Cara Kiff, PhD

For adults, it often shows up as overthinking. You replay the meeting on the drive home, rewrite the email 6 times, or lie awake at 2 a.m. solving problems that have not happened yet. Many of my adult clients are attorneys, physicians, and other professionals whose careful thinking built their careers, until the same habit started costing them sleep, patience, and joy. Overthinking also flares during transitions, such as a child leaving for college, a career shift, or a new chapter that looks different than planned.

For college students and young adults, it may look like perfectionism that turns every B into a crisis, panic before exams, or a low mood that friends never see. The years between home and full independence bring more decisions than any other stage, and I help young adults make them without spiraling.

For children and teens, anxiety can show up as stomachaches before school, meltdowns over homework, rituals that take over the morning, or a teen who stops going out. Parents often end up reassuring, negotiating, and rearranging family life around the fear. I work with kids and teens directly, and I also meet with parents on their own. Research shows that changing how parents respond to anxiety can reduce a child’s symptoms, even when the child never attends a session.

At every age, my approach rests on the same science. Cognitive behavioral therapy (CBT) teaches you to spot the thought loops that drive worry and test them against what happens in real life, including through exposure, which helps you, or your child, face what has been avoided in small, planned steps. Acceptance and commitment therapy (ACT) helps you step back from anxious thoughts instead of arguing with them, so you can act on what matters even when worry shows up. When emotions feel too big to manage, skills from dialectical behavior therapy (DBT) help you get through hard moments without making them worse. Together we set concrete goals, track progress, and change course when something is not working.

Before private practice, I built a research career studying how temperament, parenting, and stress shape anxiety across development, including an NIH-funded postdoctoral fellowship at UCLA’s Semel Institute. That background helps me see how the worried 8-year-old and the overthinking 45-year-old connect, and it means I choose treatments with strong evidence behind them.