When anxious thoughts keep coming back, a teenager can start to build their day around avoiding them. Checking, reassurance seeking and avoiding certain places can feel like relief in the moment, yet they often keep the worry going. Exposure and response prevention, often shortened to ERP, is a structured approach that helps young people practice facing fears in small, planned steps. Many families now ask whether it can work over video, and for many teens it can.
What ERP looks like in practice
ERP starts with a conversation about what the teen is afraid of and what they do to feel safe again. The therapist and teen then build a ladder of situations, from mildly uncomfortable to very hard. Each step is practiced with support while the teen resists the urge to carry out the usual safety behavior. Over time, many young people learn that the discomfort rises and then eases without the ritual.
Why telehealth can fit this work
Many anxiety triggers show up at home, such as checking locks, washing, or avoiding certain rooms. During a video session the therapist can guide practice in the place where the worry actually happens. Families also avoid the travel time and waiting rooms that can make appointments harder to keep after school.
The parent partnership
Parents are part of the plan. A clinician can explain how to respond when a teen asks for reassurance, how to praise effort instead of perfect results, and how to keep routines steady between sessions. This shared approach helps the teen practice skills outside the session as well.
What to expect in the first sessions
The first visits are usually about listening, assessment and goal setting. A licensed clinician reviews symptoms, school life and family routines, then explains the treatment options. ERP is only one possible approach, and the plan depends on each young person's needs. Progress is tracked with clear goals so families can see what is changing.
Questions parents often ask
Parents often wonder whether exposure means forcing a child into frightening situations. It does not. Steps are chosen together, paced to the teen's comfort, and adjusted when something feels too big. Another common question is how long it takes. That varies from person to person, and the clinician can talk through realistic expectations after an assessment.
Helping practice stick between sessions
Small, regular practice matters more than occasional big efforts. Families can agree on a short routine, such as one planned exercise after school, and celebrate the effort rather than the outcome. If a step feels too hard, it is fine to go back and make it smaller. Sharing these notes with the clinician keeps the plan realistic.
About Mount Behavioral Health
Mount Behavioral Health has its only physical office in Brooklyn, and telehealth sessions are available to families across New York City. Medicaid is accepted, and after-school and evening appointments are offered so sessions fit around school. To learn more, visit exposure and response prevention or read about online therapy for adolescents.
When to reach out for urgent help
Online therapy is not a crisis service. If a young person is in immediate danger or thinking about self-harm, call or text 988 or call 911. Our licensed clinicians provide care for children, teens and young adults aged 9 to 21, and parents stay involved at every step.