Self-Help

Subscribe

Weekly Thoughts on Anxiety

By submitting this form, you are consenting to receive marketing emails from: . You can revoke your consent to receive emails at any time by using the SafeUnsubscribe® link, found at the bottom of every email. Emails are serviced by Constant Contact

Choosing The Best Type of Therapy and Therapist for Anxiety

By: Brian O'Sullivan, M.S., LMFT

What's The Best Therapy for Anxiety?

Research consistently shows Cognitive Behavioral Therapy (CBT) to be the gold standard treatment for reducing anxiety relative to medication and alternative therapies. Some may find EMDR, Somatic Therapy, or Internal Family Systems to be more helpful, depending on individual issues or preferences.

There are many things to consider when finding the right type of therapy and therapist for you and your specific concerns about anxiety. It's not a one-size-fits-all decision, but it doesn't have to be overwhelming.

In this article, I will break down the essential things to consider to help you decide if CBT, another style of therapy, or if therapy, in general, is right for you.

Disclaimer: The resources provided here are not a substitute for therapy. The information presented is for educational purposes only and should not be construed as therapy, psychological advice, or be used for diagnosis. Nothing on this website establishes a therapist-patient relationship. For personalized guidance, please consult your physician or mental health provider.

Is Therapy Even Necessary for Anxiety?

The severity of anxiety determines if therapy is needed or not. If someone often avoids situations and finds it difficult to relax, therapy is essential to address underlying causes and prevent complications. However, it's common for people, even with mild anxiety, to seek therapy and find benefits.

Instead of asking yourself whether or not therapy is necessary, try focusing on how your life might be different and weigh the pros and cons of seeking professional help. Here are some questions to consider:

  • How much is anxiety getting in the way of the things I want?
  • How different would my life be if anxiety interfered less? 
  • What would my relationships look like if I worked on anxiety?
  • What are the risks of reaching out for professional help?
  • What are the risks of not reaching out for professional help?

When determining whether or not to seek help, often, there is a hope that the anxiety will go away on its own and the question of whether or not it's best to wait it out. 

Will Anxiety Go Away on Its Own?

Persistent anxiety that interferes with work, school, relationships, or sleep is unlikely to go away on its own. It's essential to address behavioral and mental habits that maintain anxiety through education, self-help, and therapy—waiting for anxiety to go away risks long-term complications. 

In short, if anxiety is limiting you in any way, it's probably best to at least address it through self-help resources.

Here are some questions to ask yourself to help you determine how much anxiety may be limiting you:

  • How often do anxious thoughts bother me?
  • How often do I avoid certain places, people, or situations to prevent or lower my anxiety?
  • Does this avoidance cause me to miss out on anything I value?
  • When anxiety spikes, how equipped do I feel to manage it?
  • How often am I able to fully relax and recharge?
  • How long have I been dealing with anxiety?
  • Do I often seek reassurance from others?
  • Do I struggle with uncertainty and often seek certainty?

Try to keep these questions in your mind during the next week and see what comes up.

Knowing what therapy is like and having a general understanding of the different types of treatment for anxiety can also help you decide.

I will first start with CBT, the type of therapy most professionals recommend before any other forms or styles of treatment. 

How Does Cognitive Behavioral Therapy (CBT) Work for Anxiety?

CBT increases our ability to identify and change behavioral and mental habits that inadvertently maintain the anxiety cycle. CBT involves education about the brain, exploring and challenging unhelpful thought patterns and beliefs, and engaging in behavioral experiments to reduce the negative impacts of anxiety.

CBT is a collaborative process, often conducted one-on-one with a licensed therapist in a private in-person office or online using secure telehealth software. Sessions are usually weekly and last approximately 50 to 60 minutes.

CBT sessions are generally structured. In the initial sessions, the therapist collaborates with the client to understand the history of the anxiety, the challenges the client is experiencing, and any other relevant information, such as medications, medical history, and family history. The therapist then explores the client's reasons for seeking therapy and collaboratively develops goals to guide their work together.

Initial sessions also involve a significant amount of education. The therapist will educate the client about anxiety in general, the relevant parts of the brain that influence anxiety, and how anxiety is maintained. The therapist will also inform the client about CBT, how it works, and what to expect throughout therapy.

Here is what you can expect throughout CBT therapy for anxiety:

Beginning of Treatment:

  • Completing assessment forms and an assessment interview by the therapist over 1 to 3 sessions
  • Psychoeducation on the anxiety, the brain, CBT overview
  • Developing goals for therapy

Middle of Treatment: 

  • Identify and challenge unhelpful and irrational thoughts that maintain anxiety
  • Identify "core fears" and "core beliefs" that are hidden drivers of unhelpful thoughts, feelings, and behaviors
  • Challenge and restructure unhelpful thought patterns
  • Learn skills and new ways to respond to anxiety
  • Engage in behavioral experiments and learn to confront and accept anxiety

End of Treatment:

  • Reflect on progress made and skills/techniques that contributed to progress
  • Develop a plan for maintaining anxiety gains and preventing relapse
  • Plan and discuss potential future anxiety triggers and strategies to utilize

Other Types of CBT for Anxiety

Aaron Beck, an American psychiatrist, developed cognitive behavioral therapy (CBT) in the 1960s. Since then, others have built on his framework.

Below are more specific types of CBT that are effective for anxiety:

Exposure & Response Prevention (ERP)

Exposure therapy falls under the umbrella of CBT and involves systematically engaging in situations that trigger a person's anxiety. By exposing ourselves to generally safe but anxiety-provoking situations, we allow our brains to learn that the situation isn't as dangerous as it thinks. As a result, the brain learns that it no longer needs to send anxiety signals. This is the exposure piece of ERP. 

When anxiety hits, we often respond by trying to avoid or escape the situation. Though these reactions are natural and instinctual, they reinforce anxiety and prevent the brain from learning the crucial lessons needed to reduce anxiety. The response prevention consists of the client and therapist working together to eliminate unhelpful responses to the anxiety and triggers.

Acceptance & Commitment Therapy (ACT)

Another style of therapy that falls under the umbrella of CBT is Acceptance and Commitment Therapy (ACT). The overall goal of ACT is to increase one's ability to remain in the present moment while observing one's thoughts, feelings, and urges and, at the same time, engage in behaviors that are consistent with one's values.

ACT sessions involve the therapist and client working together to uncover and clarify the client's core values, learn and develop mindfulness practices, identify and relate to feelings and thoughts in new, more flexible ways, and experiential exercises that facilitate a deeper understanding of these elements.

Which Type of CBT is Best for Anxiety?

A blend of traditional CBT, Exposure & Response Prevention, and Acceptance and Commitment Therapy is often very effective for anxiety. Most anxiety therapists should be experienced in all three therapies and use a blended approach to tailor sessions to a client's preference and severity of symptoms.

How Many Therapy Sessions Do I Need for Anxiety? 

Many clients find 3 to 15 therapy sessions, with occasional follow-up sessions, effective for anxiety. However, it can vary and is influenced by things like the severity, duration, and type of anxiety, the client's motivation level, and the quality of the alliance between the client and therapist.

How Often Should I Attend Therapy for Anxiety?

Attending therapy weekly is best for most people with anxiety. Weekly sessions allow the therapist and client to identify patterns and make it easier for the client to learn and apply new skills. In general, attending weekly increases effectiveness and decreases the total number of sessions needed. 

Are There Other Types of Therapy for Anxiety Other Than CBT?

Therapies for anxiety other than CBT are Eye Movement Desensitization and Reprocessing (EMDR), Internal Family Systems (IFS), Somatic Experiencing (SE), and Psychodynamic. However, CBT, Exposure and Response Prevention, and ACT are usually the best place to start, as they address anxiety directly.

Other Questions:

Should I Choose a Therapist or Psychologist for Anxiety?

Therapists and psychologists are both qualified to treat anxiety using CBT and other therapies. Psychologists have more education than therapists and often conduct assessment services. Both can offer effective anxiety treatment; choose based on personal preference and a specialization in anxiety.

Should I Choose a Psychologist or Psychiatrist for Anxiety?

Both psychologists and psychiatrists treat anxiety, just in different ways. Psychologists provide talk therapy and assessments, while psychiatrists are medical doctors who prescribe medication. First, start with a psychologist or therapist for talk therapy, then a psychiatrist if drugs are needed.

Should I go to a Psychiatrist for Anxiety?

Psychiatrists are medical doctors who prescribe medications. While they have some training in talk therapy, it's usually not as extensive as therapists or psychologists. It's generally better to first see a talk therapist than a psychiatrist if recommended or if talk therapy alone isn't effective.  

References

Ardito, R. B., & Rabellino, D. (2011). Therapeutic alliance and outcome of psychotherapy: historical excursus, measurements, and prospects for research. Frontiers in Psychology, 2, 270. https://doi.org/10.3389/fpsyg.2011.00270

Zur, D. (2019, February 12). How to choose a Therapist, DR. OFER Zur, Ph.D. Retrieved April 11, 2021, from https://www.zurinstitute.com/choosing/

Self-Help

Choosing The Best Type of Therapy and Therapist for Anxiety

By: Brian O'Sullivan, M.S., LMFT

What's The Best Therapy for Anxiety?

Research consistently shows Cognitive Behavioral Therapy (CBT) to be the gold standard treatment for reducing anxiety relative to medication and alternative therapies. Some may find EMDR, Somatic Therapy, or Internal Family Systems to be more helpful, depending on individual issues or preferences.

There are many things to consider when finding the right type of therapy and therapist for you and your specific concerns about anxiety. It's not a one-size-fits-all decision, but it doesn't have to be overwhelming.

In this article, I will break down the essential things to consider to help you decide if CBT, another style of therapy, or if therapy, in general, is right for you.

Disclaimer: The resources provided here are not a substitute for therapy. The information presented is for educational purposes only and should not be construed as therapy, psychological advice, or be used for diagnosis. Nothing on this website establishes a therapist-patient relationship. For personalized guidance, please consult your physician or mental health provider.

Is Therapy Even Necessary for Anxiety?

The severity of anxiety determines if therapy is needed or not. If someone often avoids situations and finds it difficult to relax, therapy is essential to address underlying causes and prevent complications. However, it's common for people, even with mild anxiety, to seek therapy and find benefits.

Instead of asking yourself whether or not therapy is necessary, try focusing on how your life might be different and weigh the pros and cons of seeking professional help. Here are some questions to consider:

  • How much is anxiety getting in the way of the things I want?
  • How different would my life be if anxiety interfered less? 
  • What would my relationships look like if I worked on anxiety?
  • What are the risks of reaching out for professional help?
  • What are the risks of not reaching out for professional help?

When determining whether or not to seek help, often, there is a hope that the anxiety will go away on its own and the question of whether or not it's best to wait it out. 

Will Anxiety Go Away on Its Own?

Persistent anxiety that interferes with work, school, relationships, or sleep is unlikely to go away on its own. It's essential to address behavioral and mental habits that maintain anxiety through education, self-help, and therapy—waiting for anxiety to go away risks long-term complications. 

In short, if anxiety is limiting you in any way, it's probably best to at least address it through self-help resources.

Here are some questions to ask yourself to help you determine how much anxiety may be limiting you:

  • How often do anxious thoughts bother me?
  • How often do I avoid certain places, people, or situations to prevent or lower my anxiety?
  • Does this avoidance cause me to miss out on anything I value?
  • When anxiety spikes, how equipped do I feel to manage it?
  • How often am I able to fully relax and recharge?
  • How long have I been dealing with anxiety?
  • Do I often seek reassurance from others?
  • Do I struggle with uncertainty and often seek certainty?

Try to keep these questions in your mind during the next week and see what comes up.

Knowing what therapy is like and having a general understanding of the different types of treatment for anxiety can also help you decide.

I will first start with CBT, the type of therapy most professionals recommend before any other forms or styles of treatment. 

How Does Cognitive Behavioral Therapy (CBT) Work for Anxiety?

CBT increases our ability to identify and change behavioral and mental habits that inadvertently maintain the anxiety cycle. CBT involves education about the brain, exploring and challenging unhelpful thought patterns and beliefs, and engaging in behavioral experiments to reduce the negative impacts of anxiety.

CBT is a collaborative process, often conducted one-on-one with a licensed therapist in a private in-person office or online using secure telehealth software. Sessions are usually weekly and last approximately 50 to 60 minutes.

CBT sessions are generally structured. In the initial sessions, the therapist collaborates with the client to understand the history of the anxiety, the challenges the client is experiencing, and any other relevant information, such as medications, medical history, and family history. The therapist then explores the client's reasons for seeking therapy and collaboratively develops goals to guide their work together.

Initial sessions also involve a significant amount of education. The therapist will educate the client about anxiety in general, the relevant parts of the brain that influence anxiety, and how anxiety is maintained. The therapist will also inform the client about CBT, how it works, and what to expect throughout therapy.

Here is what you can expect throughout CBT therapy for anxiety:

Beginning of Treatment:

  • Completing assessment forms and an assessment interview by the therapist over 1 to 3 sessions
  • Psychoeducation on the anxiety, the brain, CBT overview
  • Developing goals for therapy

Middle of Treatment: 

  • Identify and challenge unhelpful and irrational thoughts that maintain anxiety
  • Identify "core fears" and "core beliefs" that are hidden drivers of unhelpful thoughts, feelings, and behaviors
  • Challenge and restructure unhelpful thought patterns
  • Learn skills and new ways to respond to anxiety
  • Engage in behavioral experiments and learn to confront and accept anxiety

End of Treatment:

  • Reflect on progress made and skills/techniques that contributed to progress
  • Develop a plan for maintaining anxiety gains and preventing relapse
  • Plan and discuss potential future anxiety triggers and strategies to utilize

Other Types of CBT for Anxiety

Aaron Beck, an American psychiatrist, developed cognitive behavioral therapy (CBT) in the 1960s. Since then, others have built on his framework.

Below are more specific types of CBT that are effective for anxiety:

Exposure & Response Prevention (ERP)

Exposure therapy falls under the umbrella of CBT and involves systematically engaging in situations that trigger a person's anxiety. By exposing ourselves to generally safe but anxiety-provoking situations, we allow our brains to learn that the situation isn't as dangerous as it thinks. As a result, the brain learns that it no longer needs to send anxiety signals. This is the exposure piece of ERP. 

When anxiety hits, we often respond by trying to avoid or escape the situation. Though these reactions are natural and instinctual, they reinforce anxiety and prevent the brain from learning the crucial lessons needed to reduce anxiety. The response prevention consists of the client and therapist working together to eliminate unhelpful responses to the anxiety and triggers.

Acceptance & Commitment Therapy (ACT)

Another style of therapy that falls under the umbrella of CBT is Acceptance and Commitment Therapy (ACT). The overall goal of ACT is to increase one's ability to remain in the present moment while observing one's thoughts, feelings, and urges and, at the same time, engage in behaviors that are consistent with one's values.

ACT sessions involve the therapist and client working together to uncover and clarify the client's core values, learn and develop mindfulness practices, identify and relate to feelings and thoughts in new, more flexible ways, and experiential exercises that facilitate a deeper understanding of these elements.

Which Type of CBT is Best for Anxiety?

A blend of traditional CBT, Exposure & Response Prevention, and Acceptance and Commitment Therapy is often very effective for anxiety. Most anxiety therapists should be experienced in all three therapies and use a blended approach to tailor sessions to a client's preference and severity of symptoms.

How Many Therapy Sessions Do I Need for Anxiety? 

Many clients find 3 to 15 therapy sessions, with occasional follow-up sessions, effective for anxiety. However, it can vary and is influenced by things like the severity, duration, and type of anxiety, the client's motivation level, and the quality of the alliance between the client and therapist.

How Often Should I Attend Therapy for Anxiety?

Attending therapy weekly is best for most people with anxiety. Weekly sessions allow the therapist and client to identify patterns and make it easier for the client to learn and apply new skills. In general, attending weekly increases effectiveness and decreases the total number of sessions needed. 

Are There Other Types of Therapy for Anxiety Other Than CBT?

Therapies for anxiety other than CBT are Eye Movement Desensitization and Reprocessing (EMDR), Internal Family Systems (IFS), Somatic Experiencing (SE), and Psychodynamic. However, CBT, Exposure and Response Prevention, and ACT are usually the best place to start, as they address anxiety directly.

Other Questions:

Should I Choose a Therapist or Psychologist for Anxiety?

Therapists and psychologists are both qualified to treat anxiety using CBT and other therapies. Psychologists have more education than therapists and often conduct assessment services. Both can offer effective anxiety treatment; choose based on personal preference and a specialization in anxiety.

Should I Choose a Psychologist or Psychiatrist for Anxiety?

Both psychologists and psychiatrists treat anxiety, just in different ways. Psychologists provide talk therapy and assessments, while psychiatrists are medical doctors who prescribe medication. First, start with a psychologist or therapist for talk therapy, then a psychiatrist if drugs are needed.

Should I go to a Psychiatrist for Anxiety?

Psychiatrists are medical doctors who prescribe medications. While they have some training in talk therapy, it's usually not as extensive as therapists or psychologists. It's generally better to first see a talk therapist than a psychiatrist if recommended or if talk therapy alone isn't effective.  

References

Ardito, R. B., & Rabellino, D. (2011). Therapeutic alliance and outcome of psychotherapy: historical excursus, measurements, and prospects for research. Frontiers in Psychology, 2, 270. https://doi.org/10.3389/fpsyg.2011.00270

Zur, D. (2019, February 12). How to choose a Therapist, DR. OFER Zur, Ph.D. Retrieved April 11, 2021, from https://www.zurinstitute.com/choosing/