Phobias in Children: Causes, Symptoms, and Treatment

It isn’t uncommon for a child to fear clowns or the dark, but these fears can develop into phobias when they become persistent. Phobias in children can quickly become disruptive to their daily lives, so it’s essential to address your child’s excessive fears before they become difficult to manage.

What are Phobias in Children?

Phobias in children are different from anxiety in children. They are excessive fears that last at least six months [*]. These fears may be rational or irrational and are typically of something specific, like a person, animal, place, object, activity, or situation.

When children encounter these phobias, they may experience crippling anxiety, even when they aren’t in immediate danger.

What Causes Phobias in Children?

Research suggests that childhood phobias can develop as a result of the following factors:

• Genetics. Children will likely develop the same phobias as their parents [*]. Parents or guardians who become severely worried or anxious around these triggers may unintentionally instill a sense of fear in their child.
• Past traumatic incidents. Certain traumatic experiences can make children averse to triggers. For example, a road accident can make a child phobic towards car rides.
• Behavioral inhibitions. Extreme shyness and withdrawal can make children afraid to interact with others and put them at risk of developing social phobias.

What are the Most Common Types of Phobias in Children?

Common childhood phobias include:

• Animals
• Enclosed spaces
• Heights
• Insects and bugs
• Getting sick
• Going to the doctor’s clinic
• Flying
• Thunder and lightning
• The dark
• Being alone

Below are the specific diagnoses for certain phobias:

• Specific phobia. These phobias are associated with a particular object, place, or situation [*]. Children may react with severe anxiety when they encounter this phobia and avoid it at all costs.
• Agoraphobia. Children with agoraphobia fear going outside—especially in open spaces [*]. They may refuse to leave home.
• Social anxiety disorder. Kids with social anxiety may fear social interactions and performances at school and struggle to engage in school plays, recitals, or speeches.
• Separation anxiety disorder. While it’s normal for children to fear being left alone by their parents or caregivers, some may develop separation anxiety and find it impossible to function without an attachment figure.
• Selective mutism. Children with social anxiety may experience selective mutism around specific groups of people [*].

What are the Symptoms of Phobias in Children?

Children with phobias may demonstrate symptoms differently from one another. However, the most common physical symptoms include the following:

• Upset stomach
• Chest pain
• Increased heart rate
• Trembling or shaking
• Sweating
• Dizziness or faintness
• Numbness
• Chills or hot flashes
• Shortness of breath or sensations of choking

Mentally and emotionally, a child with a phobia might demonstrate a fear of losing control, going crazy, or dying.

How are Phobias Diagnosed in Children?

Parents and caregivers can get a diagnosis for their child through a child psychologist or other qualified medical practitioner. The practitioner will facilitate a comprehensive psychiatric evaluation, including an interview with the parents. Parents may be asked to provide the following information:

• Known phobia triggers
• The child’s symptoms and when they started
• The child’s current lifestyle and routine
• History of traumatic events and experiences

Different phobias may adhere to various criteria.

How are Phobias Treated in Children?

A child’s treatment plan will depend on the type of phobia they have. Your child’s doctor may also consider the child’s age, the extent of their symptoms, their tolerance for specific medications, and the parent’s preference.

Psychotherapy

Psychotherapies such as cognitive behavioral therapy (CBT) can help children tackle negative thoughts and behaviors surrounding their phobia. Over time, CBT can help children cope with the anxiety they experience and help prevent panic attacks.

Cognitive restructuring is a vital part of CBT when treating phobias. Through cognitive restructuring, children can identify negative thoughts. For instance, “What if I die if I touch a spider?” The therapist can validate these fears while providing children with accurate information about the true dangers of spiders.

Other CBT-forward techniques for treating phobias include positively reinforcing children when they face their fears or practicing coping strategies in a safe environment like at home or school.

Exposure Therapy

Exposure therapy is one of the most effective ways to eliminate a phobia. However, parents and caregivers should only attempt this with the help of a trained professional. The two types of exposure therapies are:

• Systematic desensitization. This type of exposure therapy is gradual. Caregivers expose children to parts of their triggers from least to most triggering. For example, if a child is phobic of car rides, a parent might expose them to different parts of the car’s exterior before gradually taking them inside.
• Flooding. Unlike systematic desensitization, flooding entails abrupt exposure to the triggers themselves. Children may overcome their phobias quicker through flooding, though professionals recommend exercising this technique with extreme caution.

Depending on the type of exposure therapy your provider deems most suitable for your child, the process might occur in two ways:

• In vivo. Directly translating to “in real life,” in vivo means exposing someone to a phobia in person.
• Imaginal. This medium of exposure therapy involves asking the child to imagine their fear and work through their feelings. Imaginal therapy may be ideal for children who are phobic towards something that could be dangerous in person. Modern technology applies virtual reality for this type of therapy [*].

Medication

Medications like antidepressants or anti-anxiety pills can help children manage severe phobias. Practitioners typically prescribe:

• Antidepressants
• Benzodiazepines
• Monoamine oxidase inhibitors (MAOIs)

Beta-blockers also provide short-term relief by lowering blood pressure and heart rate. While rare, practitioners may also prescribe antiepileptic drugs or tricyclic antidepressants.

How Can Parents and Caregivers Help a Child Live with Phobias?

Early detection and intervention are essential for helping children manage phobias. Here are a few tips for parents and caregivers.

Have conversations

Encourage your child to stay vocal about their phobias. Young children may know what they’re afraid of but struggle to explain the reasons behind their fear. For example, if your child is scared of dogs, you might ask them, “What type of dog scares you?” or “What about dogs do you find scary?”

Offer comfort and validation, but move on quickly to not intensify the fear. Discuss how you can work together so your child can overcome their fear and set reasonable goals.

Make healthy lifestyle changes

You don’t want your child to hyperfocus on their phobia—so what can you do? Healthy lifestyle changes can help children manage stress and keep their spirits up. Encourage activities like sports, creative outlets, or volunteering.

Help your child get into a predictable routine for stability and introduce a nutritious, balanced diet.

Stay updated with your child’s counselor

Schedule regular discussions with your child’s healthcare provider to track their progress. They can provide additional advice, whereas you can give context for your child’s improvement. Being involved with your child’s school can help them with separation anxiety.

Get involved with others

Tell your friends and family about your child’s phobia to encourage them to stay mindful. Work directly with your child’s healthcare provider to give your child’s school the appropriate information. Consider reaching out to community groups or enrolling your child in group therapy.

The Bottom Line

Managing a phobia takes a lot of time and effort, so be patient with your child. Stay involved with their school counselors and healthcare providers to provide the best care possible.

Explore our anxiety worksheets to supplement your child’s journey toward overcoming their phobias.

Sources:

1. Wardenaar KJ, Lim W, Al-Hamzawi AO, et al. “The cross-national epidemiology of specific phobia in the World Mental Health Surveys.” Psychological Medicine, 2017.
2. Loken EK, Hettema JM, Aggen SH, Kendler KS. “The structure of genetic and environmental risk factors for fears and phobias.” Psychological Medicine, 2013.
3. LeBeau RT, Glenn D, Liao B, et al. “Specific phobia: a review of DSM-IV specific phobia and preliminary recommendations for DSM-V.” Depression and Anxiety, 2010.
4. Gittelman R, Klein DF. “Childhood Separation Anxiety and Adult Agoraphobia.” Routledge eBooks, 2019.
5. Muris P. “Current Challenges in the Diagnosis and Management of Selective Mutism in Children.” Psychology Research and Behavior Management, 2021.
6. Freitas JRS, Velosa VHS, Abreu LTN, et al. “Virtual Reality Exposure Treatment in Phobias: a Systematic Review.” Psychiatric Quarterly, 2021.