Barb Shepard, LMHC

07/15/2025

Pediatric Acute-onset Neuropsychiatric Syndrome (PANS)—and its subset, Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections (PANDAS)—are clinical diagnoses estimated to affect about 1 in 200 children.

These conditions cause the sudden onset of obsessive-compulsive disorder (OCD) along with symptoms such as food restrictions, tics, aggression, and behavioral regression. They profoundly impact not only the child’s development—but the well-being of the entire family.

Thanks to emerging research and advocacy, awareness of PANS/PANDAS is growing, helping families access needed support. Leading centers like Massachusetts General Hospital and Stanford Children’s Health now offer dedicated PANS programs.

In February 2025, the American Academy of Pediatrics released a clinical report officially recognizing PANS as a legitimate diagnosis—a major milestone for families navigating this complex and often misunderstood condition.

I’ve recently updated my website to include an overview of PANDAS/PANS and therapeutic treatment approaches to support affected children and families.

https://barbshepardcounseling.com/pandas-pans/

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One morning, you woke up to a child you didn’t recognize. The confident, happy and curious child you once knew changed almost overnight into someone you barely recognized. Suddenly, they became ter…

06/08/2025

If you’ve been doing exposure work for anxiety or OCD but still feel stuck, you’re not alone. A key piece that’s often overlooked is response prevention—resisting the compulsions or safety behaviors that follow anxiety. Without it, even the best exposures can keep the cycle going. Response prevention is where real, lasting change begins. Read the full post to learn why response prevention might be the missing link in your treatment.

We often hear about the importance of facing our fears—whether in everyday life or in anxiety and OCD treatment. And for good reason: being able to tolerate discomfort, step outside of our comfort …

05/24/2025

PANDAS and PANS: What Parents, Clinicians, and Educators Need to Know

OCD that appears suddenly and intensely in children can sometimes have an underlying medical cause linked to the immune system. In this blog post, I explore PANDAS and PANS—conditions where infections trigger an immune response that affects the brain and behavior. With ongoing research and debate, it’s important for parents, clinicians, and educators to recognize the signs and understand the treatment complexities. This post offers clear information and support for those impacted by these challenging disorders.

Did you know that abrupt onset of obsessive-compulsive disorder (OCD) or tics in children can have medical causes? Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infe…

02/06/2025

Parenting children who don’t fit society’s cookie-cutter mold carries a heavy mental, emotional, and spiritual load. Managing the challenges that come with OCD, anxiety, or raising highly sensitive kids can take a huge toll on a family.

Many parents I work with talk about how hard it is to explain to others the constant strain they feel on their nervous system—being in fight-or-flight mode while trying to meet their child's high needs.

The isolation that comes with this type of parenting—the patience, the love, the advocacy required of you, on top of life’s other demands—can sometimes feel even heavier than the challenges of the diagnosis itself.

But there is so much strength in what you’re doing. Even on the hardest days, when you feel like you’re not getting it right—you are. It all matters.

Read more on today's blog, "Evidence of Trying: A Love Note to Parents of Neurodivergent Kids"

I hope that when you look around your house today,you find evidence of trying. The soccer jersey, worn only once,because the gameplay was overstimulating. The jeans with tags still on,while the wel…

01/30/2025

Ever wonder why OCD treatment sometimes feels like playing whack-a-mole with symptoms? The key to real progress isn’t just tackling surface-level fears—it’s identifying the deep, core fears driving compulsions. Whether it’s fear of harm, being alone, or feeling bad forever, getting to the root of the anxiety makes exposure therapy exponentially more effective. Check out my latest blog to learn why core fears are a game-changer in OCD treatment:

When addressing obsessive-compulsive disorder (OCD), one key concept often discussed by experts is core fears. But what exactly are these core fears, and why are they so crucial in the treatment pr…

01/16/2025

Wondering if your efforts in managing anxiety or OCD are paying off? This guide breaks down what real progress looks like in anxiety and OCD treatment and how to recognize it.

If you’ve ever questioned whether your work in managing anxiety or OCD is making a difference, this guide will help you recognize what true progress looks like. First Things First: You’re Not Aimin…

01/12/2025

Great article by This is CNY! Always grateful to be part of the conversation about the evolution of the sober curious movement and the impact of alcohol on mental health. Check it out for guidance on finding NA options in CNY for Dry January!

Whether you’re sober curious or just trying to reset for the new year, CNY bars have plenty of NA options to choose from year-round.

01/09/2025

A common question I often receive from parents of anxious children is: “What should I do if my child refuses to participate in therapy?”

An essential part of the therapeutic process for treating children with anxiety is assessing their readiness to engage. Willing participation is crucial, as forcing the issue may backfire and hinder progress.

In the meantime, there are constructive steps parents can take until their child shows more readiness for therapy. These strategies are outlined in SPACE, which stands for Supportive Parenting for Anxious Childhood Emotions. This evidence-based therapy model was developed by Dr. Eli Leibowitz at the Yale Child Study Center.

In today’s blog, I’ll highlight key concepts from the SPACE program and explore how to support your child’s anxiety when they aren’t yet ready to make changes themselves.

As a parent, it can be an incredibly helpless experience to watch your child struggle with anxiety – especially when they don’t seem motivated to work on it. There are many reasons why …

11/10/2024

On cloud nine after completing a three-day intensive training in Pediatric OCD, hosted by the International OCD Foundation's Behavior Therapy Training Institute (BTTI).

This past weekend was so much more than just a training—it was a full-circle moment for a little girl who once struggled with anxiety and OCD.

It was a validation of why clients should want an OCD therapist on their side in life. This group of professionals possesses grit, enthusiasm, and tenacity like no other.

Of all the incredibly useful aspects of Exposure and Response Prevention (ERP) Therapy, perhaps the most important foundational concept is that life will throw us curveballs we never expected—and yet, it’s our job to take those challenges in stride and keep going.

ERP teaches you how to get back up after being knocked down, to constantly prioritize the next brave action step, and to live with arms wide open so you can receive all the good things life has to offer—even when tough moments happen.

I truly believe that those who have weathered life's storms are the ones who eventually see the brightest skies. For those who overcome OCD, the skies are even bluer. It's a silver lining you never expected, but one that’s undeniably yours.

My own journey with OCD has led me exactly to this moment—feeling supremely grateful for this time spent with an amazing community of OCD educators and clinicians.

I can’t wait to bring these tools back to Syracuse and do what I love most: helping others overcome their biggest fears and get their lives back.

10/14/2024

“Why Bother with Mocktails?“

This is a reasonable question, often asked with good intentions! In a world where alcohol is deeply ingrained in all aspects of our social lives, it’s understandable why some might be confused when alcohol-free folks choose to drink a mocktail or non-alcoholic (NA) beverage.

The fact that this question is so common tells us a lot about cultural conditioning—beliefs so ingrained in our society that we don’t even think to question them.

Alcohol has historically been a part of every social gathering, every milestone event, and every weekend activity. The idea that we need to “take the edge off” with a substance, or make ourselves more exciting, edgy, or interesting by drinking alcohol, has been a long-held societal belief.

https://barbshepardcounseling.com/2024/10/14/why-choose-mocktails/

Now, however, the choice to drink less or no alcohol has become a socially celebrated option—one that might even be seen as more interesting than the old narrative that alcohol is a necessity for fun.

Read more in this week's blog post!

“Why Bother with Mocktails?” This is a well-meaning question, often asked with good intentions! In a world where alcohol is deeply ingrained in all aspects of our social lives, it’s und…

09/15/2024

It’s impossible to tell just by looking at someone if they’re struggling with postpartum anxiety (PPA). When healthcare providers screen new moms for postpartum anxiety, it’s often the ones suffering the most who speak up the least. Why? A major reason is shame.

In today's blogpost, we talk about common symptoms of postpartum anxiety and how mental health providers and physicians can create safe spaces for moms with PPA to speak up and get the support they need.

It’s impossible to tell just by looking at someone if they’re struggling with postpartum anxiety (PPA). When healthcare providers screen new moms for postpartum anxiety, it’s often the ones sufferi…

08/29/2024

Yesterday, the Surgeon General released a report sounding the alarm on the growing stress and mental health struggles of today's parents. The stressors of modern parenting are now being considered an "urgent public health issue" that requires "immediate awareness and action."

The challenges facing today's parents are unprecedented: raising children during medically complicated times; making decisions about expensive (and limited) childcare options; balancing the ever-increasing demands of both home and work life; witnessing a rise in health issues, developmental disorders, and mental health conditions in children; and living in a world where we are expected to carry on with "business as usual" while knowing that homicide is one of the leading causes of death among kids. This is alarming, to say the least.

This generation of parents and children is STRUGGLING. The report raises awareness of an issue that must be addressed collectively as a society—not left to individual families who have felt isolated and expected to handle everything alone. Parents cannot function effectively when they are constantly overwhelmed by stress and feel completely let down by systems that have a responsibility to support them.

The first step toward change is awareness.

https://www.hhs.gov/sites/default/files/parents-under-pressure.pdf