?

Child therapy is a structured, evidence-based process in which a trained clinician works with a child to address emotional, behavioral, social, or developmental challenges that are getting in the way of their well-being and daily functioning. While adult therapy relies heavily on verbal reflection and insight, effective child therapy meets children where they are, using age-appropriate methods, including play-based techniques, to help younger children process their experiences, learn new skills, and build the emotional tools they need to thrive.

Child therapy is not about labeling a child or implying something is fundamentally wrong with them. It is about giving them a safe, supportive space to understand what they are feeling and to develop the coping strategies, communication skills, and behavioral patterns that will serve them for the rest of their lives. The skills children build in therapy compound over time, shaping how they handle challenges well into adolescence and adulthood.

At Old Town Psychology, parents are considered an essential part of the process. We do not simply see your child for fifty minutes and send everyone home. We keep you informed, involved, and equipped, because what happens between sessions, at home, and at school, matters enormously for your child’s progress.

What Are the Signs My Child Needs Therapy?

Children express distress differently from adults, and the signs are not always obvious. Some children become louder, acting out, throwing tantrums, or becoming aggressive. Others become quieter, withdrawing, avoiding, or clinging. Many show their struggles through changes in sleep, appetite, school performance, or social behavior. As a parent, trusting your instincts matters. If something feels off, it is worth exploring.

Consider reaching out for a consultation if your child is experiencing any of the following:

Emotional and behavioral signs

• Intense emotional outbursts, temper tantrums, or extreme crying that feel difficult to de-escalate
• Aggressive behaviors such as hitting, throwing objects, or hurting themselves
• Persistent clinginess or significant separation anxiety
• Constant reassurance-seeking that does not seem to resolve the underlying worry
• Talking frequently about death or dying, or expressing a wish not to be here

Social and academic signs

• Avoiding playdates, social activities, or peer interactions
• Difficulty making or keeping friendships
• A noticeable drop in grades or a loss of interest in school
• School refusal or school avoidance, including morning resistance, physical complaints before school, or outright refusal to attend
• Getting into trouble at school or in other settings

Physical and developmental signs

• Significant changes in eating or sleeping patterns
• Tics or repetitive behaviors that are distressing or disruptive
• Self-scratching, hitting, or other self-directed behaviors
• Difficulty focusing, sitting still, or completing tasks at home or school

Life circumstances

• A major life transition, such as divorce, a move, a new sibling, or a loss
• Exposure to bullying, whether as a target, a bystander, or a participant
• A chronic medical condition that is affecting your child’s mood, confidence, or daily life

If you answered yes to one or more of these, child therapy may be a meaningful and effective next step for your child.

Conditions Child Therapy Can Help With

Children face a wide range of challenges, and the right therapeutic approach depends on what your child is specifically experiencing. At Old Town Psychology, we treat the following conditions and concerns in children and adolescents:

• Anxiety, including generalized anxiety, social anxiety, separation anxiety, and specific phobias
• Obsessive-compulsive disorder (OCD)
• Depression and persistent low mood
• Attention-deficit/hyperactivity disorder (ADHD), including focus, impulse control, and executive function challenges
• School refusal and school avoidance, including anxiety-driven avoidance, emotionally-based school non-attendance, and reintegration support
• Focus and learning challenges, including difficulties with sustained attention, task completion, and academic performance
• Behavioral issues such as tantrums, defiance, aggression, and difficulty following rules
• Self-esteem and confidence challenges
• Perfectionism
• Body image concerns
• Social difficulties, including trouble with peers, friendship challenges, and bullying
• Family conflict and major life transitions, including divorce, relocation, loss, and blended family adjustment

As a full-lifespan, one-stop practice, we also offer comprehensive psychological assessments for children, including autism evaluations, ADHD testing, IQ testing, and learning disorder assessments, so if your child needs both a diagnosis and ongoing therapeutic support, we can provide both in one place.

What Does Child Therapy Look Like?

At Old Town Psychology, every child’s treatment plan is built around their specific needs, age, and presenting concerns. There is no single script. Effective child therapy is responsive, flexible, and grounded in what the research shows works.

Evidence-based approaches we use include:

• Cognitive Behavioral Therapy (CBT): A structured, skills-focused approach that helps children understand the connection between their thoughts, feelings, and behaviors. CBT is particularly effective for anxiety, depression, OCD, and a range of behavioral challenges.
• Exposure and Response Prevention (ERP): The gold-standard treatment for OCD and anxiety-based avoidance, ERP helps children gradually face their fears in a supported, structured way, building genuine confidence and reducing the power that feared situations hold.
• Play Therapy and Play-Based Techniques: For younger children who do not yet have the verbal capacity for traditional talk therapy, play is the language of treatment. Therapists use structured and child-directed play to help kids process emotions, practice new behaviors, and build coping skills in a way that feels natural and safe.
• Parent Management Training: Parents are not spectators in their child’s therapy. Parent management training equips caregivers with specific, evidence-based strategies for responding to their child’s behaviors, setting consistent limits, and reinforcing the skills their child is building in sessions.
• Parent Coaching and Joint Sessions: We offer dedicated parent coaching sessions for caregivers who want targeted support in navigating their child’s challenges. We also offer joint parent-child sessions to strengthen communication, work through relational dynamics, and help families navigate difficult transitions together. Because a child’s progress is only as sustainable as the environment they return to every day, supporting parents is an essential part of how we work.

Sessions are paced to your child’s comfort, and our clinicians take the time to build genuine rapport before diving into structured work, because children do their best therapeutic work when they feel safe and understood.

What Our Patients Say

"We brought our daughter in for testing and the OTP team was amazing. They were so kind, caring and great with children. My daughter is shy and takes a little time to warm up when first meeting someone new. The Doctor was patient and encouraging and my daughter had a wonderful time. They also provide fast results and meet with you to explain everything in the report. I would definitely recommend them."

"Very prompt response to our inquiry. Welcoming environment and very professional, thorough communication. The staff genuinely seems to care that your needs are met."

"Excellent service, knowledgeable staff, incredible responsiveness, diligence and follow through -- we feel lucky we found such a great therapy practice. We cannot recommend them highly enough!"

“My daughter took WISC-V test there and we are very pleased with our experience. They are professional, patient and wonderful throughout the entire process. My daughter had such a great time that she hardly felt that was a test - she even asked when she could take it again. I would highly recommend them to whoever needs child IQ testing services.”

“I took my children here for TAG testing. Both of my kids actually enjoyed their assessments. I was very pleased with the time and care taken to assess my children, the thoroughness of the report, and the fact that there was a follow-up session to discuss any questions that I had relative to the assessment included. Also-- the tea selection in the waiting room is top tier :)”

“Very prompt response to our inquiry. Welcoming environment and very professional, thorough communication. The staff genuinely seems to care that your needs are met.”

Take the Next Step

You know your child better than anyone. If something feels off, trust that instinct. Early support makes a lasting difference, and your child does not have to keep struggling while you wait for an opening. At Old Town Psychology, we maintain immediate availability for new child therapy clients. 

Old Town Psychology is a boutique psychology practice in the heart of Northern Virginia, offering expert, personalized care for children, teens, and adults across the full lifespan.

To schedule a consultation or learn more about child therapy, contact us today.