GET HELP

Fear of Being Judged in Teens: Support Strategies Available

Meagan Burkhart
November 24, 2025
Authored by: Meagan Burkhart,
Edited by: Emma Loker, BSc, PgDip
CALL (866) 901-4047
INSURANCE VERIFICATION

We all worry about being judged from time to time. Perhaps we’re stressed about giving a presentation in front of a class, or we have a date and are worried about how we’ll come across. It’s natural to feel concerned about what others will think in scenarios like these. 

However, if a teen has a persistent fear of judgment that interferes with their everyday life, this could be a sign of an underlying anxiety disorder. 

Social stress increases during adolescence as peer relationships become more important, so the fear of being judged is, in some ways, expected. The difference between problematic – or pathological – worrying and normal worrying is how a teen reacts.1,2 

If your child turns to safety-seeking behaviors or avoidance in response to worry, it may be time to investigate mental health treatment for teens. A mental health professional can provide support and guidance in this process. 

This page can help you understand the ins and outs of the obsessive thoughts teens can experience, including those around being judged, and when these may indicate an anxiety disorder. It explores:

  • Worrying and intrusive thoughts in adolescents
  • Obsessive thoughts in teens
  • Perfectionism and anxiety in teens
  • Cognitive distortions in youth
  • Mental health treatment for teens
  • Where to find professional support
Teenage boy sat on steps in school looking down at the floor due to fear of being judged

Worrying and Intrusive Thoughts in Adolescents

Excessive worrying in childhood and adolescence is relatively common. It’s often tied to poor academic performance, missing school, trouble concentrating, withdrawing from social situations, and sleep problems. Aside from these issues, teens may also face additional stressors such as concerns about their social status. 

Because the brain is still developing during adolescence, teens are particularly susceptible to developing excessive worries. Additionally, the combination of genetics, temperament, cognitions, emotion, and parental risk factors could lead to pathological worry and anxiety in teens.2

Worrying can present itself differently from teenager to teenager. In fact, even a teen’s sex can influence how it manifests. For example, females are more likely to worry about social situations and being judged, whereas males tend to worry more about physical situations. Focusing on females, we can see that excessive fears of being negatively judged by others are tied to having unreasonably high expectations and cognitive distortions. 

When teens continue to focus on these intrusive thoughts and they impact their behaviors, it is a sign of rumination. Rumination can involve going over and over past social situations in our minds and only recalling the negative information, which can lead to feelings of inadequacy and trigger social anxiety. This can cause someone to keep thinking about perceived judgments, creating a cycle of embarrassment, fear, and intrusive thoughts in adolescents.2,3 

If you notice that your child is falling into this negative cycle, it could be a sign of obsessive thinking, which we will cover in the next section.

Obsessive Thoughts in Teens

Repetitive, intrusive thoughts can become problematic when they also come with dysfunctional beliefs about the importance, meaning, and power of the thoughts. Basically, when the thoughts get to the point that they are overpowering your child mentally, it could be a sign of obsessive-compulsive disorder (OCD).4,5 

When we talk about obsessive thoughts becoming dysfunctional, we are referring to maladaptive metacognition, or thoughts about the thoughts. For example, believing that continuing to ruminate will help them avoid problems or cope with their worries. Alternatively, they may think their thoughts are dangerous, feel like they need to control them, or  feel self-conscious about having them. These are all indicators of maladaptive metacognition.4,5

In addition to intrusive, obsessive thoughts, a core symptom of OCD in teens is the presence of compulsions. Compulsions are repetitive behaviors that someone performs to decrease distress from intrusive thoughts. In some cases, the compulsive behaviors are time-consuming, so they end up interfering with an adolescent’s daily life.5,6 

In terms of the content of some of these obsessive thoughts, it can differ depending on the person’s age and traits. Compared to adults, adolescents report higher rates of harm-related and religious obsessions. Plus, adolescents with OCD often meet the diagnostic criteria for other psychiatric disorders. These include generalized anxiety disorder (GAD), major depressive disorder (MDD), attention-deficit/hyperactivity disorder (ADHD), oppositional defiant disorder (ODD), and conduct disorder (CD).5

Knowing how intrusive, obsessive thoughts are related to other mental health disorders in teens is important for getting your child the appropriate treatment.

Perfectionism and Anxiety in Teens

Clinical perfectionism is when teens base their self-esteem on achieving exceptionally high standards, even though this has negative effects on their physical or mental health. Perfectionism is known to contribute to the maintenance of mental health disorders like OCD, depression, and anxiety. Therefore, understanding perfectionist anxiety in teens is important for early intervention.6

Studies have looked at different dimensions of perfectionism to better understand how it is displayed in adolescents. The following six dimensions were identified:7

  1. High personal standards
  2. Worry about mistakes and interpreting errors as failure
  3. Doubt about their own actions
  4. Perceived high expectations from parents
  5. Excessive criticism from parents
  6. Preferring organization and cleanliness in most situations

Further, adolescents with perfectionistic tendencies who also have issues with excessive worrying and rumination are at a greater risk of developing mental health problems than those who don’t.7

If your child is expressing constant worry over making mistakes and needing to achieve high standards, this could be a sign of a larger mental health problem. Additionally, anxiety and perfectionism are linked to distorted patterns of thinking, which can be targeted through mental health interventions.

Cognitive Distortions in Youth

Cognitive distortions in youth are faulty patterns of thinking. For example, different types of cognitive distortions include catastrophizing, overgeneralizing, personalizing, and selective abstraction. All of these thinking patterns are maladaptive, meaning that they can result in negative outcomes for the adolescent. 

Cognitive distortions are closely tied to anxiety symptoms in teens. Therefore, teens often default to cognitive distortions in social situations to deal with stress. Plus, in the long term, cognitive distortions are predictive of increased stress.8

One theory related to cognitive distortions in youth is that using these negative thought patterns in social situations reinforces poor interpersonal style, increases conflict, and leads to self-fulfilling negative expectations. Due to this impact, cognitive distortions in social situations are closely tied to social anxiety disorder and fear of being judged as a teenager. 

Additionally, because cognitive distortions are negatively biased and inaccurate, they can end up affecting a teen’s social skills, which may then cause increased conflict and stress.8 

Mental Health Treatment for Teens

Anxiety, obsessive thoughts, and cognitive distortions can negatively affect a teen’s mental and physical health in the long term – especially if these issues remain untreated. Fortunately, there is a variety of different treatment approaches that are commonly used to alleviate these issues. 

Some of the evidence-based mental health treatment options for teens include: 

Cognitive Behavioral Therapy (CBT)

One of the main forms of mental health treatment that addresses a variety of disorders is cognitive behavioral therapy (CBT). CBT is effective in treating anxiety disorders such as generalized anxiety disorder, social anxiety disorder, and obsessive-compulsive disorder, as well as mood disorders like depression. 

This form of treatment is present-focused, short-term, and active, meaning it requires adolescents to practice skills at home and participate in therapy sessions. CBT also includes several different interventions, like psychoeducation for parents and teachers, youth anxiety coping skills, and exposure.9 

Teaching coping skills like relaxation, positive affirmations, and problem-solving can contribute to confidence-building in teens, as these skills can be applied to different aspects of their lives.9 

Mindfulness-Based Psychotherapy

Another avenue to explore for treating your child’s anxiety and worry is mindfulness-based psychotherapy. Mindfulness can be defined as focusing on and accepting emotions, thoughts, and sensations in the present moment without judgment.10

Two specific types of psychotherapy that involve mindfulness are mindfulness-based stress reduction (MBSR) and mindfulness based cognitive therapy (MBCT). Both methods have been shown to be effective in treating GAD, social anxiety, and panic disorder in adolescents. Some of the mindfulness practices that are used include meditation-based relaxation.10 

Psychodynamic Psychotherapy

A third therapeutic modality used for children and adolescents with depression, social anxiety disorder, obsessive-compulsive disorder, and generalized anxiety is psychodynamic psychotherapy. Psychodynamic therapy is a long-term treatment option that helps adolescents delve into their unconscious mind. This involves going back to past emotions, conflicts, and distressing situations that impact their current behavior.10,11 

Some aspects of psychodynamic therapy that are particularly important for treating the obsessive thoughts teens experience include:11

  • Focusing on affect and expression of emotion
  • Recognizing attempts at avoiding distressing thoughts and feelings
  • Identifying patterns and themes that recur throughout the adolescent’s life
  • Discussing the past
  • Focusing on interpersonal relationships
  • Building the therapeutic relationship

In support of this approach, studies have found that the severity of mental health symptoms decreased after adolescents completed a full course of psychodynamic therapy.11

Overall, there are a variety of therapeutic interventions that can help with fear of being judged, excessive worrying, and obsessive thoughts in teens. Finding the right program for your child requires looking at their style of learning, emotional involvement, and communication skills, among other factors.

Teenage girl walking in park with friends smiling after support for fear of being judged

MissionPrep: Compassionate Teen Programs for Anxiety and Worry

If you feel that your child is dealing with one or more of the issues discussed on this page, it may be time to look into teen behavioral health treatment programs. At Mission Prep, we have a variety of treatment options to fit your child’s needs. 

From outpatient CBT to intensive outpatient programs (IOP) and residential mental health facilities, Mission Prep is equipped to handle all levels of severity. If you’ve been searching for “therapy for anxious teens near me”, we can help. Contact us today to speak to one of our trained practitioners. Our team is available 24/7 to offer you advice and recommendations for effective mental health treatment for your child.

References

  1. Shipp, L., Leigh, E., Laverton, A., Percy, R., & Waite, P. (2025). Cognitive Aspects of Generalised Anxiety Disorder in Adolescents: Exploring Intolerance of Uncertainty, Cognitive Avoidance, and Positive Beliefs About Worry. Child Psychiatry & Human Development, 1-14. https://doi.org/10.1007/s10578-025-01809-3 
  2. Songco, A., Hudson, J. L., & Fox, E. (2020). A cognitive model of pathological worry in children and adolescents: A systematic review. Clinical Child and Family Psychology Review, 23(2), 229-249. https://doi.org/10.1007/s10567-020-00311-7 
  3. Tsarpalis-Fragkoulidis, A., Tran, U. S., & Zemp, M. (2024). Fears of positive and negative evaluation and their within-person associations with emotion regulation in adolescence: a longitudinal analysis. Development and Psychopathology, 1-13. https://doi.org/10.1017/S0954579424001366 
  4. Isaksen, C. S., Hybel, K. A., Wolters, L., Højgaard, D. R., Farrell, L., & Thomsen, P. H. (2025). Metacognition in Children and Adolescents With Obsessive-Compulsive Disorder Treated With Cognitive Behavioral Therapy. Behavior Therapy, 56(1), 95-109. https://doi.org/10.1016/j.beth.2024.04.011 
  5. Stiede, J. T., Spencer, S. D., Onyeka, O., Mangen, K. H., Church, M. J., Goodman, W. K., & Storch, E. A. (2024). Obsessive–Compulsive Disorder in Children and Adolescents. Annual review of clinical psychology, 20. https://doi.org/10.1146/annurev-clinpsy-080822-043910
  6. Lunn, J., Greene, D., Callaghan, T., & Egan, S. J. (2023). Associations between perfectionism and symptoms of anxiety, obsessive-compulsive disorder and depression in young people: a meta-analysis. Cognitive Behaviour Therapy, 52(5), 460-487. DOI: https://doi.org/10.1080/16506073.2023.2211736   
  7. Gil, T. C., Obando, D., Garcia-Martin, M. B., & Sandoval-Reyes, J. (2023). Perfectionism, academic stress, rumination and worry: A predictive model for anxiety and depressive symptoms in university students from Colombia. Emerging Adulthood, 11(5), 1091-1105. https://doi.org/10.1177/21676968231188759 
  8. Harrison, T. J., Ginsburg, G. S., Smith, I. C., & Orlando, C. M. (2023). Youth stress generation: an examination of the role of anxiety, anxiety symptoms and cognitive distortions. Anxiety, Stress, & Coping, 36(3), 304-319. https://doi.org/10.1080/10615806.2022.2076083 
  9. Kendall, P. C., & Peterman, J. S. (2015). CBT for adolescents with anxiety: mature yet still developing. American Journal of Psychiatry, 172(6), 519-530. https://doi.org/10.1176/appi.ajp.2015.14081061 
  10. Wehry, A. M., Beesdo-Baum, K., Hennelly, M. M., Connolly, S. D., & Strawn, J. R. (2015). Assessment and treatment of anxiety disorders in children and adolescents. Current psychiatry reports, 17(7), 52. https://doi.org/10.1007/s11920-015-0591-z 
  11. Midgley, N., O’Keeffe, S., French, L., & Kennedy, E. (2017). Psychodynamic psychotherapy for children and adolescents: an updated narrative review of the evidence base. Journal of Child Psychotherapy, 43(3), 307-329. https://doi.org/10.1080/0075417X.2017.1323945 

Related Articles

Is Olanzapine (Zyprexa) Safe for Teens?

Olanzapine: Is Zyprexa Safe for Teens?

The Definitive Guide to Chlorpromazine (Thorazine) for Teens

The Definitive Guide to Chlorpromazine (Thorazine) for Teens

Understanding Quetiapine (Seroquel)

Seroquel: Quetiapine for Teens

Second-Generation Antipsychotics for Teens

Second-Generation Antipsychotics for Teens

Risperidone for Teen Mental Health

Risperidone for Teen Mental Health

Lurasidone for Treating Teen Mental Health (And Side Effects to Look Out For)

Lurasidone for Treating Teen Mental Health