Does Therapy Help With Anxiety?

Reviewed by Dr Lucy Russell DClinPsyc CPsychol AFBPsS

Hayley Vaughan Smith, Person Centred Counsellor and The Ridge Practice and Everlief Child Psychology — Author: Hayley Vaughan Smith, Person-Centred Counsellor

It is completely normal to feel anxious from time to time.

Humans are wired to be alert and it’s part of our response to fear or panic, threat or feeling stressed or under pressure.

Many people respond to anxiety in positive ways. Anxiety can:

Motivate us
Alert us to danger
Help us assess risks
Help us problem-solve

However, when anxiety is starting to affect your quality of life, it’s important to take note.

You might benefit from finding ways to help you cope and manage anxious thoughts and feelings.

Anxiety is one of the most common mental health conditions in the UK, the USA and most “Western” countries. According to the National Institute of Mental Health (NIMH):

“…anxiety disorders are among the most common mental health conditions in the United States, and approximately 19% of the general population has a diagnosed anxiety disorder.”

Are you or your child experiencing high anxiety levels, worrying or feeling overwhelming apprehension?

So, does therapy help with anxiety? Let’s take a look at the benefits that different therapeutic approaches might offer you.

Can Anxiety Go Away With Therapy?

The short answer is ‘yes’.

Anxiety and anxiety disorders are treatable and skills can be learnt to help manage any remaining anxiety. For example, the US recovery rate from generalised anxiety disorder with therapy is 57%.

There are many effective ways to help manage anxiety.

Many people notice significant improvements from psychotherapy and other forms of talking therapy.

But, it’s important to find the best approach for you, as one size doesn’t fit all.

The long answer is ‘it’s complicated’.

Adults or children who have successfully been treated for anxiety may not be fully “cured”.

Humans can function pretty well in the world with some anxiety. Temporary states of mild anxiety can be part and parcel of life. They often pass once the initial trigger has been dealt with.

A person may have a predisposition towards anxiety symptoms. Many factors play a part, causing us to feel vulnerable or unsafe in the world:

Genetics: Anxiety can run in families and there is a genetic component.
Environment: Your family situation, how safe and supported your child feels at school.
Life experience: Loss, childhood trauma, traumatic experiences, financial difficulties.
Physical health: Injury, sudden ill-health or long-term chronic pain.

What Happens if Anxiety is Not Treated?

If left untreated, anxiety disorders may get better by themselves. Equally though, studies show untreated anxiety can significantly impact quality of life. It has been linked to poor physical health, panic attacks, depression, substance abuse, brain fog and many other problems.

How Does Therapy Help Anxiety?

Therapy can offer a safe environment in which to identify and understand and work on anxiety symptoms.

A therapeutic framework can help someone to develop different ways of coping with and managing anxiety.

For example, clinical psychologists usually support anxious patients using a therapeutic framework like this:

Assessment and formulation phase. Building rapport, developing a shared understanding of what is causing the anxiety and what is keeping it going.
Action plan. Developing a plan together. Identifying goals through questions such as: “What signs will I notice that will tell me I am feeling better?” or “What will I be able to do that I can’t do at the moment?”
Working towards those specific goals using specific therapy techniques such as cognitive restructuring (learning to spot unhelpful thought patterns and gently adapt these) and systematic desensitization (facing your fears very gradually, step by step, at your pace, also known as exposure therapy).
Reviewing progress and developing a relapse prevention plan.

What is the Best Way to Deal With Anxiety?

The first step is to notice it, and name it. Perhaps someone has noticed it and expressed concern on your or your child’s behalf? Spend some time observing where anxiety shows up, and how it presents itself.

Next, rate the impact the anxiety is having on your life (out of 10). Roughly speaking, if it’s a 1-4 you might wish to “watch and wait”, if it’s 5-7 then self-help or guided help may be best. If it’s 8-10, you need professional help.

Here are some red flags that might help you determine the impact of anxiety for you or your child.

A marked change in behaviour. For example, isolating when previously joining in was easy.
Social situations are suddenly really tricky or problematic.
Panic attacks. Characterised by an increase in heart rate, shortness of breath and feelings of impending doom.
Irrational fear. Feeling intense worry or fear around people, or in places or situations.
Long-lasting fatigue or changes in appetite and sleep patterns.
Hypervigilance. Being extremely sensitive to your surroundings and perhaps feeling jumpy.

Self Help for Adults With Anxiety

If you are looking for self-help resources for anxiety, I want to help you cut through the overwhelm by giving you a short list of personally recommended resources to help you get started.

The first is a book by psychologists Dennis Greenberger and Christine Padesky called Mind Over Mood: Change How You Feel by Changing the Way You Think. This is a fantastic practical guide based on cognitive therapy, written by two renowned experts.

My second recommendation is Overcoming Anxiety: A self-help guide using cognitive behavioural techniques by clinical psychologist Helen Kennerley. Helen Kennerley is, again, one of the top experts in the field if cognitive behavioural therapy and this book is a classic, tried and tested guide.

Finally, if you are in the UK I want to share a brilliant beginners mindfulness-based cognitive therapy course with you called BeMindfulOnline. Fifty-eight percent of people who complete the course report a decrease in their anxiety. It’s approved by the NHS and has been running for many years.

Self-Help for Children and Teenagers With Anxiety

If your child is anxious and you want to try self-help, please be aware that you will need to support them through this journey. It’s not a matter of giving them a book and letting them do it themselves.

Children’s brains are highly underdeveloped (even teens) and they will need you to work alongside them, developing a shared understanding of the underlying causes, triggers and beneficial strategies for their anxiety.

The first resource I recommend is a CBT workbook called Think Good, Feel Good: A Cognitive Behavioural Therapy Workbook for Children and Young People by Professor Paul Stallard.

Secondly, I recommend our online parent course for anxiety called Outsmart Anxiety. (Currently available to UK parents only.)

Outsmart Anxiety is an on-demand, in-depth course equipping parents to significantly decrease children’s anxiety. It is written and presented by clinical psychologist Dr Lucy Russell.

The course helps you understand the scientific reasons for your child’s anxiety as well as their personal triggers and unhelpful patterns.

You will then develop and implement a personalised action plan using the strategies you will learn.

There are two versions of Outsmart Anxiety: Teens and 12s & Under.

Outsmart Anxiety: Teens

Outsmart Anxiety: 12s & Under

What Therapy is Best For Anxiety?

Certain therapies such as CBT have a strong evidence base for successfully treating anxiety. However, first of all, it’s really important to establish what the best kind of therapy is for any individual.

In my counselling practice, it’s crucial for me to have an initial conversation with clients so I can understand what type of therapy a person might need. It’s just as important to establish what they don’t need as well as what they do need.

But does therapy help anxiety?

Research has proven that talking therapies – such as counselling and psychotherapy – can help individuals with anxiety disorders manage their mental health and lessen their anxiety symptoms.

Therapies include..

Cognitive Behavioural Therapy (CBT)

CBT focuses on identifying and adapting thinking patterns. Together, the therapist and patient identify these patterns and work out how to challenge and change them.

At the same time, patients learn to adapt any unhelpful behaviours.

For example, if you are avoiding going out because of anxiety, you draw up a gradual plan to get outside again, at your own pace.

Patients also learn how to disengage from thoughts.

Cognitive behavioral therapy usually lasts for between 6-20 sessions.

Counselling

Counselling is a talking therapy which offers a safe space and dedicated time for you to talk about the anxiety in the context of your life.

It can help you make sense of what you are feeling and reflect on how to manage this.

Counsellors may also use cognitive behavioural techniques.

Interpersonal Therapy

Interpersonal therapy (IPT) explores the way our relationships interact with our mental health. It can be particularly helpful if anxiety is acting as a barrier to healthy relationships.

The idea behind IPT is that there can a vicious cycle. Psychological symptoms occur in response to difficulties with relationships. But the symptoms (e.g. overanalysing social situations or avoiding social situations) then affect the quality of the interactions.

IPT helps people understand and adapt their interaction patterns. Through healthier relationships, the idea is that the mental health issues will improve.

IPT usually involves up to 16 therapy sessions.

Acceptance and Commitment Therapy

Acceptance and Commitment Therapy (ACT) is a mindful approach to accepting difficult experiences to improve the quality of living. It focuses on the present and seeks to move forward from overwhelming and difficult emotions.

The Association for Contextual Behavioral Science explain that ACT:

“…uses acceptance and mindfulness strategies, together with commitment and behavior change strategies, to increase psychological flexibility. Psychological flexibility means contacting the present moment fully as a conscious human being, and based on what the situation affords, changing or persisting in behavior in the service of chosen values.”

Most types of anxiety can be treated using therapy, medication or a combination of both.

Studies have shown that while medication (for example anti-anxiety medications such as SSRIs or less commonly Beta-blockers) can help to alleviate very present symptoms, psychotherapy is a better and more effective long-term treatment path to follow.

The APA (American Psychological Association) summarizes that:

“For anxiety disorders, cognitive-behavioral therapy, antidepressant medications and anti-anxiety medications have all been shown to be helpful. Research generally shows that psychotherapy is more effective than medications, and that adding medications does not significantly improve outcomes from psychotherapy alone.”

Best Therapy For Anxiety: The Strongest Evidence Base

Cognitive behavioural therapy (CBT) is widely considered to be the best therapy for anxiety. Other approaches may be helpful alongside and especially if longer term support is required or where there are other mental health issues requiring intervention or treatment.

CBT is generally a short-term treatment.

Here are some examples of the recommended therapeutic approach for specific types of anxiety.

Trauma based anxiety	Trauma-Focused CBT (TF-CBT), EMDR (Eye Movement Desensitisation and Reprocessing)
Social anxiety disorder	CBT either individually or in a group. Guided self-help – working through a CBT based workbook or online course which is supported and reviewed by a designated therapist. Anti-depressant medicines – SSRI (selective serotonin reuptake inhibitor). These are usually only available to people aged over 15 yrs.
OCD (obsessive compulsive disorder)	A specific form of CBT called exposure and response prevention.
Specific phobias	CBT including exposure therapy (systematic desensitization / gradual desensitization).
Generalised Anxiety Disorder	CBT, possibly integrated with other forms of therapy such as Acceptance and Commitment Therapy. In severe or complex cases medications (such as fluoxetine) may be prescribed by your doctor alongside therapy.

Treatment for Anxiety Attacks

An anxiety attack is also known as a panic attack (the clinical term). Its onset is usually sudden and unexpected and it can be an extremely uncomfortable and debilitating symptom of anxiety.

The level of anxiety spikes and people experience specific symptoms caused by a flood of “survival” chemicals in the body designed to prepare us to get away, fight the danger or freeze (if we can’t run or fight). It’s known as fight, flight or freeze. Symptoms of a panic attack can include:

Shaking, trembling and sweating.
Breathing difficulties and hyperventilating.
Heart palpitations.
Body pains such as a heavy chest, stabbing pains.
Feeling dizzy, fainting or feeling sick.
Numbness and tingling sensations in the extremities.
Experiencing that your surroundings don’t feel like you’re in your real life.

With the right techniques, it is possible to stop panic attacks and ward them off before they occur but you may need help to learn how to do this.

A good anxiety therapist will devise a treatment plan which may include deep breathing and progressive muscle relaxation exercises and stress management techniques.

Therapy sessions can offer a safe space to dig under the surface to understand the source of panic and explore ways of learning to take back control.

Panic attacks may be a symptom of panic disorder or other underlying mental disorder such as OCD (obsessive-compulsive disorder).

Do You Need Therapy For Anxiety? Where to Get help For You or Your Child

If you feel ready and need support from a professional clinician, you can find a licensed therapist in your area through various routes.

Personal recommendation from friends or family.
Doctor’s referral.
Search for a mental health provider online using a search engine. If you are in the UK, for a counsellor try counsellingdirectory.org. For a psychologist for your child try www.achipp.org.uk or for yourself try https://www.bacp.co.uk/about-therapy/using-our-therapist-directory/
You can also find an anxiety therapist through your health insurance company.

When anxiety is present it can sometimes be really difficult to contemplate going out to in-person appointments. Many services will now offer you online or telephone appointments.

Since the Covid-19 pandemic, many more therapists have now trained in online therapy services and it is an effective treatment that has seen significant improvements in the symptoms of anxiety.

How Long Does Therapy Take For Anxiety?

It’s not possible to answer definitively, though often 6-12 sessions are enough to feel much better. It will of course vary from individual to individual.

The type of therapy you choose and the relationship that is built with the therapist also affect how quickly you will feel better.

Mental health professionals are qualified to figure out your level of anxiety, causes, triggers, and what is the right treatment for you. If they can’t help you directly they will sign-post you to other intervention-led services.

For example, a counsellor would be able to work with someone who is experiencing anxiety and offer low intensity CBT therapy on a short-term basis. If the anxiety is more deep-rooted or complex, a psychotherapist, CBT specialist or clinical psychologist are best placed to offer support.

Does Therapy Help With Anxiety?: Summary

There are lots of treatment options for anxiety, so don’t give up if one anxiety therapy pathway doesn’t work for you.

It’s important that you discover and access the right support or help for you, whichever pathway you take.

What therapy is best for anxiety? Your therapist will help you discover which approach fits your needs best. CBT has the strongest evidence-base, but it can be successfully combined with other approaches, especially if your difficulties are more complex.