On March 7, 2020, I took a red-eye flight from California to Boston. I’d been in nine airports in the previous two weeks and was witness to a growing unease over COVID-19. Although no one was wearing a mask at that point, people were using wipes, and most tray tables stayed up. After this final flight, I stopped in the bathroom to wash my hands before leaving the airport, then pushed myself backward through the exit doors like a scrubbed-in surgeon, touching nothing.

Within a week, my spring teaching schedule had disappeared. Absent all travel, my pace slowed. The outside world felt quiet, but inside it was quite the opposite. As I watched instructional videos on handwashing pop up across the internet and on the nightly news, as schools started to close and both my sons were sent home from college, as Clorox wipes and hand sanitizer became coveted, I knew that my young clients’ anxiety and OCD were finding a foothold. I predicted a marked increase in their distress. Solid ground we’d worked hard to obtain would feel shaky again.

Families often return to my anxiety-focused practice for boosters and normal upticks in symptoms, but this felt different. Why? It challenged my fundamental stance: that it’s not what you worry about but how you respond to the worry that matters. Families make great progress when they…