A child psychologist who turns away most parents begging for help

Camilo Ortiz gets several calls a week from parents pleading with him to take their anxious child into individual therapy. He turns nearly all of them down.

This is not modesty. Ortiz is a tenured professor of clinical psychology who trains other psychologists and researches childhood anxiety. He simply doesn't believe individual, one-on-one therapy does much for most kids. "It's just a pretty easy job to play with kids in your office, so the incentives are all wrong," he says. He could fill a full caseload playing blocks with anxious five-year-olds and calling it play therapy. It wouldn't do them any good, and no one would ever be able to tell.

Ortiz's argument rests on a simple observation about how children function. Picture the best therapist in the world teaching a five-year-old a technique for managing anxiety on a Monday afternoon. Now picture that same five-year-old, dysregulated and anxious at bedtime on Friday. Is she going to recall the technique and deploy it mid-meltdown? "I can't get adults to do that," Ortiz points out. "It just doesn't work with children." What works, the evidence shows, is training the parents who spend hours a day with the child, so skills get applied in the moment they're actually needed, not once a week in an office miles from real life.

There's a second cost Ortiz worries about, one that has nothing to do with technique. Putting a child alone in a room with an adult being paid two hundred and fifty dollars an hour to fix her sends two messages whether anyone intends them or not: your mother thinks something is wrong with you, and your problem is above her pay grade. That message can quietly undercut a parent's authority in the child's eyes, regardless of how the therapy itself goes.

None of this means therapy is worthless for kids. Ortiz is a cognitive behavioral therapist himself, and he has watched exposure-based techniques transform specific, diagnosable problems: phobias, obsessive-compulsive behaviors, chronic bed-wetting. He once had a patient with a fear of germs touch the inside of a toilet bowl and then wipe his hand on a pillow to sleep on, so ordinary door handles would stop feeling dangerous by comparison. What Ortiz rejects is the premise that every anxious kid needs a standing weekly appointment. He compares it to a surgeon who says, well, he looks healthy, but let's open him up and see what we find.

If your child is anxious, look at your own reactions before you look for a therapist, since kids absorb worry from the adults closest to them long before any professional gets a turn. Practice the actual skill in the actual moment it's needed, at bedtime, at the school drop-off, at the birthday party, rather than hoping a technique taught once a week in an office will survive until it's needed. Save individual, one-on-one therapy for specific, diagnosable problems with real evidence behind them, phobias, obsessive-compulsive behavior, and similar conditions treated with proven techniques. Whenever you do hire a professional, ask directly how and when treatment will end, since a good one already has an answer waiting.