There are many therapy options for treating anxiety. The most commonly used approach is cognitive-behavioral therapy (CBT), but depending on the specific type of anxiety, a therapist might also use exposure therapy, acceptance and commitment therapy (ACT), dialectical behavioral therapy (DBT), eye movement desensitization and reprocessing therapy (EMDR), or interpersonal therapy (IPT).
Anxious feelings are normal and a healthy part of life. You probably notice an increase in anxiety before public speaking or meeting a new person; however, if anxious feelings become persistent and overwhelming, or your anxiety starts to interfere with your day-to-day life, you might be struggling with an anxiety disorder.
Anxiety is the most common mental illness in the United States. The National Institute of Mental Health (NIMH) estimated that about 19% of adults experienced an anxiety disorder within the last year.1,2 Types of anxiety disorders include generalized anxiety disorder (GAD), panic disorder, obsessive-compulsive disorder (OCD), post-traumatic stress disorder (PTSD), social anxiety, and separation anxiety.
Does Anxiety Therapy Work?
Anxiety therapy provided by a trained therapist using techniques appropriate for the individual and their specific needs can be beneficial to improve symptoms. However the extent of symptom improvement, the pace at which symptoms improve and the end results vary between each person.
There is no one-size-fits-all approach to treating anxiety. Treatment for anxiety needs to be chosen based on the individual’s specific symptoms. In some cases, the treatment will need to be individualized to combine aspects of different modalities.
Online Vs. In-Person Therapy for Anxiety
With the availability of online therapy and in-person anxiety treatments, each person must determine which option is best for their specific needs.
Online therapy pros:
- Widely available
- Saves on indirect expenses like gas and childcare
Online therapy cons:
- Missing the personal connection to the therapist
- May lack real time audio or visual communication
- May be interrupted by technical difficulties
- Therapist may miss important details (through body language) of your presentation if you are not face-to-face
- Therapist can observe you fully
- A chance to enter a calm and trusting environment
- Better opportunity for clear communication and understanding
- Can be expensive with travel and childcare costs
- Limited appointment availability
- Taking too much time out of the day
- Conflicts with work or school schedule
1. Cognitive Behavioral Therapy (CBT)
CBT is the most commonly used approach to treat essentially any type of anxiety disorder because it’s been extensively researched and shown to be effective.4 CBT for anxiety is a hands-on approach that helps individuals change their thinking and behavioral patterns, gain skills to navigate difficult situations, and maintain a sense of control and confidence.
2. Exposure Therapy
Exposure therapy is a form of CBT that helps individuals overcome their fears. The therapist works with the client to gradually face stressful or scary situations/stimuli and “rewire” the brain to reduce fear responses. It teaches coping skills and introduces new thought patterns. Different forms of exposure include imaginal exposure, in vivo exposure (facing the situation in real life), and virtual reality exposure.
Exposure therapy is often used as a treatment for specific phobias, such as a fear of being on an airplane, fear of snakes, or fear of needles/injections. Exposure therapy can also be used for more general situation-specific situations, such as social anxiety, separation anxiety, panic disorder, generalized anxiety disorder, and PTSD.
A subset of exposure therapy, called exposure response and prevention therapy (ERP) is sometimes used to treat OCD by helping the person recognize and face their fears, and then interrupt any obsession and following compulsions.
3. Acceptance and Commitment Therapy (ACT)
ACT is another effective modality of treatment for anxiety. It helps individuals to identify their values and act in ways that align with their values through acceptance and mindfulness techniques.5 ACT has been used to effectively treat social anxiety, testing anxiety, and OCD.
Elements of ACT can be combined with other treatment modalities to address symptom combinations specific to individuals. An example would be generalized anxiety that prevents a person from engaging with others and situations in a way that aligns with their values.
4. Dialectical Behavioral Therapy (DBT)
DBT is a form of CBT that helps clients balance thoughts and situations that feel opposing (e.g., accepting that you have anxiety while working to improve your management of anxiety) by engaging in mindfulness, increasing distress tolerance, increasing emotional regulation and interpersonal skills. DBT is effective in treating generalized anxiety disorder, panic disorder, PTSD, and OCD.7,8
5. Eye Movement Desensitization and Reprocessing (EMDR)
EMDR helps individuals reprocess traumatic life experiences using the brain’s natural healing process. The therapist guides the client through bilateral stimulation of the brain using specific eye movements, tapping, or tones to reprocess memories and decrease the overall physical and emotional distress.
EMDR can help treat anxiety that’s rooted in trauma, such as PTSD or specific phobias. It’s also helpful to process life events that might have caused an onset of generalized anxiety disorder and panic disorder. EMDR isn’t typically used for all forms of anxiety due to the nature of it targeting and reprocessing specific life events, but it can be a helpful and necessary tool during the treatment process.
6. Interpersonal Therapy (IPT)
IPT specifically focuses on how the individual functions socially and within their relationships. An IPT therapist would work with the individual to target specific relational issues, such as conflicts with friends and family members, unresolved grief, work and social role changes, and overall struggles relating to others.
IPT was originally developed to manage depression, but elements of this treatment can be particularly helpful if an individual’s anxiety impacts their relationships, such as with social anxiety. If a person’s anxiety is rooted in interpersonal struggles (e.g., panic disorder resulting from feeling unaccepted by others), then incorporating IPT is a crucial part of treatment.
7. Psychodynamic Therapy
Psychodynamic therapy is a version of psychoanalytic therapy but is a more brief, time-limited treatment. It focuses on early childhood development, the unconscious mind, and insight building to improve anxiety symptoms.
8. Art & Music Therapies
Any form of expressive art therapy can help manage anxious symptoms. Creating or consuming art is naturally soothing and therapeutic. On a deeper level, art and music therapies can help people express challenging and unclear thoughts, feelings, and behaviors. These therapies can help the person gain a better understanding of themselves and their motivations.
What Is the Best Therapy For Anxiety?
CBT is considered the gold-standard in anxiety treatment, largely due to the nature of the treatment targeting and reframing thought patterns. The treatment’s structure also allows it to be researched repeatedly with reliability and consistency.9 Although a therapist might later incorporate other therapeutic elements to meet a person’s needs within their individualized treatment plan, most anxiety therapists will begin with and focus on principles of CBT.
How to Find an Anxiety Therapist
When looking for treatment options, consider what type of anxiety you’re struggling with, and find a provider that works with that specific type of anxiety. Depending on the severity of your symptoms, you might also need medication for anxiety in addition to therapy.
Once you’ve identified a therapist who works well with your anxiety, the final important piece to consider is therapist “fit.” In other words, do you feel comfortable sharing with this person? Do you feel like they “get you?” If so, then you’ve likely found a provider to successfully help you treat and manage your anxiety.
If you’re feeling ready to begin your search to find a therapist, check out our online therapist directory to get started, or talk to your health care provider about options. If you’re paying out-of-pocket, online therapy companies offer a good deal of affordability and convenience, with BetterHelp and Talkspace being two of the most well known providers in the space.
How to Make Anxiety Counseling Work for You
The first step to manage anxiety is to find a therapist; however, it’s also extremely important to maximize your time and efforts once you’re in anxiety therapy. Getting the most out of therapy includes being ready to step outside of your comfort zone, making sure that you’re regularly completing and engaging with your “homework” between sessions, and communicating to your therapist what is and isn’t working.
Make Sure Your Therapist Is the Right Fit
Ideally, your first therapist would be an amazing fit, but it can actually take some time to find a good match. Give the process time and use open communication to let your therapist know how you feel about the process. Discuss options to make the sessions tailored to your needs. The therapeutic alliance (the relationship between the therapist and the client) is one of the most important factors of a successful therapy session.
Learn About Anxiety
If you had a physical health disorder, you’d likely do some research to learn about your condition, so do the same with your mental health. Learn about the roots of anxiety, how it impacts you today, and helpful strategies to decrease its impact.
Reduce Your Overall Stress If You Can
Your overall levels of stress will influence your anxiety. By working hard to recognize and limit your stress through simple lifestyle changes, you can decrease your anxiety levels.
Cultivate Your Relationships
Healthy, loving relationships are natural stress busters. Spend some time cultivating old and building new relationships with family members, coworkers, and anyone else who can add some positivity to your life.
Stick to Your Treatment Plan for Anxiety
Continuing to stay engaged throughout the process is important. It not only ensures that you’re not in anxiety therapy longer than you need to be, but it also ensures that the skills you’re learning stay with you for the rest of your life and prevent anxious thoughts and feelings from taking over in the future.
Complementary Therapies for Anxiety
Professional mental health treatments are irreplaceable when reducing anxiety, but diversifying your strategies is usually a good idea. You could consider:
Your physical state has a significant influence on your anxiety. Adding exercise can help regulate your anxiety levels during the times you exercise and beyond.
A therapist may offer relaxation techniques, but you could pursue options on your own. From deep breathing and progressive muscle relaxation to autogenic training and guided imagery, there is a relaxation technique for each situation.
Certain forms of hypnosis for anxiety can complement other anxiety treatments. When considering hypnotherapy, be sure to thoroughly interview the professional to understand their credentials and training background.
Biofeedback is any treatment that helps you gain control over the body’s responses by observing functional data (such as heart rate and blood pressure) from your body. In the treatment of anxiety, you could use a heart rate monitor to observe and learn to manage your heartbeat when exposed to a stressor.
The food and drinks you consume can have an immediate impact on your anxiety. Low blood sugar from not eating and excess caffeine can increase your anxious response. Be sure to eat a healthy, balanced diet based on whole foods and drink plenty of water.
Final Thoughts on Anxiety Counseling
Experiencing an anxiety disorder can be an extremely stressful and overwhelming experience. However, you are not alone in experiencing anxiety, and there are many treatment options and therapists available to help you get back to feeling more like yourself and in control of your thoughts and anxious feelings.