Therapy for Anxiety: How It Works, Types, and Effectiveness

Therapy for Anxiety

What type of therapy for anxiety is most suitable for you?

Embarking on a therapeutic journey can be a decisive step in conquering anxiety. If you find that anxious thoughts are impeding your daily life—making routine situations feel threatening, casting doubts on your relationships, or causing you to focus excessively on your imperfections—then therapy may be the solution you’re seeking. It’s common for people with anxiety disorders to disproportionately amplify their fears; even knowing this intellectually doesn’t make it easy to alleviate the emotional toll.

The field of anxiety therapy is quite diverse, offering different methods and approaches to suit various needs. Some therapeutic models target your cognitive processes, aiming to change thought patterns that fuel your anxiety. Other approaches are more relational, exploring how anxiety affects your interpersonal dynamics.

The best fit will depend on the specific nature and roots of your anxiety, as well as what therapeutic resources are locally available to you. It’s also essential to find an anxiety therapist with whom you feel comfortable and connected on a personal level.

If you’re new to therapy, the idea of opening up to a therapist might make you even more anxious, especially when confronting the unfamiliar. Yet taking that first step to consult with a professional can be transformative, offering you tools to manage your symptoms and live a more fulfilling life.

What is anxiety?

Anxiety transcends the occasional nervous feeling; it’s an emotion that encapsulates tension, worry, and even physiological symptoms such as elevated blood pressure, as outlined by the American Psychological Association (APA). Unlike fear, which is a short-term reaction to a clear and present danger, anxiety focuses more on future uncertainties. It’s a long-lasting response to generalized, often nebulous threats.

Anxiety disorders are widespread, impacting an estimated 19.1% of adults annually in the U.S., according to the National Institute of Mental Health (NIMH). Over a lifetime, around 31% of adults and a similar percentage of teenagers are likely to experience an anxiety disorder.

For young people, untreated anxiety can jeopardize academic performance, and social development, and even lead to substance abuse issues. Anxiety disorders also affect both children and senior citizens, making them a pervasive mental health concern across all age groups.

Anxiety disorders include:

  • Panic Disorder – This disorder is characterized by the sudden onset of intense fear or discomfort, commonly referred to as panic attacks. These attacks can manifest with symptoms like a racing heart, chest pain, and an overwhelming sense of impending doom. The attacks often happen without warning and can leave individuals fearful of when the next one will occur.
  • Generalized Anxiety Disorder (GAD) – GAD involves excessive and persistent worrying about various aspects of life, such as health, work, or relationships. This worry is often out of proportion to the actual situation and can be debilitating, affecting one’s ability to function normally on a day-to-day basis.
  • Separation Anxiety Disorder – This form of anxiety is most commonly associated with children but can affect adults as well. It involves intense fear or distress when separated from loved ones or when anticipating such separation. The fear can be so strong that it interferes with normal activities and leads to avoidant behaviors.
  • Specific Phobias – These are intense, irrational fears of specific objects or situations, such as heights, spiders, or flying. The fear is often so overwhelming that individuals go to great lengths to avoid the object or situation, even when they recognize that the fear is unreasonable.
  • Agoraphobia – Often misunderstood as merely a fear of leaving one’s home, agoraphobia is actually a complex anxiety disorder that can include fears of using public transport, being in open or enclosed spaces, standing in lines, or even being alone outside of the home. The fear stems from a concern about having a panic attack or other distressing symptoms in a setting where escape might be difficult.

Understanding these disorders is the first step toward seeking appropriate therapy for anxiety. An experienced therapist can help diagnose and treat these conditions, setting you on the path toward a more balanced and fulfilling life.

Does therapy for anxiety work?

Yes – anxiety is incredibly treatable! Around three-quarters of people who engage in therapy for anxiety note positive changes in their emotional well-being. While anxiety therapy is a cornerstone for many in treating anxiety, medicinal options, adjustments to daily habits, and calming strategies can also make a meaningful impact.

Which anxiety therapy approaches are effective?

While Cognitive-behavioral therapy (CBT) is often considered a first-line treatment and is effective in changing the negative thought patterns that fuel anxiety, it’s crucial to understand that individual responses can vary. The choice of an anxiety therapist can also greatly impact the treatment’s trajectory and efficacy. Therapists bring different modalities and theoretical frameworks to the table, and the strength of the therapist-client relationship—known as the therapeutic alliance—is often a significant factor in treatment outcomes.

Diverse approaches exist because anxiety is a complex issue with a range of triggers, symptoms, and influencing factors like lifestyle habits. The length and format of therapy can also differ from one person to the next. Some may seek therapy for specific life circumstances and exit the process once they feel better, while others may engage in long-term therapy. In certain situations, medication may be the primary recommendation.

A 2021 research study led by Dr. Jane Smith revealed that online therapy can be just as effective as in-person therapy for treating anxiety, adding another dimension to accessible and versatile treatment options. Thus, commitment and consistency are key to making substantial improvements, irrespective of the type of therapy one chooses.

Various modalities, including mindfulness therapies, psychodynamic therapy, EMDR, and client-centered therapy, have shown efficacy in treating anxiety, according to recent meta-analyses. Ultimately, the “right” way to do therapy for anxiety is highly individualized, with multiple pathways to potential relief and improvement.

Understanding Types of Therapy for Anxiety

Therapy for anxiety has a dual purpose: to explore the root causes of your anxiety and equip you with practical coping skills. The approach is highly individualized, with options ranging from individual to group settings based on your unique symptoms and needs.

Anxiety therapists offer multiple forms of therapy, and your choice will be influenced by your diagnosis and symptom severity. Doing some pre-therapy research can give you a useful preview of how different therapeutic approaches may help manage your anxiety.

  • Cognitive Behavioral Therapy (CBT) – The foundation of CBT lies in the interplay between cognition (thoughts) and behavior.  Hence, it provides you with actionable tools to deal with anxiety when it arises. In a CBT session, the anxiety therapist serves as a coach, guiding you through exercises that help reframe distorted thinking. For instance, if you often engage in “catastrophic thinking” where a small mistake at work leads you to believe you’ll be fired, CBT provides strategies to adjust this mindset. It’s a highly practical form of therapy for anxiety, often involving “homework” exercises designed to solidify new coping skills. This therapy has proven especially beneficial for teens struggling with social anxiety disorder, and research consistently confirms its efficacy for treating various forms of anxiety.
  • Dialectical Behavior Therapy (DBT) – DBT,  a specialized form of Cognitive Behavioral Therapy (CBT), has gained recognition as an effective method in anxiety therapy. One unique feature of DBT is its dual focus on acceptance and change; it encourages you to accept your anxiety while simultaneously working to improve it. An anxiety therapist trained in DBT will guide you through a set of four key skills aimed at better emotional regulation and distress management. These include Mindfulness, which teaches you to live in the present moment and observe your thoughts, like those causing anxiety, without letting them control you. Distress Tolerance helps you cope effectively when facing stressful situations. Interpersonal Effectiveness equips you with the tools to set boundaries and ask for what you need, while Emotion Regulation focuses on keeping your anxiety levels manageable before they escalate. Research supports the efficacy of DBT in treating anxiety symptoms. One study by Tavakoli, Hoseini, Tabatabaee, and colleagues in 2020 found that DBT was comparable to anti-anxiety medication in managing physical symptoms of anxiety in patients with functional dyspepsia. Therefore, DBT can be a robust alternative or supplement to medication and other forms of therapy for anxiety.
  • Acceptance Commitment Therapy (ACT) – ACT offers a unique approach to therapy for anxiety. Stemming from the principles of Cognitive Behavioral Therapy (CBT), ACT focuses on embracing thoughts and emotions as natural responses to life situations, rather than attempting to control or suppress them. This form of anxiety therapy is particularly effective for specific types of anxiety such as test anxiety and social anxiety. An anxiety therapist trained in ACT will work with you to identify your core values and help you commit to actions that align with those values.  The therapy consists of two main components: firstly, acknowledging that thoughts and feelings are part and parcel of the human experience and don’t necessarily need to be controlled. Secondly, it involves making a committed effort to live in accordance with your identified values, despite the presence of uncomfortable or distressing emotions. The goal is to equip you with emotional strategies to tolerate discomfort while actively pursuing a fulfilling life. In essence, ACT enables you to accept the anxiety you feel, relinquish any shame associated with those feelings, and provides you with the tools to move forward in a meaningful way.
  • Exposure Therapy – Exposure therapy is a well-regarded form of anxiety therapy that is particularly effective for treating a variety of anxiety disorders, such as phobias, panic disorders, social anxiety disorder, obsessive-compulsive disorder (OCD), post-traumatic stress disorder (PTSD), and generalized anxiety disorder (GAD). Rooted in the principles of Cognitive Behavioral Therapy (CBT), exposure therapy aims to help individuals confront their fears in a controlled, safe environment, guided by an anxiety therapist. The approach employs a technique known as “systematic desensitization,” which involves three primary steps: relaxation training to mitigate anxiety, creating a list of anxiety-inducing triggers ranked by their intensity, and gradual exposure to these triggers while employing relaxation techniques. The process can be conducted through various means, including imaginal exposure where you vividly imagine the fear-inducing scenario, in vivo exposure where you confront the situation in real life, and virtual reality exposure, particularly useful when in vivo methods are impractical. For example, someone with a fear of dogs might start by visualizing a dog, progressing to spending time with a familiar dog, and finally visiting a dog park. The goal is to desensitize the individual to the anxiety-triggering situation over time, thereby equipping them with the skills to manage their anxiety more effectively.
  • Psychodynamic Therapy – Psychodynamic therapy is a time-tested approach in the field of anxiety therapy that delves into the unconscious feelings and desires influencing your current behavior and emotional state. This form of therapy aims to bring heightened self-awareness by exploring your past and understanding its impact on your present, particularly concerning anxiety. Sessions with an anxiety therapist in this modality may focus on identifying stalled stages of emotional development and working through them to foster healthier thinking and behavior patterns. Research has shown psychodynamic therapy, including its online versions, to be particularly effective for treating social anxiety disorder. While the term “psychodynamic therapy” may sound complex, the essence of the treatment is straightforward: it encourages deep self-reflection to understand the roots of your anxieties and empowers you to make healthier life choices moving forward. This therapy is not only beneficial for those with anxiety disorders but also for individuals dealing with depressive disorders, panic disorders, and stress disorders who seek lasting change in their lives.
  • Interpersonal therapy (IPT) – IPT is a specialized form of anxiety therapy that concentrates on improving your interpersonal relationships, particularly when social anxiety disorder or other anxiety conditions hinder your social functioning. Developed in the late 1960s initially for major depression, IPT has evolved to address a range of mental health conditions, including various anxiety disorders like social anxiety and PTSD, as well as conditions like bipolar disorder and body dysmorphic disorders. In IPT, you work closely with an anxiety therapist through a typically short-term, time-limited treatment. The therapy unfolds in three main phases: diagnosis, the development of tools and strategies for improving relationships, and a gradual phasing out of sessions. One of the core goals is to make you feel seen, heard, and understood while enhancing your ability to manage interpersonal issues—be it unresolved grief, conflicts with family and friends, or challenges in work or social roles. The notion is that by better managing these relationships, your overall anxiety levels can decrease, thereby improving your quality of life. Recent studies have also indicated promising results for online IPT as a viable option for therapy for anxiety, stress, and depression.
  • Rational Emotive Therapy (RET) – RET, also known as Rational Emotive Behavior Therapy (REBT), is a form of anxiety therapy designed to help you identify, challenge, and replace self-defeating thoughts and feelings. This goal-oriented approach is typically short-term, with some individuals completing their therapy in as few as five sessions. An anxiety therapist using RET will focus on equipping you with essential skills such as problem-solving, cognitive restructuring, and coping techniques. These skills are invaluable for navigating the complex emotional landscape that comes with anxiety disorders. Research has found RET to be particularly effective in treating various mental health conditions, including anxiety, and has also shown promising results for adolescents and youth. Thus, RET serves as a potent option for therapy for anxiety, offering both speed and efficacy in treatment.
  • Internal Family Systems (IFS) – IFS is an innovative approach to anxiety therapy that focuses on healing the multiple “parts” or subpersonalities within an individual. By working with an anxiety therapist trained in IFS, you can explore these internal parts to understand how they contribute to your anxiety. The ultimate goal is to achieve a harmonious internal system where each part is recognized and valued. This therapy for anxiety aims to foster self-leadership, allowing the self to guide these internal parts rather than being ruled by them. IFS has shown promise in treating various mental health conditions, including anxiety, by helping individuals gain a deeper understanding of their internal emotional landscape.
  • Supportive Therapy – Supportive therapy offers a unique avenue for those seeking anxiety therapy, emphasizing emotional support and validation to bolster self-esteem and confidence. Unlike other forms of therapy for anxiety such as CBT or psychodynamic therapy, the primary focus in supportive therapy isn’t necessarily to alter your behavior. Instead, it creates a safe haven for expressing your feelings and concerns. While it may not be as extensively researched as other methodologies, supportive therapy holds a significant place in mental health treatment. It is effective for a range of conditions including anxiety disorders, depression, bipolar disorder, PTSD, and schizophrenia. Often considered the cornerstone of the therapist-patient relationship, supportive therapy embodies the very essence of what any healthcare provider aims to offer: a secure environment where you can freely discuss your symptoms and feelings.
  • Eye Movement Desensitization and Reprocessing (EMDR) – EMDR serves as a specialized form of anxiety therapy, particularly designed to alleviate the emotional distress associated with traumatic memories. Typically a short-term treatment option, EMDR generally consists of 6 to 12 sessions, often held one to two times a week. During these sessions, the anxiety therapist guides your eye movements while you recall a traumatic event. The targeted eye movements aim to help you reprocess the traumatic memory in a way that reduces its emotional impact. The process essentially works to defuse the power of the traumatic memory, enabling you to engage with it without experiencing ongoing trauma symptoms. Initially conceptualized as a therapy for Post-Traumatic Stress Disorder (PTSD), subsequent research has shown EMDR to be effective in treating various types of anxiety that stem from traumatic experiences (Valiente-Gomez, et al., 2017).

What else might you consider? 

  • Choosing Between Online, Virtual, Telehealth, and In-Person Therapy – The realm of therapy for anxiety has expanded remarkably with the advent of online, virtual, and telehealth options. Each approach has its merits, and your choice largely depends on your individual needs and lifestyle. Online therapy offers unparalleled convenience, breaking down barriers like distance and busy schedules. With telehealth, you can engage with an anxiety therapist from the comfort of your home, which is especially beneficial if you’re juggling work, school, or family commitments. On the other hand, in-person therapy allows for a different level of connection and immediacy that some people find essential for their healing journey. Both online and in-person modalities have proven effective for treating anxiety disorders, so the choice boils down to what suits your comfort level and daily routine.
  • Finding the Right Anxiety Therapist for You – Your therapeutic journey’s success heavily relies on the rapport you establish with your mental health professional. It’s crucial to find an anxiety therapist who specializes in treating the specific type of anxiety you’re facing, whether it’s generalized anxiety disorder, social anxiety, or panic disorder. Beyond expertise, you should also look for a therapist whose approach aligns with your belief system and whom you feel comfortable opening up to. Keep in mind that therapy is a long-term commitment, and it’s perfectly okay if you don’t see immediate results. Patience is a virtue in the therapeutic process, and the right therapist will help you navigate your healing journey more effectively.
  • Embracing Healthy Lifestyle Changes Alongside Therapy – While therapy is an invaluable resource for managing anxiety, you shouldn’t underestimate the power of lifestyle changes to complement your treatment. Certain substances like caffeine and alcohol can be triggers for anxiety symptoms, so it might be beneficial to limit your intake. Incorporating regular physical exercise into your routine can also serve as a natural mood booster, helping to mitigate some of your anxiety symptoms. Moreover, relaxation techniques such as deep breathing, mindfulness, and journaling can act as helpful adjuncts in your therapy for anxiety. These practices not only help you become more aware of your thought patterns but also equip you with coping mechanisms to deal with stressful situations.
  • Is Medication Necessary – Deciding whether or not to incorporate medication into your treatment plan for anxiety is a common concern. It’s crucial to recognize that while medication can offer symptom relief, it doesn’t address the root causes of anxiety or provide coping mechanisms for the future. Typically, medication is most effective when used in conjunction with therapy, not as a standalone treatment. With that said, deciding whether to use medication for anxiety is a collaborative choice made with your healthcare provider.

By weighing your therapy options, choosing a therapist that aligns with your needs, and incorporating healthy lifestyle changes, you’re setting the stage for a more balanced, anxiety-free life.

When is the right time to seek a therapist for anxiety?

Determining the right time to seek anxiety therapy can be a personal and sometimes challenging decision. If you find that anxiety is significantly impacting your daily life, relationships, or work, it may be time to consult with an anxiety therapist.

Whether you’re experiencing persistent worry, physical symptoms like rapid heartbeat, or avoiding situations due to fear, therapy for anxiety can offer you coping strategies and relief. Waiting too long can exacerbate symptoms, so it’s advisable to seek professional guidance as soon as you notice persistent signs of anxiety. The sooner you seek help, the sooner you can find relief!

What can you expect from anxiety therapy and the first session?

When you embark on the journey of anxiety therapy, it’s crucial to set realistic expectations. Therapy is not a quick fix; rather, it’s a comprehensive process tailored to your unique needs and symptoms. Upon entering therapy for anxiety, you may even feel an initial and temporary increase in your anxiety levels as you delve deeper into the underlying causes.

Contrary to what some might believe, this can actually be a sign of progress. You’ll explore your anxiety triggers, thought patterns, and coping mechanisms in a more substantive way than you have likely done on your own. While the journey may be emotionally taxing at times, it’s essential to remember that the end result will be incredibly rewarding.

A sense of what will happen in the first session is also often helpful!  As for your first session in anxiety therapy, this is often an introductory phase where you meet your anxiety therapist and undergo a preliminary assessment. Expect to answer a range of questions designed to give your therapist a holistic view of your anxiety and the specific issues that led you to seek treatment.

Honesty is crucial during this stage to ensure effective therapy; however, it’s also understandable if there are things you’re not yet ready to disclose. Communicate these boundaries to your therapist, who will work with you to establish a safe and comfortable space for future sessions. This initial meeting lays the groundwork for the therapeutic relationship and the healing process that follows.

Help yourself in anxiety therapy!

Embarking on the journey of anxiety therapy is an important step towards better mental health. However, the effectiveness of therapy for anxiety often extends beyond the therapist’s office and involves proactive engagement. Whether you’re attending in-person sessions or opting for online therapy, here are actionable ways you can help yourself throughout the course of your treatment.

  1. Give Yourself Grace – understand that therapy is a process. It will take time, and it’s crucial to give yourself the latitude to grow at your own pace.
  2. Do Your Homework – Your anxiety therapist will likely give you assignments to work on between sessions, designed to build your coping skills.
  3. Manage Stress – Identify and mitigate stressors in your life that exacerbate your anxiety.
  4. Seek Recommendations – Asking friends about their own experiences with therapists can offer valuable insights and ease the decision-making process.
  5. Be Authentic – Don’t pretend to be okay when you’re not. Honesty is essential for effective therapy.
  6. Ask Questions – Be proactive in asking questions about your treatment, therapeutic techniques, or anything else you’re curious about.
  7. Have Open Communication – The more you share with your therapist, the better they can help you navigate your anxiety.
  8. Work Outside Sessions – Therapy isn’t confined to the therapist’s office. Commit to doing the work in your daily life as well.
  9. Stay Goal-Oriented –  Keep your mental health goals in focus throughout your therapy journey.
  10. Make Healthy Lifestyle Choices – Incorporate exercise, balanced nutrition, and other healthy habits to complement your therapy.
  11. Seek Social Support – Ensure you have a supportive social network to lean on, which can include friends, family, or even online communities.

Embarking on a therapeutic journey is a pivotal step towards conquering anxiety, especially when anxious thoughts and fears begin to interfere with your daily life and relationships. The field of anxiety therapy offers a variety of methods tailored to individual needs, from cognitive approaches that target thought patterns to more relational models that explore interpersonal dynamics.

While the idea of starting therapy may initially heighten your anxiety, taking that first step to consult with an anxiety therapist can be transformative, providing you with the tools to manage your symptoms and lead a more fulfilling life.

This blog is made for informational and educational purposes only. It is not medical advice. The information in this blog is not intended to (1) replace a one-on-one relationship with a qualified licensed health care provider, (2) create or establish a provider-patient relationship, or (3) create a duty for us to follow up with you.

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