OCD Can Affect Much More Than Worries or Rituals
Who I Work With
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Ages 5–25
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Children • Teens • Young Adults
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Treatment Approach
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Cognitive Behavioral Therapy (CBT), Exposure Therapy, SPACE (Supportive Parenting for Anxious Childhood Emotions) when appropriate, parent coaching, and school collaboration.​
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Parent Involvement
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Parent involvement is tailored to each family's needs. Younger children often benefit from active parent participation, while teens and young adults are typically seen individually. Regardless of your child's age, I'll help you know how to support progress between sessions.
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​Therapy Options
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​In-Person
Philadelphia's Main Line & Surrounding Suburbs
In-home sessions
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Secure Online Sessions
Pennsylvania & PSYPACT Participating States
(check if your state participates in PSYPACT here)
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Complimentary Phone Consultation
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20-minute phone call
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Speak directly with Dr. Fiona Macphee
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Discuss your concerns and determine whether my approach is the right fit
On This Page
Anxiety Is a Normal Emotion That Sometimes Becomes Overprotective
Anxiety is a normal and important emotion. It's part of our brain's natural alarm system, helping us recognize danger and respond when something is truly unsafe.
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Sometimes, though, that alarm system becomes overprotective. It begins treating everyday situations—like going to school, sleeping alone, speaking in class, making friends, trying something new, or separating from parents—as if they're dangerous, even when they aren't.
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Children naturally do what brings immediate relief from anxiety. They may avoid situations that make them anxious, ask for repeated reassurance, stay close to parents, or rely on routines or other "safe" behaviors that help them feel less anxious.
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Although these strategies reduce anxiety in the moment, they also teach the brain that those situations are dangerous. Over time, anxiety grows stronger and begins interfering with school, friendships, family life, and independence.
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The good news is that anxiety is highly treatable. With the right support, children can learn that they are capable of handling anxiety—and that it doesn't have to make their decisions for them.
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Confidence grows by gradually facing fears—not by avoiding them.
Licensed Clinical Psychologist
New York University • Child Mind Institute • University of Pittsburgh Medical Center • Florida International University • University of Washington • Seattle Children's Hospital
PSYPACT Authorized
Meet Dr. Fiona Macphee
For more than a decade, I've helped children, adolescents, and young adults overcome anxiety disorders across outpatient clinics, intensive outpatient programs, partial hospitalization programs, and community-based settings.
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My training includes New York University, the Child Mind Institute, Florida International University, and UPMC, where I received advanced training in evidence-based treatments for childhood anxiety, OCD, and related disorders. Throughout my career, I've worked with children and families experiencing generalized anxiety, social anxiety, separation anxiety, selective mutism, panic attacks, school avoidance, OCD, and specific phobias.
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When anxiety begins affecting family life, I also work closely with parents to help them respond in ways that build confidence rather than unintentionally strengthen anxiety. When appropriate, I incorporate principles from SPACE (Supportive Parenting for Anxious Childhood Emotions), an evidence-based parent-focused approach that helps caregivers reduce accommodations while maintaining a warm, supportive relationship with their child.
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One of the most rewarding parts of my work is watching children discover they are far more capable than anxiety has led them to believe. Whether we're working toward returning to school, sleeping independently, participating in social activities, or overcoming long-standing fears, my goal is to help children build confidence that lasts long after therapy has ended.
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✓ 10+ Years Treating Childhood Anxiety
✓ CBT, Exposure Therapy & ERP
✓ SPACE-Informed Parent Coaching
✓ School Collaboration & 504/IEP Support
✓ In-Home, Community-Based & Telehealth Care
Anxiety Can Show Up in Many
Different Ways
Anxiety doesn't always look like constant worrying. Depending on the child, it may show up as avoidance, perfectionism, irritability, emotional outbursts, panic attacks, physical complaints, or refusing situations that feel overwhelming.
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Some children become quiet and withdrawn.
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Others become frustrated, argumentative, or emotionally reactive.
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Many look confident on the outside while quietly struggling on the inside.
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Common signs include:
✓ Excessive worry or reassurance seeking
✓ Refusing or avoiding school
✓ Difficulty separating from parents
✓ Panic attacks or intense physical symptoms
✓ Difficulty sleeping alone
✓ Avoiding social situations or speaking in class
✓ Perfectionism and fear of making mistakes
✓ Avoiding new experiences
✓ Irritability or emotional outbursts
✓ Frequent stomachaches, headaches, or other physical complaints
✓ Avoiding activities they once enjoyed
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Over time, anxiety can interfere with school, friendships, extracurricular activities, family relationships, and growing independence.
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These experiences may be related to generalized anxiety, social anxiety, separation anxiety, selective mutism, panic disorder, specific phobias, OCD, or other anxiety-related conditions.
How Anxiety Treatment Works
One of the most effective treatments for childhood anxiety is Exposure Therapy, a specialized form of Cognitive Behavioral Therapy (CBT).
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Rather than trying to eliminate anxiety, treatment helps children gradually face the situations anxiety has been telling them to avoid. As they do, they discover that anxiety naturally decreases over time and that they are capable of handling much more than anxiety led them to believe.
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Every treatment plan is individualized based on your child's age, developmental stage, symptoms, and goals. While every child is different, treatment often includes several key components.
Understanding the Anxiety Cycle
Situation feels scary
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Child avoids the situation, seeks reassurance, or relies on "safe" behaviors
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Anxiety decreases for a little while
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The brain learns, "Avoiding kept me safe."
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Anxiety grows stronger
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Treatment helps children gradually face fears instead.
What Therapy Looks Like
Understanding Anxiety
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One of the first steps in treatment is understanding how anxiety works.
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Together, we'll identify the situations that trigger anxiety and the patterns—such as avoidance, reassurance seeking, and other "safe" behaviors—that keep it going. Understanding these patterns helps children and parents begin breaking the anxiety cycle.
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Gradually Facing Fears
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Children build confidence by gradually facing the situations anxiety has been telling them to avoid.
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Using Exposure Therapy and other cognitive behavioral strategies, we'll create individualized practice exercises that help your child take manageable steps toward feared situations. Every step is collaborative, carefully planned, and tailored to your child's readiness.
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Parent Coaching & Family Support
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Parents often play an important role in helping children overcome anxiety.
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When appropriate, parent sessions focus on responding to anxiety in ways that build confidence, reducing accommodations that unintentionally keep anxiety going, and supporting your child's progress between sessions. I also incorporate principles from SPACE (Supportive Parenting for Anxious Childhood Emotions) when appropriate.
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Real-World Exposure Practice
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Some of the most meaningful progress happens outside the therapy office.
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When appropriate, we may practice skills in schools, stores, restaurants, parks, or other community settings throughout Philadelphia's Main Line and surrounding suburbs. This helps children build confidence where anxiety actually occurs.
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School Collaboration
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When anxiety interferes with school, collaboration can be an important part of treatment.
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When appropriate, I work with teachers and school staff through consultations, parent-teacher meetings, and 504 or IEP meetings to help children practice new skills consistently across environments.
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The Goal of Treatment
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The goal is to help children feel confident enough to face challenges without anxiety making their decisions for them. As confidence grows, children can return to school, friendships, activities, and other parts of everyday life that anxiety may have been getting in the way of.
Extended & Intensive Support
Some children benefit from additional support when anxiety has become significantly disruptive to daily life.
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Depending on your child's needs, treatment may include extended therapy sessions, in-home or community-based exposure sessions, school observations, meetings with educators, or coordinated care with other professionals. These services allow us to spend more time practicing skills in the environments where anxiety is actually occurring.
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When appropriate, I also offer intensive treatment options designed to help children make meaningful progress over a shorter period of time.
Frequently Asked Questions
Do I need an anxiety diagnosis before contacting you?
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Not at all.
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Some families contact me after receiving a diagnosis, while others simply notice that anxiety seems to be interfering with their child's daily life.
Every new therapy client begins with a comprehensive diagnostic interview. If questions remain after that interview, I may recommend a more formal psychological evaluation to better clarify the diagnosis and guide treatment recommendations.
Will parents be involved in treatment?
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Parent involvement depends on your child's age, developmental stage, and treatment goals.
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Younger children often benefit from greater parent involvement, while therapy for teens and young adults is usually conducted primarily with the client. Regardless of your child's age, I'm available to help parents understand anxiety and support progress between sessions.
Do you use the SPACE approach?
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Yes—when appropriate.
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SPACE (Supportive Parenting for Anxious Childhood Emotions) is an evidence-based parent-focused approach that helps caregivers reduce accommodations that unintentionally keep anxiety going while maintaining a warm, supportive relationship with their child.
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I often incorporate SPACE principles alongside Cognitive Behavioral Therapy and Exposure Therapy when they fit a family's goals and needs.
Do you work with schools?
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Yes.
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When appropriate, I collaborate with teachers, school counselors, and other members of your child's educational team. This may include consultations, parent-teacher meetings, classroom recommendations, and participation in 504 Plan or IEP meetings.
Where do you provide therapy?
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In Person
In-home and community-based therapy throughout Philadelphia's Main Line and surrounding suburbs.
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Telehealth
Secure online throughout Pennsylvania and PSYPACT participating states where I am authorized to practice.
Do you accept insurance?
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I am an out-of-network provider.
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Many families are able to receive partial reimbursement through their out-of-network benefits. I'll provide the documentation needed for you to submit claims, and my office is happy to answer questions about the reimbursement process.
What happens during the complimentary phone consultation?
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During our 20-minute phone call, we'll discuss the concerns that brought you here, answer your initial questions, and determine whether my practice is the right fit for your family.
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If it seems like a good match, we'll talk about the next steps for scheduling an intake evaluation.
Ready to Take the Next Step?
A complimentary consultation is an opportunity to tell me what's been going on, ask questions, and determine whether my approach is the right fit for your child.
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We'll briefly discuss your concerns and what treatment might look like, so you have a clearer sense of the next step.
Looking for help with ADHD, OCD, emotional outbursts, or executive functioning? Explore my other specialty areas.
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