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Center for the Treatment and Study of Anxiety

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Philadelphia, PA
Center for the Treatment and Study of Anxiety

CTSA advances anxiety disorder treatment with evidence-based therapies, research, and training opportunities for professionals.

The Center was founded in 1979 by Edna B. Foa, Ph.D., a world leader in anxiety disorders research, who is the Director of the Center. The Center for the Treatment and Study of Anxiety is a division of the University's Department of Psychiatry, and is located on the campus of the University of Pennsylvania in the city of Philadelphia, Pennsylvania. Unlike many clinical and research programs, which specialize either in adults or children, the Center’s unique strength is in providing clinical services across the developmental lifespan: we provide treatment to children, adolescents, and adults. Our treatments are tailored to each age group and are sensitive to developmental aspects of our patients.

03/13/2026

CTSA Clinician Fact of the Day: A Little‑Known Insight About Specific Phobias

Did you know?

Although many people assume specific phobias fade over time, they often persist for years—and even decades—in a substantial subset of patients, particularly when untreated. Research shows that phobias can last for decades in 10–30% of individuals, and are linked with elevated risk for other anxiety, mood, and substance‑use disorders.

And here’s another surprising detail:
Many individuals experience multiple phobias simultaneously—an estimated 75% of people with a specific phobia fear more than one object or situation.

Clinician takeaway:
Even when a phobia seems “narrow,” remember that comorbidity and chronicity are the rule, not the exception—early, targeted, evidence‑based intervention (especially exposure therapy) is key to preventing long‑term impairment.

Learn more at our April 20, 2026 - Overcoming Fear: Exposure Therapy for Specific Phobias Workshop: https://www.med.upenn.edu/ctsa/Specific_Phobias.html

03/11/2026

3 Mistakes Clinicians Make When Delivering Exposure Therapy
…and how to avoid them to strengthen outcomes.

Mistake #1: Staying in the Comfort Zone
Clinicians sometimes choose exposures that are too mild, hoping to ease clients in gently.

But exposures that don’t activate anxiety don’t create corrective learning.

What to do instead:
Choose tasks that reliably trigger discomfort (but are still safe). The learning happens in the stretch zone, not the comfort zone.

Mistake #2: Providing Reassurance
It’s easy to unintentionally comfort the client during exposures—validating, explaining, micro‑coaching, or “softening” the uncertainty.

But reassurance = safety behavior, and safety behaviors block the brain from learning “I can handle this.”

What to do instead:
Hold back reassurance. Allow the client to sit with uncertainty and discover their own capability.

Mistake #3: Ending Exposure Too Soon
Many clinicians end exposures the moment anxiety decreases—but that can actually reinforce avoidance.

What to do instead:
Continue the exposure long enough for the client to learn that anxiety naturally rises and falls without escape or avoidance.

You’re building tolerance, confidence, and flexibility.

Want more tips like this? Follow for evidence‑based therapy guidance.
—or—
Enroll in one of our Exposure Therapy Training Workshops: https://bit.ly/CTSAtrainings

03/09/2026

📘 Understanding the Role of Avoidance in Anxiety

Learn more in our training workshops: https://linktr.ee/ctsaatpenn

Avoidance feels helpful in the moment—but for clients with anxiety disorders, it’s one of the strongest forces keeping symptoms alive.

When clients avoid feared situations, sensations, or thoughts, their anxiety gets short‑term relief but long‑term reinforcement. The brain never has the chance to learn: “I can handle this.”

Instead, it learns: “That was dangerous—good thing I escaped.”

This creates a powerful cycle:
➡️ Anxiety → ➡️ Avoidance → ➡️ Temporary Relief → ➡️ More Anxiety

For therapists, helping clients understand this cycle is key to motivating meaningful behavior change.

Avoidance maintains anxiety by:
• Reinforcing perceived danger
• Blocking corrective learning
• Increasing anticipatory fear
• Shrinking life activities and flexibility

Therapeutic takeaway:
Exposure, behavioral activation, values-based action, and gradual approach all interrupt the cycle—allowing clients to build confidence, expand their world, and experience true long‑term relief.

03/06/2026

ARFID is more than picky eating.

Learn more at our ARFID treatment workshop on April; 27, 2026: https://linktr.ee/ctsaatpenn

Avoidant/Restrictive Food Intake Disorder is a DSM‑5 eating disorder defined by a limited volume or variety of intake without weight or shape concerns. It can lead to significant weight loss, nutrient deficiencies, growth issues, and psychosocial impairment — and it’s often missed in clinical settings.

ARFID typically presents in three overlapping profiles:
✨ Sensory‑Driven: Intense reactions to textures, tastes, smells, or appearance. Diet limited to “safe” foods.
⚡ Fear‑Based: Avoidance following choking, vomiting, or GI pain. Food feels unsafe.
🌙 Low‑Appetite / Lack of Interest: Low hunger cues, early satiety, minimal motivation to eat.

Red flags clinicians should watch for:
🚩 Eating fewer than 10–15 foods
🚩 Weight loss or stalled growth
🚩 Nutrient deficiencies (iron, zinc, vitamin D, protein)
🚩 Distress around new foods or mealtimes
🚩 Avoiding entire food categories (e.g., proteins, mixed textures)
🚩 Unexplained GI symptoms
🚩 Reliance on supplements or shakes to maintain weight

ARFID is treatable. Early recognition and coordinated care make a huge difference in outcomes.

03/04/2026

🧠 Understanding Relationship OCD (ROCD): What Therapists Should Know

Join our April 13, 2026 workshop to learn more: https://bit.ly/CTSAtrainings

ROCD is a subtype of OCD marked by intrusive doubts about one’s romantic relationship or partner—not a sign of typical ambivalence or relational conflict.

Key Features to Watch For:

Obsessions:
• “Do I really love them?”
• “Are they right for me?”
• “What if I’m making a mistake?”
• Hyper-focus on partner “flaws,” morality, attractiveness, compatibility.

Compulsions:
• Reassurance seeking (from partner, friends, therapist)
• Mental reviewing and comparison
• Checking feelings (“Do I feel enough right now?”)
• Avoidance of commitment decisions or intimacy triggers

Why It Matters in Therapy
ROCD frequently appears as relationship distress, and clients often interpret symptoms as meaningful signals rather than obsessive doubt. Mislabeling symptoms as purely “relationship problems” can inadvertently reinforce compulsions.

Evidence‑Based Treatment Strategies
✔️ Exposure and Response Prevention (ERP):
Target triggers like “relationship doubts,” feared futures, or partner imperfections while preventing reassurance, rumination, and checking.
✔️ Processing:
Focus on meta-beliefs (certainty, perfectionism, morality) rather than debating the content of the relationship.
✔️ Address Safety Behaviors:
Therapists should avoid providing certainty or evaluating the relationship—this becomes reassurance.
✔️ Use Values Work:
Help clients distinguish OCD‑driven fear from authentic values-based action.

Therapist Takeaway
Relationship discomfort is universal, but ROCD turns normal uncertainty into a compulsive cycle of doubt, checking, and reassurance. When clinicians can correctly identify ROCD, treatment becomes clearer, more targeted, and significantly more effective.

03/02/2026

🧠 Incorporating Loved Ones Into Exposure Therapy: What Therapists Should Know

Join our March 25, 2026 workshop to learn more: https://www.med.upenn.edu/ctsa/Incorporating_Loved_Ones_in_Exposure_Based_Treatment.html

When navigating anxiety disorders, trauma-related fears, or OCD, clients don’t heal in isolation—and neither should their exposures. Inviting loved ones into the exposure process can strengthen outcomes, increase generalization, and reduce safety behaviors.

Here’s how therapists can effectively integrate family and support partners into exposure‑based treatment:

👉 1. Teach Supportive Responding
Coach loved ones to reinforce approach behaviors, not avoidance. This means praising effort, staying calm during exposures, and resisting reassurance-giving. A supportive partner can be a powerful co‑coach.

👉 2. Identify Safety Behaviors Hidden in Relationships
Sometimes clients rely on partners for avoidance without realizing it—like asking them to accompany them everywhere, check things repeatedly, or handle triggering tasks. Bringing loved ones into session helps reduce these subtle barriers to progress.

👉 3. Use Loved Ones to Strengthen Real‑World Practice
Having supporters participate in exposures outside the therapy room helps skills transfer into daily life. They can help implement exposure hierarchies, document wins, and encourage continued practice.

👉 4. Address Emotional Dynamics
Partners may unintentionally act from fear, protection, or guilt. Helping them understand the rationale for exposure therapy reduces conflict and increases alignment with treatment goals.

👉 5. Model the Process in Session
Let loved ones witness exposures so they understand what "therapeutic discomfort" looks like. This builds confidence and prevents accidental interference later.

💡 Exposure therapy is most effective when clients feel supported—not shielded.

Integrating loved ones empowers the whole system and strengthens long‑term resilience.

02/27/2026

✨ Understanding the Anxiety Cycle ✨

Anxiety often follows a predictable loop, and recognizing it is the first step toward treating it.

Here’s how the cycle works:
🔹 Trigger — Something sets off worry, fear, or uncertainty.
🔹 Anxiety Increases — The mind and body go into alert mode.
🔹 Avoidance or Compensatory Behaviors — Trying to escape the discomfort (reassurance-seeking, checking, avoiding, compulsions).
🔹 Short‑Term Relief — You feel better momentarily.
🔹 Long‑Term Learning — Your brain mistakenly believes: “I must do something to feel safe when anxiety shows up.”
🔹 …and then the next trigger starts the cycle again.

The relief feels real—but it actually keeps anxiety going.

The good news? You can learn to help your clients step out of the loop and teach their brain a new pattern. 💙

Join Dr. Sandy Capaldi for CTSA's Basics of Exposure Therapy for Anxiety Disorders workshop on March 23, 2026: https://www.med.upenn.edu/ctsa/Basics_of_Exposure_Therapy_for_Anxiety_Disorders.html

02/26/2026

Ready to take your EX/RP skills to the next level? Join CTSA's Dr. Jessica Bodie on March 20, 2026 for an advanced, full‑day CE workshop focused on delivering effective EX/RP for pediatric OCD.

Perfect for clinicians who already have foundational training and want to deepen their expertise working with youth.

Spots are limited—secure yours today!
https://bit.ly/EXRPforKids

02/25/2026

🚫 Safety Behaviors: The Hidden Barrier in Exposure Therapy 🚫

Did you know that safety behaviors—those subtle “just-in-case” actions clients use to feel secure—can actually block the full benefits of exposure therapy? 🛑

When clients lean on these behaviors during exposure, they never truly learn that feared situations are safe without them. The result? Slower progress and lingering anxiety.

✅ Want to master strategies to identify and reduce safety behaviors in your sessions?
✅ Ready to help clients achieve lasting change through effective exposure therapy?

Join CTSA’s Workshop Trainings and gain practical, evidence-based tools to:

Spot safety behaviors early
Structure exposures for maximum impact
Empower clients to embrace uncertainty and thrive

📅 Upcoming workshops:

March 16-19, 2026 - Intensive Workshop in Exposure and Response Prevention for OCD

March 20, 2026 - EX/RP for Pediatric OCD

March 23, 2026 - Basics of Exposure Therapy for Anxiety Disorders

March 25, 2026 - Incorporating Loved Ones in Exposure-Based Treatment

🔗 Register now: https://bit.ly/4k1dGa0

Let’s transform exposure therapy together! 💪

02/24/2026

✨ Black History Month Spotlight: Dr. Kenneth B. Clark & Dr. Mamie Phipps Clark ✨

Drs. Kenneth and Mamie Clark were groundbreaking psychologists whose work forever changed the understanding of race, identity, and child development in America. Their famous “Doll Study” revealed how segregation and racism shaped the self‑esteem of Black children, offering powerful evidence of the emotional harm caused by discrimination.

Their research played a pivotal role in the historic Brown v. Board of Education decision, helping end legal school segregation. Beyond their pioneering scholarship, they co‑founded the Northside Center for Child Development, providing mental‑health support, educational services, and advocacy for children and families in underserved communities.

🖤 Their legacy lives on—in psychology, in education, and in every effort to build a more just and equitable future for all children.

02/23/2026

💭 Thoughts Are Just Thoughts — And That’s Okay.

One of the cornerstones of exposure therapy for anxiety and related disorders is something very simple but very powerful:

Your thoughts don’t define you.

They don’t predict the future, tell the truth, or determine your worth. They’re mental events—nothing more, nothing less.

What often makes thoughts feel intense or overwhelming isn’t the thought itself, but the meaning, fear, or urgency we attach to them.
✨ “What if this means something?”
✨ “Why am I thinking this?”
✨ “I need to figure this out right now!”

Our brains—especially anxious ones—love to create stories. Not because we’re broken, but because our minds are trying to protect us.

Here’s a gentle reminder:
🌱 You don’t have to get rid of thoughts to feel better.

Sometimes the most helpful thing to do is pause, notice,
“Oh… this is just a thought,”
and keep moving toward what actually matters to you.

Let the thought be there. And focus on living life, even with the background noise.

For more information and to get training in exposure therapy, visit our website: https://bit.ly/CTSAtrainings

02/20/2026

Supporting people through exposure therapy means helping them navigate the discomfort that often leads to early dropout. Some individuals disengage when exposures feel overwhelming or progress doesn’t seem fast enough.

But as we know, discomfort is expected—and therapeutic. Anxiety spikes, hesitation, and frustration signal that corrective learning is happening.

At CTSA, we maintain engagement by breaking exposures into manageable steps, providing clear psychoeducation, offering tools for between‑session anxiety, and staying flexible when motivation dips.

When people stay the course, exposure therapy delivers lasting, meaningful change.

Address

3535 Market Street, 6th Floor
Philadelphia, PA
19104

Opening Hours

Monday	9am - 5pm
Tuesday	9am - 5pm
Wednesday	9am - 5pm
Thursday	9am - 5pm
Friday	9am - 5pm

Telephone

+12157463327

Website

http://www.med.upenn.edu/ctsa/, https://linktr.ee/ctsaatpenn

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